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Woodside Care Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 5 December 2017

We carried out this unannounced inspection on 11 September 2017.

Woodside Care Home can provide accommodation and personal care for 39 older people, people who live with dementia and people who have a physical disability. There were 29 people living in the service at the time of our inspection.

The service was run by a company who was the registered provider. There was a manager whom we registered to be in their post shortly before this 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. In this report when we speak both about the company and the registered manager we refer to them as being, ‘the registered persons’.

At our inspection on 21 July 2016 we found that there were three breaches of the regulations. Two of the breaches had reduced the registered persons' ability to consistently provide people who lived in the service with safe care. In more detail, we found that there were shortfalls in the arrangements that had been made to promote good standards of hygiene and to maintain particular areas of the accommodation. As a result we rated our domain ‘safe’ as ‘Requires Improvement’. The third breach referred to other developments that needed to be made to ensure that the service was well managed. Therefore, we also rated our domain ‘well led’ as ‘Requires Improvement.’ In addition to these concerns, we concluded that changes needed to be made to ensure that people consistently received effective care and so we rated our domain ‘effective’ as ‘Requires Improvement’. As a result of these ratings we concluded that the summary rating for the service was ‘Requires Improvement’.

Shortly after our inspection the registered persons told us that they had made the necessary improvements to address each of our concerns. We completed a further inspection on 26 January 2017 to check on the progress that had been made. We found that sufficient steps had been taken to address the breaches relating to the service’s ability to ensure that people received safe care. We found that new and strengthened provision had been made to promote good standards of hygiene to reduce the risk of people acquiring avoidable infections. We also noted that improvements had been made to the accommodation, although more still needed to be done to provide people with a comfortable setting in which to live. We did not change the rating of our domain ‘safe’ which remained as ‘Requires Improvement’. This was because we needed to see that the improvements which had been made would be sustained.

In relation to our domain ‘well led’, we found that the registered persons had not made enough progress to ensure that the service was robustly managed and so we concluded that the breach had not been met. Therefore, we repeated the breach and rated our domain ‘well led’ as ‘Requires Improvement’. In line with our inspection methodology we did not review what improvements had been introduced to promote the service’s ability to provide people with effective care.

After our inspection the registered persons told us that they had made further improvements to address the concerns we had raised about the management of the service.

At the present inspection we found that a number of improvements had been made to the way in which the service was run. However, these had not resulted in people always receiving a high quality service. Therefore, we concluded that the service was still not fully being managed in the right way and we decided that the breach of the regulations relating to this matter had not been resolved. You can find out what action we have told the registered persons to take in relation to this breach at the end of the full version of this report.

In addition, we found further shortfalls in the arrangements that had been made to provide people with safe care. This was because people had not always been suitably protected from avoidable risks to their health and safety. In addition, we noted that medicines had not consistently been managed safely. We concluded that the shortfall in question was a breach of the regulations. You can find out what action we have told the registered persons to take in relation to this breach at the end of this report.

Our other findings at this inspection were as follows. There were not enough housekeeping and laundry staff on duty to meet the minimum level set by the registered persons. Some of the necessary background checks on new care staff had not been completed in the right way. However, care staff knew how to respond to any concerns that might arise so that people were kept safe from abuse.

Although some care staff had not received all of the training the registered persons said they needed, in practice they knew how to care for people in the right way. People enjoyed their meals and they were helped to eat and drink enough. Care staff had ensured that people received all of the healthcare they needed.

The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered persons had not fully ensured that one person only received lawful care. However and more generally, people were helped to make decisions for themselves whenever possible. When people lacked mental capacity the registered persons had ensured that decisions were taken in people’s best interests.

Care staff were kind and people were treated with compassion and respect. People’s right to privacy was promoted and there were arrangements to help them to access independent lay advocacy services if necessary. Confidential information was kept private.

People had been consulted about the care they wanted to receive and they had been given all of the help they needed. Care staff promoted positive outcomes for people who lived with dementia and people were supported to pursue their hobbies and interests. There were arrangements to fairly and quickly resolve complaints.

Good team working had been promoted and staff were encouraged to speak out if they had any concerns about the care people were receiving.

Inspection areas

Safe

Requires improvement

Updated 5 December 2017

The service was not consistently safe.

People had not always been protected from avoidable risks to their health and safety.

Medicines were not always managed safely.

Background checks had not always been completed for new care staff in the right way.

The registered persons had not deployed enough housekeeping and laundry staff to meet the minimum level of cover they considered to be necessary.

Care staff knew how to keep people safe from the risk of abuse including financial mistreatment.

Effective

Requires improvement

Updated 5 December 2017

The service was not consistently effective.

Care had not always been provided in an organised way to ensure that people’s legal rights were reliably protected.

Although in practice care workers knew how to care for people in the right way, they had not received all of the training the registered persons considered to be necessary.

People enjoyed their meals and they had been helped to eat and drink enough.

People had been assisted to receive all the healthcare attention they needed.

Caring

Good

Updated 5 December 2017

The service was caring.

People received kind and compassionate care.

People’s right to privacy was respected and their dignity was promoted.

Arrangements had been made to enable people to be supported by lay advocates if necessary.

Confidential information was kept private.

Responsive

Good

Updated 5 December 2017

The service was responsive.

People had been consulted about the care they wanted to receive and had been given all of the assistance they needed.

Care staff promoted positive outcomes for people who lived with dementia.

People were supported to pursue their hobbies and interests.

Complaints had been properly investigated and quickly resolved.

Well-led

Requires improvement

Updated 5 December 2017

The service was not well led.

People had not been fully involved in the development of the service.

Quality checks had not always been completed in right way.

There was good team work and care staff had been encouraged to speak out if they had any concerns.