Archived: The Woodlands

Updated 10 November 2021

The inspection

This was a targeted inspection to check whether the provider was meeting requirements in specific areas of concern; with reference to safe levels of staffing.

Inspection team

The inspection was undertaken by two inspectors.

Service and service type

The Woodlands is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and specific aspects of these 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

This was an unannounced inspection. The inspection took place on 7 October 2021.

What we did before the inspection

Our planning considered information the provider sent us since the last inspection. This included information about incidents the provider must notify us about, such as abuse or other concerns as well as information about how the provider was managing COVID-19 We reviewed information sent by the provider about specific incidents.

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.

During the inspection

We spoke with two support staff, cook, deputy manager, registered manager and the provider. Due to people’s limited communication and understanding, we could not have detailed conversations with them. However, we observed how people were supported and cared for to help us understand the experiences of people who could not talk with us .

Over the course of the inspection we reviewed the care plans and risk assessments of five people and a selection of other records including staff rotas.

Updated 10 November 2021

About the service

The Woodlands is a residential care home providing personal care for up to 19 older people. Some of these people are living with dementia. At the time of the inspection, 14 people were living at the service.

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

Since our last inspection, improvements had been made to the management of risks related to people's health. Risks relating to hydration, nutrition and constipation were now managed safely. However, we identified other risks in relation to moving and handling.

Improvements had also been made to the safe management of medicines. However, further improvements were required to ensure medicines were managed safely.

Improvements had been made to risks in the environment and window restrictors now met Health and Safety Executive standards. However, we identified other areas of potential risk which we discussed with the manager. Action was taken to mitigate these risks during our inspection.

People told us they felt safe. The registered manager and staff understood their safeguarding responsibilities to protect people from avoidable harm. Staff received training in safeguarding and felt confident to raise safeguarding concerns if required.

The provider's recruitment processes did not always ensure staff were suitable for their roles in line with the requirements for employers in health and social care. There were enough staff to meet people's needs but throughout the day where people were left without sufficient observation.

People were not always encouraged or motivated to take part in activities to enhance their social and emotional wellbeing.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; however the policies and systems in the service did not always support this practice.

Staff understood their responsibility to report accidents and incidents. These accidents and incidents were reviewed, and action was taken to reduce the risk of re-occurrence. Where necessary, referrals had been made to other healthcare professionals to ensure people remained well.

The provider had systems and processes in place for checking the safety and quality of the service. However, these had not always been effective. Since our last inspection, the registered manager had responded well and made sure any identified risks were being managed safely.

The registered manager understood their regulatory responsibilities and had provided us (CQC) with statutory notifications about important notifiable events and incidents that occurred in the service.

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 on 11 December 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

We completed a responsive inspection at The Woodlands in November 2019 as we had received concerns about the management of risks related to people's health. We only looked at the areas of 'safe' and 'well led' as we wanted to be sure people were safe.

This was a planned comprehensive inspection to look at all areas of care delivery, based on the previous rating.

Enforcement

At this inspection we some found improvements had been made and the provider was no longer in breach of regulation 12 (Safe Care and Treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. However, enough improvement had not been made and the provider was still in breach of regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.