Woofferton Residential Care Home

Woofferton Residential Care Home is a care home providing accommodation and personal care to a maximum of 15 people over the age of 65 years in one adapted building. At the time of our inspection there were 12 people using the service.

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

People received their medicines when they needed them. We have made recommendations regarding the storage and recording of people’s medicines. People felt safe living at the home and with the staff who supported them. The provider’s staff recruitment procedures helped to protect people from harm. Risks to people were assessed and there were plans in place to mitigate risks. The provider followed best practice in relation to infection control and prevention and management of risks relating to COVID-19.

People were supported by staff who were trained and competent to carry out their role. People were assessed to ensure their needs and aspirations could be met. People were provided with enough food and drink to meet their needs. People were very positive about the quality and quantity of the food they received. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the provider's policies and procedures supported this practice. People lived in a home which was well-maintained and adapted to meet their needs. People saw healthcare professionals when they needed.

People told us they were supported by kind and caring staff who respected their wishes and treated them with respect. People were supported to live their lives as they chose and were regularly consulted about the care they received. People’s privacy was respected, and they could spend time alone in their bedroom when they wanted. People were supported to be as independent as they could be.

People told us staff knew them well and what was important to them. People were supported to maintain contact with those who were important to them and were provided with opportunities for social stimulation. People’s communication needs were assessed and responded to. People did not raise any concerns about the care they received but felt confident action would be taken to address any concerns they may have. There were systems in place to ensure people’s needs and preferences would be understood and met during their final days.

Staff morale was good and staff told us they felt well supported. Staff received the supervision and support needed to carry out their role effectively. The views of people were sought and valued. Systems to monitor and improve the quality of the service provided had improved. The provider worked in partnership with other professionals to ensure good outcomes for people. The provider was aware of their legal requirement and of their responsibility to be open an honest when things go wrong.

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 requires improvement (published 24 July 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Woofferton Residential Care Home 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.

Woofferton is a residential care home providing personal care to 13 people aged 65 and over at the time of the inspection. The service can support up to 15 people in one adapted building.

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

People were not always protected from the risk of injury because there were no effective systems in place to identify, monitor or mitigate risks. The provider’s quality assurance procedures had not been effective in identifying the shortfalls we identified at the inspection. Staff were not supported in their role through regular supervisions and appraisals.

People were cared for by staff who were kind and respectful. One person said, “I don’t think you could get a better care home than this. The staff are really lovely.” People told us staff understood the things that were important to them and that they were cared for in a way which met their needs and preferences.

Staff had been trained and knew how to protect people from the risk of harm or abuse. The provider’s recruitment procedures ensured that staff were suitable to work with people. People received their medicines when they needed them by staff who were trained and competent to carry out the task. Staff followed good infection control procedures and people lived in a home which was clean and fresh smelling.

The provider ensured staff received the training needed to meet the needs of the people who lived at the home. People were positive about the meals offered and they told us they had plenty to eat and drink. People saw doctors and other health care professionals when they needed. 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.

Before people moved to the home an assessment was carried out to make sure the home could meet their needs and preferences. Diversity and communication needs were also considered. Information could be produced in accessible formats for people where required. People told us they were provided with opportunities for social stimulation and that their visitors could visit them when they wanted. People were satisfied with the service they received and they felt confident in raising concerns where needed.

People’s views were encouraged through informal discussions and annual surveys.

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 October 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to safe care and treatment, staffing and good governance.

Please see the action we have told the provider to take at the end of this report.

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The provider of Woofferton Residential Home is registered to provide accommodation and personal care for up to 15 people. At the time of this inspection 14 people were living at the home.

The registered provider was also the registered manager and was present for 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.

The service was last inspected on 15 April 2014 and was meeting the requirements of the law in all areas inspected at the time.

People were kept safe by staff who understood how to identify and report potential harm and abuse. Staff were aware of the risks to people and what they needed to do to help reduce those risks, such as helping people to move safely around the home. People were supported by sufficient numbers of staff who had the skills and knowledge to meet their needs. People were supported to take their medicine when they needed it.

Staff respected and supported people's right to make their own decisions and choices about their care and treatment. People's permission was sought by staff before they helped them with care tasks. Staff had received training relevant to their roles and felt supported by the registered manager. People were supported to eat and drink enough to maintain good health. People had access to other healthcare professionals as required to make sure their health needs were met.

People felt staff treated them with kindness and compassion and they felt involved in their own care. Staff respected people's dignity and privacy and supported them to keep their independence. People received care that was personal to them because staff knew them well. People received their care when they needed it and were not kept waiting by staff when they asked for assistance. People knew how to make a complaint and felt able to discuss any concerns with the registered manager.

The registered manager and staff had created an environment that was homely and welcoming. The provider encouraged staff to value people and support them in a dignified and compassionate way. Staff were clear on their roles and spoke about the people they supported with fondness and respect.

We saw that systems were in place to monitor and check the quality of care and to make sure people were safe. The provider used the information to drive continuous improvement of the service they provided.

This is a summary of what we found-

Is the service safe?

The people we spoke with told us they felt that their dignity was respected and they were assisted to live their life as they wished. They considered they were kept safe and listened to. We observed that people were free to go about their daily routine as they wished. One person told us, 'I feel happy here. The staff are always on hand to help me and I can do as I please'.

We saw records that informed us that a person living with dementia was cared for effectively by staff who responded to their dignity and protected them from harm. The staff had worked with external healthcare professionals to improve the safety and quality of life for the individual.

Staff understood generally about the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and how they would be put into practice in the service. No applications had been submitted.

Recruitment practice was thorough and safe for new starters. The checks required by legislation had been carried out before the applicant cared for people who used the service. This meant that suitable staff were employed to care for people who used the service.

Is the service caring?

The people we spoke with told us that staff treated them kindly and that their individual needs were met. We saw in records that people's care was regularly reviewed with them and that they were encouraged to be as independent as they wanted to be. The registered manager had made changes to the staffing structure and compliment of the home. There had been an emphasis on respectful behaviour and positive attitudes towards people who used the service. People told us that their relative was encouraged to make their views of the care known to staff. This showed that staff listened to people and cared about them if they were unhappy with anything. Staff told us they tried to look after people in the way they wanted.

Is the service responsive?

The people's views were sought through an annual survey. This meant that people could express their views anonymously if they wished. We were told that the registered manager was regularly in contact with people so any issues were discussed on an informal basis as and when they occurred and action immediately taken. We saw records that told us a person's ability to make decisions had been considered. Contact with other health professionals ensured that the person received the external professional support they required. This meant people were supported to express their views and staff were responsive to their needs to enhance their well-being.

Is the service effective?

People's on going needs were regularly re assessed and care planned with them. The registered manager had received information from the funding authority where it had not been possible to visit the individual in person before admission. Records for pre admission assessments were in place. People told us they had been satisfied with how they were admitted to the service. They said they had been asked about their preferences, choice and wishes before they moved in. Staff we spoke with showed that they knew people's needs well. This meant people were supported to maintain optimum health and well-being and that planned care was effective.

Is the service well led?

Since our inspection December 2013 the registered manager had reviewed the documentation of the service and made improvements to the records that the service kept.

Staffing had been reviewed so that more care staff hours were on the rota at weekends. Staff stated that 'This has made care better for people all the time'. The provider may wish to note that although the rotas were better they did not display the full name, qualification and role within the home and nor were the registered manager shifts clearly recorded. This meant it could not be clear to people who actually worked on any day.

The system to assess and monitor that there were sufficient numbers of staff, with the right competencies, skills and knowledge to meet people's needs was improved upon and in place. We saw that staff practice was monitored and questioned and concerns dealt with through the appropriate channels. This meant the service had implemented a more inward looking practice and had recognised the need to improve their management systems to lead the home better.

Staffing levels at Woofferton were not sufficient to meet all of the preferences and choices of the people that lived in the home, particularly at night. Some people considered there were enough staff on duty to meet their current needs. They said, "I have no complaints and if I needed more help I expect that would be given". Staff told us they were rushed to get work done, particularly at weekends when less staff were on duty. We were told caring and domestic roles and responsibilities were not entirely clear. There was no deputy manager in place when the registered manager was not on duty. This meant staff were sometimes engaged in non-care duties and the provider could not ensure that staff could respond to people's changing needs.

The provider acknowledged at our last inspection in January 2013 the need to produce and monitor the service's records more robustly. The care records in place did not enable staff to be aware of problems swiftly and act upon them to keep people safe at all times. This meant staff may not understand how people preferred their care to be delivered. Other records required to be maintained were not easily accessible as the manager was not on duty.

We viewed records that showed people had been involved in and consulted about their care and support. People received a care needs assessment prior to being admitted to the home. We saw that staff supported people sensitively and politely. We spoke to people who said staff promoted their privacy and dignity whilst delivering their care.

The service had systems in place to manage and monitor the prevention and control of infection within the home. The provider had carried out some refurbishment to the d'cor of the home.

People told us that the staff asked them if they were alright and if they were happy with everything. They said that they were able to express their wishes and share their views about how they were feeling. People said that if they had any concerns or worries that they would speak with a member of staff or the manager.