We inspected this service on 4 April 2016 and the inspection was unannounced.

L'Arche Ipswich The Cornerstone is an outstanding service that is registered for personal care and offers live-in support to people living with a learning disability. The people who used the service call themselves and are referred to within the organization as core members. The core members, or people who use this service, live as a community along with their assistants (staff) in two lively shared houses close together in Ipswich. The majority of the assistants share the accommodation with the people they support.  On one site seven people live with five assistants living in the community and three assistants living outside it. On the other site three people live with two assistants, they are also supported by other assistants that live outside the community.

The provider has progressive and unquestionably high expectations of itself; one of their stated aims is to make known the gifts of people with learning disabilities revealed through mutually transforming relationships. Another is ‘Creating mutually supportive communities with people with learning disabilities.’ L’Arche is a Christian based organisation, but welcomes all people whether they follow a faith or not.

There was a committed registered manager in post, who is creative in finding ways to support the people that use the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were more than sufficient assistants in place to enable people to live active and enriched lives. The assistants knew what to do if they suspected someone was being abused or harmed, and recruitment practices were robust and contributed to protecting people from staff who were unsuitable to work in care. People who use the service were included as part of the recruitment team in a meaningful way and the manager and staff were looking at ways to expand this within the organisation. The service found ways to make sure that people were able to be in control and manage their own medicines safely if they are able to do so. Medicines were managed and stored properly so that people received them as the prescriber intended.

The assistants had received a wide range of training so that they had a good understanding of how to meet people’s needs. They understood the importance of gaining consent from people while working with them and they were clear about their roles.

People participated in all the stages of choosing, planning and the preparation of their meals. People we spoke with enthusiastically talked about their role in cooking meals for their housemates. House meetings were held weekly to discuss and plan the week’s menu and shopping, among other things. One meeting we took part in provoked fervent discussion about what they wanted from life as well what activities they wanted to take part in and people who used the service lead the discussions from the front.

The assistants treated people in a way that reflected how they themselves expected to be spoken to and supported them to reach their full potential. Their interaction was indicative of two adults talking together on an equal basis. They were respectful of the people’s privacy and dignity and offered guidance and reassurance if they needed it to maintain their health and wellbeing. The assistants also made sure that, if people became unwell, they were supported to access healthcare professionals for treatment and advice about their health and welfare. They did this in partnership with people so that the outcome matched their expectations.

The assistants showed commitment to understanding and responding to each person’s needs and preferences so that they could engage in the way they wanted to. It was evident that people passed their time in the way they desired. The assistants worked hard in making sure this could happen for them while still taking risks in their day to day living. The service supported people in positive risk taking; taking a positive attitude to risk assessing helps services to find positive ways to manage risks that empowers people to make choices, while supporting them to take informed everyday risks.

The assistants understood the importance of responding to and resolving concerns quickly if they were able to do so. They also ensured that more serious complaints were passed on to the management team for investigation. The complaints procedure, as with all other communications, was produced in a format people could easily understand. People told us that if they had a complaint to make or a worry to voice, they felt confident to raise them in the open and inclusive atmosphere there was in the community.

The manager told us that they believed that complaints and concerns raised gave them opportunities to find way to improve the service they offered people.

The service was outstandingly well led by a management team that was committed to finding new and innovative ways to support the people to be citizens in the wider community, to lead a full and active life and to be in full control of what happened to them. The assistants told us that the manager led by example and was supportive and easy to talk to. The manager was responsible for monitoring the quality and safety of the service, which they did in a stalwart fashion as they did in all their duties.

The service continually asked people for their views about the day to day care they received through the services’ annual quality assurance surveys. They were also given many opportunities to take part in debates and discussions about improving their quality of life nationally and internationally. This meant that their thoughts and expectations led improvement to the service they received. The provider’s outlook was reflected in the way this service was run and they included the people who used the service in decisions about how the organisation was run.

The six people who used this service lived alongside the staff who often came from abroad to work and live in the service. They all lived together as a community, which was how they referred to themselves. As a community, staff would often spend their leisure time with the people who used the service and celebrated birthdays and special occasions together.

We talked with three of the six people who used the service, they told us that they liked living in the Cornerstone. People also told us that they got on well with the staff and that they supported them to go out to do their personal shopping, to follow their favourite activities, to be part of the local community and to go on holiday. This was substantiated by the records we looked at. People also told us that their views were listened to and that staff made sure they gave them as much or as little support as they needed. One person told us, “The staff are good, they make things happen for me.” We observed that there was a good rapport between the people who used the service and the staff. We saw that staff interacted with people in a friendly, respectful and professional manner.

There were systems in place to enable people to take their medication and to manage it safely. The staffing levels were set at a sufficient level to support people and the provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

We had the opportunity to talk with two of the people who lived in Cornerstone and where the agency is also based. Both of the people we spoke with were very happy with the care they received. They told us that they were supported to live the way they wanted to live and were able to make their own minds up about what decisions they took. They were complimentary about the people who supported them.