Woodlands Care Home

Woodlands Care Home provides accommodation with personal care for up to 31 people. The service provides support to people living with dementia, mental health conditions and people over 65 years. Accommodation was provided on 2 floors accessed by stairs and a lift. People had their own room and access to communal areas such as a lounge and dining room. There was a garden which is accessed from the ground floor. At the time of the inspection there were 25 people living at the service.

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

Some aspects of the environment needed repair. For example, we found radiator covers were not always attached to the walls securely. The registered manager took action to address this concern during the inspection and make sure all radiator covers were secure or repaired. The registered manager told us there was a plan to update the environment. People’s rooms were being refurbished as and when possible.

Prior to our inspection, we were told a fire exit was blocked. We checked during our site visit and found it was not blocked but equipment stored nearby needed better organisation. The registered manager took action to address this during our inspection.

Whilst there were some shortfalls with the environment the home was clean and smelt fresh. Systems were in place to make sure all areas of the home were thoroughly cleaned.

People had their medicines as prescribed. A new electronic system for medicines management had been installed since the last inspection. This alerted staff to any missed medicines so staff could take immediate action. People who were prescribed ‘as required’ medicines did not always have guidance in place for staff to follow. The registered manager took action to address this during the inspection.

People were being supported by enough staff. We observed during our site visit people’s needs were met in a timely way. However, some people and staff told us there were times there were not enough staff available at night. We shared this with the registered manager who told us they would review peak times with staff. Staff had been recruited safely.

Staff received training on a range of topics and had support from the provider. This included areas such as safeguarding and infection prevention and control. New staff had induction which included shadowing of more experienced staff. We observed staff were working safely following good infection prevention and control procedures.

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.

Mealtimes were relaxed and unhurried. People had their meal in a timely way from staff who were aware of their nutritional needs. People had access to snacks and drinks throughout the day. People’s health needs were met as staff referred them to healthcare professionals in a timely way.

Risks to people’s safety had been assessed and care plans were in place to give staff guidance. The provider had updated their care planning system to electronic recording which enabled staff to access all the information they needed. There was a daily handover where updates were shared, and staff told us there was good communication amongst the teams.

Systems were in place to monitor quality and identify areas for improvements. There were various action plans in place which were produced following quality audits. The registered manager and provider kept oversight of actions to make sure they were carried out and closed. Incidents and accidents were recorded and reviewed by management. Any lessons learned to prevent reoccurrence were shared with staff during handovers and meetings.

People, relatives and professionals all shared positive comments about the staff approach to care and told us they felt people were safe and well cared for. All relatives we spoke with told us they would not hesitate to recommend the service to others. People and relatives had opportunity to share feedback via surveys and in meetings.

There was a registered manager in post, and we were told their approach was inclusive, open and transparent. Communication from the management was good and the registered manager knew people’s needs well.

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 7 February 2019) and there was 1 breach 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

We carried out an unannounced comprehensive inspection of this service on 3 December 2018. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this 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.

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

• The provider did not consistently ensure that all confidential staff records were appropriately stored and secured.

• We could not be assured people were assisted to eat and drink sufficient amounts.

• We could not be assured the provider had assessed and implemented sufficient numbers of staff at night.

• Quality assurance systems were not consistently effective in driving improvement in all aspects of care delivery.

• Arrangements and the administration and management of medicines had improved since our last inspection.

• Staff provided compassionate care and interacted with people in a person centred manner.

• People had access to a number of activities.

• People were supported to access healthcare

• Staff were knowledgeable about the requirements of the Mental Capacity Act 2005 and had applied their knowledge appropriately.

• There is more information about this in the full report.

Rating at last inspection:

At our last inspection we rated the service as Good, however, we issued a requirement as we found a breach of Regulation 12, safe care and treatment. The report was published on 15 July 2016. Following the inspection, we asked the provider to tell us the actions they would take in response to the one breach of Regulations found during this inspection.

About the service:

Woodlands Care Home is a residential care home providing personal care for up to 31 older people, some of whom were living with dementia. At the time of our inspection 26 people were living in the home.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up: We will ask the registered provider for an action plan to address the requirements we found during the inspection. We will continue to monitor all information received about the service to understand any risks that may arise and to ensure the next inspection is scheduled accordingly.

Woodlands Care Home is registered to provide accommodation and personal care for up to 31 people. The service does not provide nursing care. At the time of our inspection 30 people were living at the home. The home provides a service for older people and people living with dementia. Accommodation at the home is provided over two floors, which can be accessed using stairs or passenger lift. There are large garden and patio area’s which provide a safe and secure private leisure area for people living at the home.

The service did not have a registered manager. 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.

Medicines were not always administered, stored or disposed of safely.

People told us they were safe and well cared for at the home. People knew how they could raise a concern about their safety or the quality of the service they received.

The service had carried out risk assessments to ensure that they protected people from harm.

The provider had robust recruitment systems in place.

There were enough staff deployed to provide the support people needed. People received care from staff that they knew and who knew how they wanted to be supported.

Staff had developed caring relationships with people who used the service. People were included in decisions about their care.

Staff knew how to identify abuse and protect people from it.

People were provided with meals and drinks that they enjoyed. People who required support to eat or drink received this in a patient and kind way.

The manager was knowledgeable about The Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. The Mental Capacity Act Code of Practice was followed when people were not able to make important decisions themselves. The manager understood their responsibility to ensure people’s rights were protected.

People and relatives were asked for their views on the service and their comments were acted on. There was no restriction on when people could visit the home. People were able to see their friends and families when they wanted.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

A relative visiting whilst we were there told us: 'I am very pleased with the quality of care, staff are always respectful and helpful of everyone's needs. The communication with the family is very good'. Members of staff working at woodlands told us they were well supported and trained to meet the needs of people.

The home is registered for 31 people. There were 24 people living there on the day of our inspection and we spoke with eight of them. People told us what it was like to live at Woodlands Care Home and described how they were treated by members of staff and their involvement in making choices about their care. They told us members of staff were kind and helpful. People we spoke with felt that their personal care was carried out in a manner that promoted their privacy and dignity. They told us that the staff always asked how they were and told them what they were going to do to assist them. Relatives told us the care was good and spoke highly about the care provided by members of staff. A relative visiting whilst we were there told us: 'I would be horrified if my mother had to leave. I hunted high and low to find this home' ' Members of staff working at the home told us they were well supported and trained to meet the needs of people.