William Wood House

Since the last inspection improvements had been made and the service was no longer in breach of previous regulations.

We assessed the service against ‘right care, right support, 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 that most people take for granted. We found people received care in accordance with this guidance and staff had received appropriate training relating to people with a learning disability and autistic people.

Overall, people and their relatives provided positive feedback about the service, speaking highly of the permanent staff and leadership team. While they shared that standards occasionally varied when temporary agency workers were used, the registered manager was addressing this. Active recruitment was underway to expand the permanent team and reduce agency reliance.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Medicines were managed safely with appropriate systems in place for ordering, storage, administration and disposal.

The leadership team gathered feedback and reviewed comments from people and their relatives to drive service development. Since the previous inspection, oversight and governance arrangements had been strengthened. Quality-monitoring systems were in place, with the leadership team conducting regular audits and analysing accidents and incidents to identify trends and prevent recurrence.

Staff understood what abuse was, had completed safeguarding training and understood the importance of reporting any concerns in a timely way helping to ensure people were protected from the risk of abuse and that any concerns were identified, reported and acted upon promptly to maintain their safety and wellbeing.

Safe recruitment processes were in place, and staff received ongoing supervision, appraisals, and relevant training. Feedback regarding staffing arrangements was mixed. While several staff members felt supported and reported positive experiences, others indicated that deployment levels were occasionally insufficient to meet the increasing needs of people using the service. Additionally, some staff found managing rotas, unplanned calls, and daily schedules challenging.

While some staff described the registered manager as visible and approachable, others felt the workplace culture lacked sufficient openness and transparency, highlighting that interpersonal dynamics occasionally made it difficult to raise concerns. The registered manager acknowledged the complexities of overseeing two services simultaneously and explained that recent leadership changes had caused some disruption. Receptive to our feedback, the registered manager outlined comprehensive action plans, with support from the provider, to address these issues.

Improvements had been made to ensure risks to people were mitigated. Risk management plans were in place to provide staff with clear guidance on supporting individuals and safely managing potential hazards. While we found inconsistencies in the promptness of care plan updates following changes in people's needs, care delivery remained safe. The registered manager took immediate action to resolve these administrative discrepancies. They also confirmed the provider had recognised the limitations of the current care planning system, and the service was transitioning to a new digital system with enhanced monitoring and reporting functions, to underpin and maintain the quality and accuracy of individualised care records.