Archived: Woodleigh

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Policies and procedures had been developed by the registered provider (Warrington Borough Council) to provide guidance for staff on how to safeguard the care and welfare of the people using the service.

The registered manager demonstrated awareness of the Mental Capacity Act and the circumstances when it was necessary to apply for authorisation to deprive a person of their liberty and to ensure the correct safeguards were in place. Likewise, management and staff spoken with demonstrated a sound awareness of the different types of abuse and the action that should be taken in response to suspicion or evidence of abuse.

Records highlighted that there had been eight safeguarding referrals since our last inspection. Records confirmed that any safeguarding incidents were referred to the local authority's safeguarding unit in accordance with the organisation's policies and procedure.

Examination of the duty rotas, direct observation and discussion with the registered manager confirmed there was a skill and gender mix of staff on duty at different times.

Since the last inspection the service had utilised a care staffing tool to assist in monitoring the dependency levels of the people using the service and the staffing hours required to meet their needs.

We noted that at the time of our inspection the service had a number of staff vacancies. Staff spoken with reported that the use of different agency staff was impacting on the work of permanent staff, as they were supporting agency staff in addition to their existing duties. The registered manager told us that that the service was in the process of recruiting to fill the vacant posts to ensure continuity in staffing.

Is the service effective?

The people living at Woodleigh were observed to be relaxed in their home environment and in the company of the staff team. No concerns, complaints or allegations were brought to our attention during the inspection.

People were observed to be clean and well-presented. Those who were able to discuss arrangements made for their care told us that they were happy and overall very satisfied with the service. A programme of activities was displayed in the reception area for people using the service to access and participate in.

Menus viewed confirmed the people using the service had access to a varied, balanced and wholesome diet. Refreshments and snacks were also served throughout the day and bowls of fresh fruit were available on each unit for people to eat.

We noted that the service was last inspected by the local authority's environmental health department during July 2013 and was awarded a five star food hygiene rating.

We discreetly observed the arrangements for the evening meal during our inspection. Staff were observed to be available during meal times and were seen to offer appropriate levels of support to people who required assistance with eating and drinking.

Overall, feedback received from people using the service or their representatives about the meal options and standard of catering provided was positive. Comments received from people using the service included: 'The food is nice'; 'I have my food specially prepared for me and they never forget I like it pureed as I have difficulty chewing' and 'There is always a choice for each meal and the meals are generally nice'

Likewise, one relative reported: 'We've no concerns about the meals. People appear well fed with plenty of refreshments'

Is the service caring?

The atmosphere in the home was relaxed and sociable. We observed staff carrying out their duties and responsibilities in a relaxed and positive manner. Staff were seen to be sensitive to the needs of the people using the service and were attentive to their individual needs.

Comments received from people using the service included: 'I can't fault this place'; 'The staff are nice'; 'It's a nice place to be'; 'We have an activities person who helps to keep us occupied' and 'I'm happy. That's what matters. If I wasn't I'd be sure to complain.'

Likewise, feedback received from relatives included: 'We are very happy. Our relative is well looked after and we have no concerns' and 'Recently there appears to have been an increase in the use of agency staff. This could impact on care standards but so far it's been okay.'

Is the service responsive?

We looked at the personal files of three people who lived at Woodleigh during our site visit and found copies of assessments from social workers. This helped to provide evidence that the needs of the people living at Woodleigh were being kept under regular review.

Files viewed also contained a range of assessment and care planning information that had been developed and produced by the provider. A range of supporting documentation including: consent forms; life maps; activity sheets; personal profiles and information sheets; risk assessments; health care; weight records; activity and daily life records; communication records and other key documentation was also available to refer to.

Some care plan documentation viewed was in need of review. The manager told us that the service had vacancies for three senior staff and that this had impacted on the review and development of care plans.

We noted that the management team was in the process of developing new care plans to improve and develop existing records. This will help to safeguard the health and welfare of the people using the service and to deliver person centred care.

Is the service well- led?

The service has a registered manager in place to provider direction and leadership to the staff team. The provider (Warrington Borough Council) and the registered manager have always worked well with us and keep us up to date on any significant events via statutory notifications.

A range of internal auditing systems have been established to enable the registered manager to maintain an overview of the service. For example, we saw evidence of audits of: personal file, staff supervision, financial, accident and incident, medication and workplace health and safety checks / audits. We also sampled maintenance records for the fire alarm system, emergency lights and fire extinguishers and found evidence of routine maintenance and servicing.

We noted that the frequency of some internal audits was inconsistent and there was no record of the last fire drill for night staff. The management team told us that they would take action to address these issues.

The provider had established systems to involve and obtain feedback from people using the service and / or their representatives. We noted that easy read surveys had not been used to help people understand the information. We have raised this point with the provider to help develop and improve the quality of future consultation processes.

People spoken with confirmed they had access to information about the service and that they were treated with respect and their dignity was maintained. Comments included: 'I like it here'; 'I have always been well looked after and the food is great' and 'The staff are good and are always there when needed.'

Likewise feedback received from relatives included: 'I thank God every day that we found Woodleigh'; 'On a scale of 1 to 10 I would rate the standard of care at ten'; 'The way this place is run is amazing. Management and staff are excellent and the standard of care is very good' and 'Overall I'm delighted. The only area I would like to see improve is more stimulation and activities for the residents.' This information was shared with the management team for action.