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Inspection carried out on 11 May 2021

During a routine inspection

About the service

Wood Hill House is a care home that provides accommodation, nursing and personal care for adults living with a range of care and support needs, including people living with a physical disability, people with mental health needs and people with a learning disabilities or autistic spectrum disorder. The home can accommodate up to 83 people in one purpose-built building over four floors, each of which has separate adapted facilities. At the time of this inspection there were ten people residing permanently at Wood Hill House and three people in receipt of respite care.

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

There were systems in place to recognise and respond to any allegations of abuse. Staff had received training in safeguarding vulnerable adults. Safe recruitment procedures made sure staff were of suitable character and background. There were enough staff deployed to meet people’s care and support needs in a timely way. Medicines were stored safely and administered as prescribed. We were assured there were effective systems in place to help prevent and reduce the spread of infections.

Staff were provided with an induction and relevant training to make sure they had the right skills and knowledge for their role. Staff were supported in their jobs through team meetings, supervisions and appraisals. 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 were supported to eat and drink to maintain a balanced diet. People were encouraged to maintain good health and have access to health and social care services as required. Positive and supportive relationships had been developed between people living at Wood Hill House and the staff. People’s right to privacy was respected and staff ensured people's dignity was maintained. Care records provided person-centred information to enable staff to meet people’s needs and preferences.

The service was well-led. Comments about the manager were overwhelmingly positive. There were effective systems in place to monitor and improve the quality of the service provided. The provider had a comprehensive set of policies and procedures covering all aspects of service delivery.

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.

The service was not able to demonstrate how they were meeting one of the underpinning principles of right support, right care, right culture. People’s individual needs were not fully met by the size and design of the service. The service can accommodate up to 83 people and as result there were large communal areas that were not conducive to meeting the varied and complex needs of some of the people who used the service. The premises had not been personalised to reflect the individual preferences of the people living there. The type and layout of the building therefore did not meet all the components of right support, right care, right culture.

Best practice guidance regarding accommodation for autistic people recommends it should usually be provided in small, local community-based units. Best practice guidance for people with a learning disability recommends living alone or with a small number of other people in shared housing that has a small-scale domestic feel. The manager and provider told us they had long term plans to improve the design of the service and reduce the bed capacity.

Right support:

• Model of care and setting maximises people’s choice, control and independ