Woodside Lodge

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We assessed a total of 2 quality statements from this key question. We have combined the scores for these areas with scores based on the rating from the last inspection, which was good. Our rating for this key question has deteriorated to requires improvement. We found the provider was failing to meet their legal requirements and were in breach of two legal regulations. The provider failed to ensure people’s care records were always in place, up to date or robust to guide safe practice. This included where care and support for people to manage their diet and nutritional needs. The provider failed to ensure they always followed their requirements to seek consent and act in line with legal requirements where people could not consent to their accommodation and the care provided.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

Some people and relatives we spoke with told us the food needed to be improved. Comments included, “The food is dreadful. It’s really awful. There’s no choice."; “I don’t like the food. I need soft food as I can’t swallow properly and last week they gave me 5 big cubes of liver; "[The] food is not particularly great, [people are] not able to make food choices” and “the food’s not bad. It’s not what I’m used to but you get used to it”.

We spoke with staff and leaders, including kitchen staff about people's prescribed modified diets and found staff lacked the sufficient understanding of how each person required their meals prepared to manage the risk of choking and dysphagia. For example, the chef could not confirm when asked how they had prepared 2 people’s meals during the onsite assessment where they required modification of their meals to manage their assessed risk.

We were not assured the provider appropriately managed risks where people were prescribed a modified diet. The chef, leaders and staff were not always able to demonstrate they knew and understood people's needs and how food should be prepared in accordance with peoples assessed level of risk. Risk assessments, information in the kitchen and staff knowledge was conflicting which placed people at an increased risk of choking and aspiration. We reviewed people's care records related to their meals and found no evidence that people were provided with meals or snacks after their teatime routines to ensure there nutrition and hydration needs were met. Weight records for some people were not complete, and the provider failed to effectively embed nationally recognised tools to manage associated risks to people’s health and care needs. The provider did not demonstrate they had considered all relevant best practice guidance for dementia friendly care environments. For example, we found the home lacked appropriate consideration of orientation for people, including ensuring all people's room doors had their names or signage was accessible. There were no tools in place to support people to make choices around their meals such as visual plates or photos. Spaces were not clutter free and people could not independently access outdoor areas. Care records lacked detail and guidance for staff about people’s individual diagnosis, such as dementia. There was a lack of detail around how their dementia affected them and how to support them if their condition deteriorates.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We observed staff seek verbal consent from people before they supported them to undertake care tasks. A person we spoke with told us staff supported their wishes where they did not consent to have overnight checks as this disturbed them.

From discussions with staff and leaders it was clear leaders did not have a sufficient knowledge of their legal requirements. Those responsible for undertaking assessment of capacity did not fully understand their roles and responsibilities under the code of practice to appropriately assess people's capacity where this was appropriate.

The provider failed to ensure the correct procedures were followed where people were not able to provide informed consent to their accommodation and care and support needs. Records for recording decisions where people lacked capacity did not demonstrate practices were undertaken in-line with legislation. We found multiple examples where people's capacity had not been considered where relevant to do so, and where acts were being carried out in people's best interest. Specific decisions for people included bedrails, sensor mats, accommodation, consent to care, medicines, welfare checks and where they were prescribed a modified diet.