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We are carrying out checks at Woodside Grange Care Home using our new way of inspecting services. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Good

Updated 9 March 2017

We inspected Woodside Grange Care Home on 21 December 2016 and 11 January 2017. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.

We completed a full inspection of the home in August 2015 and found that that action was needed to ensure the systems for overseeing the service were effective and identified risks. Following a number of concerns being raised we conducted a focused inspection on 14 and 28 April 2016. We rated Woodside Grange Care Home as requires improvement because action was needed to ensure sufficient staff were deployed and governance arrangements were improved.

Woodside Grange Care Home is a purpose built care home for up to 121 people, which provides nursing and personal care for both older people with dementia and younger people with mental health needs. There are three floors to the building, each connected by two vertical passenger lifts. All bedrooms are lockable, there are spacious single rooms, with en-suite facilities. The building is surrounded with private grounds and has on site car parking facilities.

The home has had a registered manager in since November 2016. 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.

At previous inspections we found that albeit the provider had systems for monitoring and assessing the service, these had failed to identify that staff were working in silos so not using the resources effectively. It was unclear as to what systematic oversight was given to the nursing service. At the inspection in April 2016 we found that staffing levels had been reduced during then night and for 96 people who used the service up until 9pm there were 12 staff members on duty and overnight there were 11 staff members. We found these staffing levels did not meet the needs of the people.

At this inspection we found action had been taken to ensure staffing levels were now sufficient to meet people needs of the 87 people who used the service and significant improvements had been made to the way the home was run.

People told us that since the change of directors, the manager and deputy manager they were happy with the service. They felt the new team had made a lot of improvements to the home and felt the staff did a good job. We heard how people felt the home was well-run and that the registered manager was extremely effective.

We found that a range of stimulating and engaging activities were provided. There were enough staff to support people to undertake activities in the home and community. We saw people went on trips to local tourist attractions and events.

People’s care plans were detailed and tailored for them as individuals. People were cared for by staff that knew them really well and understood how to support them. We observed that staff had developed very positive relationships with the people who used the service. The interactions between people and staff were jovial and supportive. Staff were kind and respectful.

Staff were supported and had the benefit of a programme of training that enabled them to ensure they could provide the best possible care and support. Staff were all clear that they worked as a team and for the benefit of the people living at Woodside Grange Care Home.

The registered manager understood the complaints process and detailed how they would investigate any concerns. We heard that since they had come into post work had been completed to review all of the previous complaints to ensure appropriate action had been taken to resolve these concerns. We heard how the director of operations and registered manager were actively seeking people’s views and suggestions were acted upon. They had also promoted a reflective learning culture in the home, which allowed staff to look at even the smallest of incidents to determine what lessons could be learnt.

The registered manager and staff had a clear understanding of safeguarding. The registered manager acted as a champion for people and would raise complaints and safeguarding matters when this was needed.

Where people had difficulty making decisions we saw that staff worked with them to work out what they felt was best. Staff understood the requirements of the Mental Capacity Act 2005 and had appropriately requested Deprivation of Liberty Safeguard (DoLS) authorisations.

We reviewed the systems for the management of medicines and found that overall people received their medicines safely.

People told us they were offered plenty to eat and we observed staff assisted individuals to have sufficient healthy food and drinks to ensure that their nutritional needs were met. The cook provided a home cooked healthy diet and provided a range of fortified meals for people who needed extra calories to ensure they maintained their weight. People were supported to manage their weight and nutritional needs.

People were supported to ensure their health and well-being were promoted. The staff had formed good links with the Consultants, GPs, dieticians, speech and language therapists, tissue viability nurses, community nurses and the falls team.

Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with vulnerable people. The staff team was stable and a number of the staff had worked at the home for over four years.

The service had a strong leadership presence with a director of operation, a director of care and registered manager who had a clear vision about the direction of the service. They were committed and passionate about the people they supported and were constantly looking for ways to improve. Thorough and frequent quality assurance processes and audits ensured that all care and support was delivered in the safest and most effective way possible.

Inspection areas

Safe

Good

Updated 9 March 2017

The service was safe.

Staff were knowledgeable in recognising signs of potential abuse and reported any concerns to senior staff.

There were sufficient skilled and experienced staff on duty to meet people’s needs. Robust recruitment procedures were in place. Appropriate checks were undertaken before staff started work.

People’s risks were monitored and managed appropriately with the least restrictive option always considered

People lived in a clean and well maintained home with environmental risks managed appropriately.

People’s medicines were on the whole managed safely and audited regularly

Effective

Good

Updated 9 March 2017

The service was effective.

Staff had the knowledge and skills to support people who used the service. They were able to update their skills through regular training.

Staff felt supported by their colleagues and the registered manager and staff worked as a team.

People’s consent was sought at all times. Staff followed the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguard authorisations.

People were provided with a choice of nutritious food.

People’s on-going healthcare needs were managed and monitored effectively, working with healthcare professionals in the community.

Caring

Good

Updated 9 March 2017

The service was caring.

Staff knew people really well and used this knowledge to care for them and support them in achieving their goals.

Staff were considerate of people’s feelings at all times and always treated them with the greatest respect and dignity.

Responsive

Good

Updated 9 March 2017

The service was responsive.

People’s needs were assessed and care plans were produced identifying how to meet them.. These plans were tailored to meet each person’s individual requirements and reviewed on a regular basis.

We saw people were encouraged and supported to take part in a wide range of activities.

The people we spoke with were aware of how to make a complaint or raise a concern. They told us they had no concerns but were confident if they did these would be looked into and reviewed in a timely way.

Well-led

Good

Updated 9 March 2017

The service was well-led.

People benefitted from a service which had a strong management team. The registered manager was always looking for ways to improve.

The values of the registered manager were consistently demonstrated by the staff in their interactions with people and with each other.

People’s views were sought and acted upon. Relatives’ views were sought.

Robust and frequent quality assurance processes ensured the safety, high quality and effectiveness of the service.