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Inspection carried out on 3 September 2019

During a routine inspection

About the service

Wood Street is registered to provide personal care and support to people with a learning disability or autistic spectrum disorder, physical disability, older people and younger adults living in a ‘supported living’ service.

This service provides care and support to people living in 15 ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of this inspection, the service was providing personal care to 76 people.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism.

Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the director of care and support at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used positive behaviour support principles to support people in the least restrictive way.

People’s experience of using this service and what we found

People were supported by kind and caring staff who treated people as individuals and with dignity and respect. The provider had robust recruitment systems to ensure staff were safely recruited. Staff spoke knowledgably about the systems in place to safeguard people from abuse. People were supported by staff who were inducted, trained and supervised.

People told us they felt safe and systems were in place to safeguard people. Risks to them were identified and managed. Where required people were supported with their medicines. Infection control measures were in place to prevent cross infection. The support required by people with health and nutritional needs was identified and provided.

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.

People told us staff were kind and caring. Their privacy and independence were promoted. Systems were in place to deal with concerns and complaints. This enabled people to raise concerns about their care if they needed to.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People had person centred support plans in place. They were actively involved in their care and contributed to the development of care plans and reviews. People had staff support to access activities and holidays. This was flexible and provided in response to people’s choices. People’s communication needs were identified, and their end of life wishes were explored and recorded.

The provider had effective quality assurance systems to monitor the quality and safety of the care provided. People were asked for their views and their feedback used to improve the service and make any necessary changes.

For more details, please see the full report which is on the CQC

Inspection carried out on 5 December 2016

During a routine inspection

We inspected Antill Road on 5, 6,7,8,12,13 and 15 December 2016, the inspection was announced. Our last inspection took place on the 8 August 2013 where we found the provider was meeting all of the regulations we checked.

Antill Road is registered to provide personal care and support to 169 adults with complex needs in their own homes including people with a learning disability, mental health needs and people with autism spectrum disorder (ASD). The services are provided to people in supported living schemes and in addition to this a floating support service and a specialist outreach service is provided for people on the autism spectrum. Some people fund their care packages with the specialist outreach service through direct payments from their local council, which meant they had chosen to buy services from the provider.

The provider is the landlord for the majority of the supported living schemes that were provided in Waltham Forest and some of the schemes are owned by private landlords and the local authority. The schemes are located in the boroughs of Bromley, Camden, Enfield, Hackney, Haringey, Islington, Tower Hamlets and Waltham Forest. The Care Quality Commission regulates the provision of personal care services but does not regulate housing support. At the time of our inspection there were 120 people receiving personal care services.

There were four registered managers in post during 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.

Information about the home was accessible and understood by people who used the service. People had communication plans in place and staff followed these. People were listened to and their rights were respected and staff provided person-centred care.

Recruitment checks were completed to assess the suitability of the staff employed. Staff received suitable training and good support to enable them to carry out their roles. There was a suitable number of staff to meet the needs of the people who used the service.

The provider ensured the administration, storage and disposal of medicines were managed safely.

Suitable arrangements were in place to ensure people received good nutrition and hydration.

Staff had a good understanding of safeguarding procedures and followed protection plans to minimise the risk of harm to people. The provider worked in in partnership with other stakeholders to minimise future re-occurrences of any incidents.

People were supported by staff to attend health care appointments when there were changes to their health care needs or associated risks to their health. Staff followed the legal requirements in relation to the Mental Capacity Act 2005. Staff understood the MCA and presumed people had the capacity to make decisions first.

People were supported to maintain positive relationships with their relatives and friends. Relatives were complimentary regarding the care and support provided by staff. People had access to activities that were important to them and were encouraged to be active in the community.

Relatives knew how to make a complaint but some felt their concerns were not resolved within the appropriate timescales. There was an easy read complaints policy available for people.

Systems were in place to effectively improve the quality of care delivered.

Inspection carried out on 8 August 2013

During a routine inspection

We visited a house that was shared by five people who were using the service. They had agreed that we could visit them but only one person chose to speak with us. The person who spoke with us said that staff �help me to cook�, and �take my medicine and look after myself.�

We looked at the care plans for the five people who were sharing a house. We found that the plans were written in a clear way and took the preferences and views of each person into account.

Safeguarding concerns were reported and responded to properly.

The service kept records that showed training courses staff had completed and when these had been done. The staff training plan showed that staff were provided with the necessary training for the specific areas of care and support which they provided.

The organisation wide survey for 2012 showed that over 90% of people were either �very� or �usually" satisfied with the service. The provider developed an action plan to respond to issues people had raised.

We found that the service was using the organisational complaints procedures for investigating and responding to complaints. Timescales for resolving complaints were usually adhered to and the organisation kept people informed if it may take longer.

Inspection carried out on 16 July 2012

During a routine inspection

We asked one person about how they like to spend their time and if they are supported by staff in living their daily lives. This person told us about some of the things that they do each day and how they were supported by staff to live their life. The other three people who we visited were unable to hold voice conversations with us but we did spend time observing how they were treated by staff and this was seen to be very positive.