We carried out an unannounced inspection of the service on 15 and 21 January 2019. Woodlands – Innova House CLD is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. This service supports people who have a learning disability.

Woodlands – Innova House CLD accommodates up to nine people living in five separate houses on one site. During our inspection there were seven people living on the site. This is the service’s second inspection under its current registration. The service was rated as ‘Requires Improvement’ after the last inspection. This rating has now improved to ‘Good’.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

A registered manager was present during the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At the last inspection on 13 and 21 March 2018 and 11 May 2018 we identified five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to; person centred care, the need for consent, safe care and treatment, safeguarding service users from abuse and improper treatment and good governance. After this inspection we asked the provider to send us an action plan to inform us how they would make the necessary improvements to ensure they complied with the fundamental standards.

At this inspection we checked to see whether improvements in these five areas had been made and found they had.

People received support that met their assessed needs. People were now protected from the risk of avoidable harm and abuse and staff understood how to act on any concerns. People now received safe care and support from staff and could live their lives without unnecessary restrictions. There were sufficient numbers of staff in place and they understood how to provide people with safe, person centred care and support. People’s medicines were now managed safely and effectively and each person’s home was free from the risk of the spread of infection. The provider had made changes to the way accidents and incidents were investigated. This included clearer processes for investigation and support for staff to learn from mistakes.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Staff were well trained and received regular supervision to enable them to carry out their roles effectively. People received care and support in line with their assessed needs and in accordance with current legislation and best practice guidelines. We found overall, people were supported effectively with their meals and leading a healthy, nutritional lifestyle. People had access to support from external health and social care agencies. The home environment was well maintained and adapted to support people with a learning and/or physical disability.

We observed people, staff and management all interacting well with each other. There was a calm, friendly and warm approach by staff when supporting people. People’s views were requested and acted on and staff communicated effectively with people. Staff treated people with respected and dignity. There were no restrictions on people’s friends or

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 sh

This inspection took place on 18 November 2015 and was unannounced. There were breaches of legal requirements at our last inspection on 7 October 2014 and we were assured by the provider that improvements were made following that inspection visit. During this inspection we found that most of the improvements that were made had been maintained and other improvements were still being made.

Accommodation for up to nine people is provided in five adjacent houses that form Woodlands - Innova House CLD. The service is designed to meet the needs of people with learning disabilities and autism. There were seven people accommodated during our inspection.

There was a registered manager in place at the time of this inspection. However a new acting manager was taking over and had started the process to register. 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 and associated Regulations about how the service is run.

People were safely cared for by staff who knew what action to take to keep everyone safe and the provider used safe systems when new staff were recruited. Risks to safety were minimised. However, we found that not all staff were following procedures to ensure people received their medicines as prescribed. Immediate action was taken during this inspection, so that only competent staff continued to manage medicines.

Following our previous inspection visit, changes were made with the induction process. Each new member of staff received an increased amount of time shadowing a suitably qualified member of staff before they worked alone with people. All staff had received a lot of training that helped them to carry out their roles and meet people’s individual needs

People received sufficient to eat and drink and they had the support they needed to see their doctor and other health professionals as needed.

Since our last inspection, improvements had been noticed in the way staff respected people’s privacy and staff were knocking on their door and giving the person chance to answer the door themselves. Staff listened to people and supported them follow their interests. Staff encouraged people with daily tasks and demonstrated a kind and caring approach at all times. People were involved in making decisions about the care and support they needed.

People’s individual needs had been assessed and full clear plans were specific to each person. Staff were knowledgeable about how to respond to people’s individual likes and interests. People had individual activity plans and had chosen what they wanted to do. Staff assisted people to take part in appropriate daily activities and holidays.

The complaints procedure was clear and people knew how to make any concerns known.

Since our previous inspection visit, a new acting manager had taken over management responsibilities and was based in an office in one of the houses of the service. This base allowed the manager to improve the monitoring of the service and, overall, we found the service was well led.

This inspection took place on 7 and 8 October 2014 and was unannounced.

Accommodation for up to nine people is provided within five adjacent houses that form Woodlands - Innova House CLD. Each house can accommodate no more than two people, but one bedroom in one of the houses is used as a staff office. The service is designed to meet the needs of people with learning disabilities and autism.

There is a registered manager and she was available throughout the first day of this 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 and associated Regulations about how the service is run.

We last inspected this service in December 2013. At that inspection we found the service was meeting all the essential standards that we assessed.

The service used safe systems when new staff were recruited. The staff were aware of their responsibility to protect people from harm or abuse, though they did not all know the action to take if there were concerns about the safety or welfare of an individual person.

Staff were allocated to people in each of the houses, but there were not sufficient numbers of experienced staff to undertake all tasks at all times without leaving people unsupervised and at risk of possible harm. However, people felt they were kept safe from other people.

Medicines were safely managed, though staff needed more information about how to manage medicines when people spent time away from the service.

Experienced staff had received regular training, but the amount of induction training provided before new staff had full responsibility for people in their care was insufficient to meet care needs effectively.

People were supported to shop for food individually and staff worked with them to cook healthy meals. People were receiving positive health care, with staff supporting them to attend appointments with health care professionals when needed.

People had built up good relationships with the staff that had been working with them for quite some time, but their privacy and independence were compromised when staff were walking in and out of people’s homes without warning.

Experienced staff responded positively to people’s individual needs, their likes and dislikes and they responded well to complaints and comments made by people.

Management systems were in place for the registered manager to monitor and audit the quality of the service provided, though the manager was not fully aware of the care practices we identified and improvements that were needed.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to the monitoring the quality of service provision, supporting new staff with induction training and respecting people’s privacy and independence. You can see what action we told the provider to take at the back of the full version of this report.

We reviewed two care and support files for people who used the service and noted that these included detailed guidance of the person’s individual needs.

Staff we spoke with were able to tell us the process for reporting safeguarding concerns, which was in line with the safeguarding policy that we reviewed.

Staff rotas we reviewed confirmed that people were supported by sufficient amounts of staff at all times. We also saw records to confirm that staff received appropriate training for their role.

We spoke with four of the people who used the service and they told us that they made their own choices about the support they received. They told us that staff respected their privacy and waited to be invited in before entering the houses.

Staff we spoke with were knowledgeable about people's individual needs. Three people who used the service told us they knew what information was in their care plans and they were each satisfied with the way staff supported them.

People told us they were happy that staff kept their tablets under lock and key and made them available when they were needed. Arrangements were in place to further improve security for storage of medicines.

People told us that there were always helpful staff around and they knew how to contact them if they needed support quickly. We saw effective recruitment and selection processes in place.

We saw written evidence of an effective quality monitoring system for the service.

One person told us how much they enjoyed living at the home. They explained how they were encouraged to be as independent as possible and were supported to become involved in all aspects of life at the home. They told us, “It’s second to none here,” and, “The whole thing works like clockwork, it’s a great place to live and the staff are great too.” A person told us they had not seen their care plan through choice but they knew they had one and that they could see it if they wanted to. They said, “I’m at the centre of everything we do.” A person told us, “I’ve got a structured day which is what I need.”

We were told that although people using the service did not receive formal opportunities to provide feedback about the service, they were able to participate in decisions about their care, treatment and support in a variety of ways. One person said they could talk about their problems to any of the staff. They were confident they would be listened to and supported.