Woodland Manor Care Home

Updated 24 October 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Woodland Manor is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The inspection was announced on the day. This was to establish if the service was dealing with any COVID -19 cases which might prevent us being able to access areas of the home.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from professionals who work with the service. We requested information, records and policies from the service. This enabled us to access records remotely and plan what we needed to focus on at the inspection visit.

We made telephone calls to 14 staff which included the deputy manager, residential care manager, a registered nurse, five team leaders, five care staff and the trainer. We spoke with four service users and five relatives. We requested written feedback from relatives and received eleven email responses from them.

We reviewed eleven service user care plans and medicine records, nine staff recruitment files and twelve staff supervision files.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection:

We spoke to one person who used the service, a registered nurse, team leader, administrator and an activity staff member. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed the environment, infection control and medicine practices and looked at records on the electronic care plan system to support the information we had already received prior to the inspection.

After the inspection

We continued to review electronic records and continued to seek clarification from the provider to validate evidence found. We looked at training data, quality assurance records, policies, action plan and had a telephone call with the registered manager to feedback our findings and establish their vision for the service.

The registered manager, provider and staff worked hard in providing us with access to the information we requested to facilitate the inspection. This enabled many aspects of the inspection to take place remotely and enabled us to focus the site visit on key areas of practice.

Updated 24 October 2020

About the service

Woodland Manor Care Home is a care home providing personal and nursing care to 41 people aged 65 and over at the time of the inspection. The service can support up to 64 people.

Woodland Manor Care Home accommodates 64 people across four separate units. Two units provide residential care and two units provide nursing care. The service supports people living with dementia. The home is purpose built, with all bedrooms having an en-suite shower, shared communal dining and sitting room facilities. It has a separate dining room for special occasions, a cafe bistro at the entrance to the home, a cinema and activity room which is accessible to people.

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

People and the majority of relatives we spoke with for feedback were happy with the care provided. Some people would prefer to be at home but overall felt they got the care and support they required. Relatives were generally happy with the care and some relatives gave us examples of where their family members health had improved. All of the relatives, whilst finding the restrictions on visits incredibly tough, acknowledged that the service had done a great job in managing and responding to the COVID -19 pandemic and preventing an outbreak.

Systems were in place to keep people safe. Risks to them were identified and managed. Safe medicine practices were promoted, and measures were in place to prevent cross infection. Accidents and incidents were monitored, and systems were in place to promote learning from accidents/incidents and prevent reoccurrence. Staff were suitably recruited, deployed and the required staffing levels were maintained. The shifts were managed, and tasks were allocated which resulted in people getting the required care in a timely manner.

People were supported by staff who were suitably inducted, trained and supported. The training and induction was tailored to different roles and regular monitoring of staff practice took place to ensure the training was embedded into practice. The management team had a presence on the units and assisted on shifts which further supported staff. People’s health and nutritional needs were identified and met, and they had access to health professionals to further promote their well-being. 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; Whilst systems and policies were in place to support this the registered manager had identified that further training was needed.

We did not review the caring domain at this inspection. However, we observed staff were kind, caring, gentle and responsive to people’s needs. People and relatives were complimentary of individual staff and gave examples where they felt they had gone the extra mile in relation to supporting them and their family member.

Person centred care was promoted and continued to be developed. People’s care, support and communication needs were identified and met. People had access to one to one and group activities and the activity team had supported people and their relatives to keep in touch during the pandemic. People’s end of life wishes, and preferences were identified, where the person and their family members had participated in that discussion. The service was supporting people on end of life care and staff had been trained and supported in that role. Systems were in place to deal with concerns and complaints. Some relatives raised concerns with us about their experiences of care. We have directed them to the provider to explore further.

People were supported by a service that was well managed and monitored. The registered manager had worked incredibly hard to improve the service and bring about positive changes and processes. They had built a strong management team to support them. As a result, communication, team work and staff morale had improved which resulted in positive outcomes for people. Regular auditing and reviewing of practices and processes took place which enabled the registered manager to have oversight of what areas needed further improvement.

People and the majority of relatives were positive about the improvements the registered manager had brought to the service. They described the registered manager as “accessible”, “approachable”, “honest”, “listens and provides clarity’. A relative commented “I think the home is extremely well managed. I have found [registered managers name] firm but caring. She explains herself clearly, she is very hardworking, dedicated to her job and goes that extra mile. I am happy to trust my mother’s care to a home managed by her”.

Staff described the registered manager as “firm”, “fair”, “friendly”, “knowledgeable”, “experienced and professional’. A staff member told us they, “Felt happier, better supported, appreciated, valued and clear of what was expected from them.” Another staff member commented, “It is more friendly here now. Staff work well as a team. Morale is good and staff feel like they can progress. Everyone gets the opportunity.”

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 Inadequate (inspected on the 6 and 7 November 2019 and republished on the 16 September 2020 once representations to our previous actions could be published). There was continued multiple breaches at that inspection.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. They have provided us with regular updates on the action plan and evidence of their auditing to show the progress made.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since November 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out this focused inspection to check that the provider 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, Responsive and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for the caring key question which was not looked at on this occasion was used in calculating the overall rating at this inspection. The overall rating for the service has changed from inadequate to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Woodland Manor Care Home on our website at www.cqc.org.uk.

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 coronavirus and other infection outbreaks effectively.

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.