Archived: 31 Woodbourne Avenue

31 Woodbourne Avenue is a residential care home providing the personal care to up to eight people. The service provides support to people with learning disabilities and autistic spectrum disorder. At the time of our inspection there were seven people using the service.

The care home accommodates seven people in one residential property in the London borough of Streatham.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

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

We have made a recommendation in relation to staff training and records management. Staff did not receive specific training in learning disabilities, autistic spectrum disorders and behaviours that may cause anxiety or distress. Statutory notifications were not always submitted in a timely manner. Risk management plans in place did not always give staff clear guidance on how to mitigate risks.

Right support: People’s identified risks were not always clearly recorded. Staff did not always receive sufficient training to support the people they were caring for. The service had enough staff, including for one-to-one support for people to take part in activities and visits how and when they wanted. Staff received support in the form of continual supervision, appraisal and recognition of good practice. People were able to eat and drink in line with their cultural preferences and beliefs. People were referred to health care professionals to support their wellbeing and help them to live healthy lives. 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.

Right Care: People felt valued by staff who showed genuine interest in their well-being and quality of life. Staff discussed ways of ensuring people’s goals were meaningful and spent time with people understanding how they could be achieved. People were supported to understand their rights and explore meaningful relationships. Staff had good awareness, skills and understanding of individual communication needs, they knew how to facilitate communication and when people were trying to tell them something. Staff were committed to encouraging people to undertake voluntary work, employment, vocational courses in line with their wishes and to explore new social, leisure and recreational interests.

Right culture – Systems in relation to governance were not always as effective as they could be. Managers worked directly with people and led by example. The service apologised to people, and those important to them, when things went wrong. The provider had a clear vision for the direction of the service which demonstrated ambition and a desire for people to achieve the best outcomes possible. The service worked well in partnership with other health and social care organisations, which helped to improve the wellbeing of people that used the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 17.11.2017).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care, right culture.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the effective and well-led sections of this full report. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the effective and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 31 Woodbourne Avenue on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

At the time of the inspection the service had a registered manager. A registered manager is a person who has registered with the 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.

Staff followed the service’s policies and procedures to protect people from a potential harm and abuse. Care plans were linked to risk assessments to guide staff on the support people required to stay safe. Robust systems were in place to check staff’s suitability for the post before they started working with people. When necessary, cover was provided to ensure adequate staffing levels at the service. Staff were trained and followed the service’s requirements on how to manage medicines safely.

Staff were provided with appropriate training for their role. The service followed Mental Capacity Act (2005) principles and applied for authorisations under the Deprivation of Liberty Safeguards (DoLS). Staff supported people to book and attend their health appointments as necessary. People made choices about the food they wanted to eat. Staff received support to carry out their responsibilities as necessary. However, the staff team was not provided with regular supervision meetings.

Staff attended to people’s needs with care and supported them to communicate according to their individual needs. People were assisted to make changes to their activities and went out in the community regularly. Staff enhanced people’s skills to carry out tasks independently where possible.

People’s care records were suitably maintained and up-to-date. Staff involved people in making decisions about the support they wanted to receive. People and their relatives felt confident to talk to the staff team about their concerns and the changes they wanted to make.

The registered manager had support from a team leader to manage the service on a day-to-day basis. Staff were encouraged to develop the service and make suggestions to improve people’s care. Staff surveys indicated poor communication from the management team. More information will be gathered to address this area. Regular audits took place to monitor the service’s performance. Medicine audits were not recorded appropriately and this will be addressed by the management team.

One person told us "this is the only home I know, I cannot imagine anywhere better to live, it is all that I want".

Another person told us "I am well cared for, I have become more independent but I still need the presence of staff to ensure I am safe should I have seizure."

People were encouraged and supported to lead fulfilling lifestyles, and had opportunities to undertake activities of daily living for themselves, some enjoyed taking in part in college courses and improving their educational skills.

A person returned from college expressing delight at their success in a maths exam, staff responded by acknowledging their achievements and complimenting them on their hard work.

Each person using the service had their support plan tailored to suit their needs; staff were familiar with individual support needs and risks associated with individual conditions. They delivered the care and support people needed.

Staff demonstrated knowledge in recognising potential signs of abuse. We saw people had assistance to help them manage their finances safely.

People using the service were including in the process of recruiting and selecting new staff. Recruitment procedures were robust and staff were vetted fully before they were appointed to work at the home.

People told us they enjoyed their lives and took part in activities they liked both at home and in the community. One person said "I like my home. I am among my friends that I have known for a long time. The house is close to the high road and to the shops and public transport".

One person told us about their involvement in local authority forums, they represented the views of other people and discussed what community services people needed.

A person using the service told us "I have voluntary work two days a week in a charity shop. I look forward to this and enjoy the work involved".

We saw that staff were enthusiastic about supporting people with pursuing lifestyles of their own choosing. For example, one person told us they enjoyed the theatre and had booked tickets for themselves and their friends to see a show as a birthday treat.