Wood Cottage

This was the first assessment of the service. We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities most people take for granted. We found people received care and support in accordance with this guidance.

The service was run by a registered manager and a service manager.

People were not always supported in a way to promote their rights, individuality, and involvement in decisions about their care, or supported involvement from relatives, advocates or staff. For example, there was no evidence of collaboration in updating care and support plans, or involvement in undertaking capacity assessments and best interest decision making.

Staff delivered evidence-based support using recognised approaches, including Positive Behaviour Support (PBS) and national health service programme ‘Stopping over medication of people with a learning disability and autistic people’ STOMP principles. Staff knew people well and provided personalised support which reflected their needs, preferences and communication styles. People were supported to maintain relationships, access the community, and participate in activities were meaningful to them, supporting independence and inclusion.

Staffing levels were sufficient to meet people's needs, recruitment processes were safe, and staff were fully trained and competent. Medicines were managed safely in line with best practice.

The provider had a positive culture where people and staff felt able to speak up and were listened to. There was evidence of partnership working with healthcare professionals and

external agencies to support coordinated care. Staff were kind, compassionate, and respectful, and interactions observed were positive and person centred.

We used the quality-of-life tool to gather evidence during this assessment. The primary purpose of the quality-of-life tool is to improve the Care Quality Commission’s ability to consistently identify and take appropriate regulatory action in services fail or are failing to meet the needs, aspirations and skills development of people with a learning disability and/or autistic people. The tool looked at how well people's care plans were delivered in practice. We found the provider was meeting the needs of people, aspirations, and skill development for people in line with their care plans.

Governance systems required strengthening to identify and address the shortfalls we found at this assessment. This was across key areas including care plan and assessment, reviewing processes with people’s involvement, infection prevention and control and environmental safety.