Archived: Woolnough House

At the time of our inspection, Woolnough House provided permanent accommodation, but also had 12 rooms available for people coming out of hospital. These rooms were being used as part of a project called ‘discharge to assess’, whereby people who were medically fit were discharged from hospital to Woolnough House for further assessment of their social care needs.

We inspected this service on 29 July 2016. The inspection was unannounced. This meant the registered provider and staff did not know we would be visiting. At the time of our inspection 28 people were using the service; 23 people living at the home and five people using the service’s ‘discharge to assess’ beds.

The service was last inspected in January 2014 at which time it was compliant with the regulations that were in force at that time.

The registered provider is required to have a registered manager as a condition of registration for this service. The service did have a manager registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

During our inspection, we found that systems were in place to support staff to identify and respond to safeguarding concerns. Risk assessments were used to identify risks and provide guidance to staff on how to safely meet people’s needs.

Appropriate checks were completed to ensure only staff considered suitable to work with adults who may be vulnerable had been employed. Sufficient numbers of staff were employed to meet people’s needs. Staff received training to support them to provide effective care and support. We identified some gaps in training and saw that the registered manager and registered provider were taking steps to address this. We have made a recommendation about training in the body of our report.

We identified discrepancies in medicine stock records and minor gaps in recording on Medication Administration Records (MARs). We have made a recommendation about this in the body of our report.

Consent to care and treatment was sought in line with relevant legislation and guidance on best practice. Staff were proactive in meeting people’s needs in a way that maintained their privacy and dignity.

People were supported to ensure they ate and drank enough and we received positive feedback about the quality of the food provided at Woolnough House. Staff worked effectively with other health and social care professionals to ensure people’s health needs were met.

People who used the service told us staff were kind, caring and attentive. Staff supported and encouraged to make decisions about their care and support. Person centred care plans were in place to guide staff on how to meet people’s individual needs. Care plans were in the process of being updated onto a new more detailed file format.

People were supported and encouraged to engage in activities. There was vibrant atmosphere within the service with meaningful stimulation. People could choose how they spent their time and staff supported people to maintain contact with family members by welcoming visitors to the service.

There were systems in place to gather and respond to feedback about the service. Complaints were appropriately dealt with in line with the registered providers complaints policy and procedure. We received consistently positive feedback about the registered manager and their management of the service. We were told the registered manager was approachable and responsive to feedback. Quality assurance systems were in place to monitor the care and support provided.

We found medication was stored safely and securely. The service had robust systems in place to ensure medication processes were well managed, so that people received their medication safely and as prescribed.

People looked well cared for and were appropriately and tidily dressed. Some people were engaged in activities, like doing a jigsaw or reading magazines.

We found people received safe, appropriate care that met their needs.

People received a diet that was varied and nutritious, and sufficient to maintain their health and well-being.

Whilst people told us they received their medicines safely and when they needed them the associated record keeping did not demonstrate that people were being protected from the risks of unsafe use and management of medication.

There were sufficient staff working to meet people's needs safely and in a timely way.

There were systems in place both to monitor how the service was running and to consult with people to gain their views about the service and the changes they would like to see.

From speaking with, and observing the attitudes and behaviours of staff we found explanations and consent was routinely sought from people before any support or care was provided. This ensured people understood and agreed to that support.

We found the service monitored people's health and wellbeing and sought guidance from healthcare professionals in a timely way.

We found the home was fresh and clean, to make it a pleasant environment for people living there.

Whilst the record-keeping at Woolnough House overall was satisfactory, some improvements could be made in relation to infection prevention and control processes and also to better evidence decisions made as part of their staff recruitment process.