We inspected the service on 13, 21 March and 11 May 2018. The inspection was unannounced. Woodlands - Innova House CLD is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Woodlands - Innova House CLD accommodates up to nine people and is designed to meet the needs of people with a learning disability. The premises comprise of five separate two bedroom houses situated around a shared communal outside area. On the day of our inspection seven people were using the service. The care service has been developed and designed in line with the values that underpin Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. The aim is that people with learning disabilities and autism using the service can live as ordinary a life as any citizen.
The service had a registered manager in place at the time of our inspection. 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.
Risks relating to people’s care and support were not always assessed and planned for to ensure people received safe care and treatment. Staff helped people to take their medicines safely and at the right time however shortfalls were identified relating to people who self-administered and protocols regarding 'as needed’ medicines. Staff were not given all the training they needed to support people with complex needs. The support staff received from their line managers, including formal supervision meetings to discuss and review their development and performance, was inconsistent.
Inconsistent pre-admission assessments meant staff were not always aware of people's background histories, preferences, routines and personal circumstances. Records, including risk assessments, in individual care plans had not always been updated and did not always accurately reflect people's care and support needs.
Inconsistent recruitment practices did not always ensure staff were suitably qualified, experienced or had the necessary skills to carry out their roles and responsibilities. There were not always enough staff deployed to support people's care and support needs.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice.
People had access to health and social care professionals when necessary, however people’s health conditions were not always known about by staff. Plans and guidance had been drawn up to help staff deal with unforeseen events and emergencies. Complaints were not consistently recorded and responded to in line with the service policy.
Although staff were kind and caring towards people who used the service, they had a lack of information available to them to ensure people would be supported in the way they preferred. There was sometimes a lack of involving people who used the service and their significant others in making decisions about their care and support. Care was provided in a way that promoted people's dignity and respected their privacy.
People were not always supported to pursue social interests and take part in meaningful activities relevant to their needs, both at the home and in the wider community.
Although people, relatives and staff were complimentary about the registered manager and how the service was run and operated, quality monitoring systems were inconsistent and audits did not always have the desired effect of identifying and addressing shortfalls in the service.
We found breaches of regulation in relation to the safe care and treatment of people, people’s rights to make decisions, protecting people from the risk of harm and the governance of the service.
This is the second time the service has been rated Requires Improvement.
You can see what action we told the provider to take at the back of the full version of the report.