Woodlands Park Care Centre

Woodlands Park Care Centre is a residential care home providing personal care to 26 people aged 65 and over at the time of the inspection. The service can support up to 35 people. The care home supports people living with dementia, mental health conditions, those with sensory impairments of physical disabilities.

The care home is set in rural Buckinghamshire and overlooks country fields. There is an extensive garden around the entire building. The care home accommodates people across two floors, each of which has separate adapted facilities. The ground floor has communal areas such as lounge areas, dining rooms and conservatories, as well as people’s bedrooms. The first floor has more people’s bedrooms.

The care home is part of the Forest Healthcare group.

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

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 protected from abuse, neglect and discrimination. Risk assessments were appropriately completed for both people's care risks and any arising from the premises. Incidents and accidents were correctly recorded, investigated and acted upon. There was good evidence that incident and accident trends and themes were detected and shared within the care home and the larger care home group. There is an ongoing staff recruitment drive, but all shifts are filled with regular (agency) workers. People’s needs were met with the number of staff deployed on each shift.

People had enough food and drinks provided to them. Staff were knowledgeable, skilled and experienced. They received a good level of training, support and had regular checks of their competency. There was some training in more current topics such as sepsis. The care home was nicely decorated for the people who lived there. It was equipped to be dementia friendly, promote reminiscence and had tactile, visual and sensory experiences throughout. The service was compliant with the requirements set for gaining consent and restricting people’s liberty. People's preferences, likes and dislikes were recorded and respected. We made a recommendation about community healthcare professionals’ record-keeping.

Staff were caring and kind with people they supported. Relatives provided positive feedback when asked about care at the home. People were asked for their opinions, but some could not communicate to us their feedback. For those that could express their comments, they told us they liked living at the home, they liked the food and they "loved" the care staff. People's dignity and privacy was respected. People's independence, as far as possible, was maintained and promoted.

Care plans were very person-centred. There was good evidence of people's life history and their stories. There was a very active social life and a passionate and energetic activities coordinator who liked to explore new ideas and provide people with social inclusion. This ensured that they had a good lifestyle, even where they did not leave the premises. There was an appropriate complaints mechanism in place. The service checked for people's end of life preferences and ensured that they had a dignified and pain-free death.

There was a positive workplace culture. Staff were satisfied and happy, smiling and working hard to ensure people received good support. The registered managers and team leader were knowledgeable, experienced and took their responsibilities seriously. The service demonstrated transparency when things went wrong. There was a good governance and audit system in place, and an action plan was used to capture and mitigate risks and work through improvements. There was good evidence of partnership working. People, relatives, health or social care professionals and staff were involved in and had a say in how the service was operated and led.

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

Rating at last inspection

The last rating for this service was Good (published 13 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

However, the inspection was prompted, in part, due to concerns received about people’s night time care, provision of adequate food and people’s access to drinks or fluids. A decision was made for us to conduct the inspection as originally scheduled, but to further examine those risks.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe and Effective sections of this full report for further details.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the time of our inspection the registered manager had been absent from the service. The service was being managed by the deputy manager with support from the regional manager. The provider notified us of the registered managers absence.

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.

Our previous inspection carried out in December 2015 found several breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we checked whether the service had achieved compliance with the associated regulations. Following our findings the provider submitted an action plan to ensure improvements were made. We found that improvements had been made at the service.

People were protected against abuse and neglect. Staff we spoke with told us they had completed training in safeguarding and would not hesitate to report any concerns. However, we continued to have some concerns in relation to the gate at the top of the main staircase. Our previous inspection identified this risk and we asked the provider to review the risks in this area. The provider has done this although we would like them to continue to assess the potential risk on an ongoing basis.

Risk assessments were in place for people living at the home. For example, people who were identified at risk of falling down the stairs. Risks were taken into account and risk assessments were in place to protect people. On two occasions we saw that the gate was left open at the top of the stairs. We pointed this out to the deputy manager, who said they would address this with the maintenance staff. The risk assessments we saw informed staff to monitor and assist when people used the stairs.

Medicines were not always administered in line with policy and procedure however; this had been picked up by the audit procedures that the home had in place. Where there were missing signatures on the Medicine administration record (MAR) sheets these were in the process of being investigated. Where there were no printed MAR charts, hand written charts were completed. The home was meeting with the pharmacy to discuss how this practice could be minimised.

We found staffing levels in the home to be appropriate to the needs of people living in the home. The service used agency staff to maintain safe staffing levels. Records showed that agency staff had received a thorough induction on the first day they worked at the service.

The environment was cleaned to a high standard and was tailored for people living with dementia. For example, ‘old-time’ memorabilia and items of interest such as old-fashioned sewing machines.

The home had a ‘daily sparkle’. This was printed information for people to read that had stories about famous film stars from the past that encouraged conversations with people.

Relatives told us how happy they were with the quality of the service and that staff were kind and considerate. One relative told us, “This has been the happiest four years of my life. I can appreciate the care the staff give to my relative.”

Staff received supervision and told us they felt supported. However, the frequency was not in line with the company policy which stated six sessions per year.

People’s social needs were being met. There was an activity coordinator who provided social activities for people who wanted to take part. At the time of our inspection there were outside entertainers playing music and singing to people.

Quality audits systems were in place to assess and monitor the service.

We have made a recommendation in relation to the potential risks associated with people using the staircase.

People's needs had been assessed before a placement at the home had begun and included risk assessments. This ensured their needs could be met appropriately.

Care plans addressed people's individual needs, were detailed, reviewed and updated regularly. People had access to healthcare professionals and specialist support to ensure they kept healthy and well. The care and support was planned and delivered in line with their care plan.

We found people were treated with dignity and respect. We observed people in the dining room during lunch time. We saw staff offered people choice of food and people were not rushed and enabled to eat their lunch at their own pace.

Daily activities were provided to ensure people's social care needs were met.

The home was comfortable, clean and warm and was in the process of being redecorated. Each person had their own bedroom which they had personalised to their own taste.