Woking Homes

We found the following examples of good practice.

People were supported to host visitors in a COVID-19 secure way. There was a dedicated visiting room with a separate entry which was deep cleaned after each visit. The registered manager implemented robust measures such as use of PPE, rapid COVID-19 testing or use of screens where necessary to protect people and visitors from the spread of the infection. Where people’s circumstances required additional measures to be put in place, staff completed individual visiting risk assessments to allow essential visiting, for example where people received care at the end stages of their lives.

The service environment and staffing were continuously reviewed by the management to ensure everyone’s safety in line with the COVID-19 national guidance. For example, staff worked exclusively in Woking Homes and staff facilities were re-configured to enable more effective infection prevention and control (IPC). For example, additional staff facilities for putting on and taking off PPE, staggered breaks and socially distanced handovers were provided to staff.

There were adequate supplies of personal protective equipment (PPE) and testing kits available in the home. Staff confirmed they were provided with guidance and access to those throughout the pandemic. Staff had clear understanding on how to safely care for people in self-isolation and what to do should they recognise people had symptoms of COVID-19. Records confirmed the management team continuously monitored testing, vaccination status and availability of IPC resources.

Staff told us they felt supported by the management throughout the pandemic. Staff who needed to self-isolate or shield as per NHS guidance were supported to do so for the required periods of time. Staff received regular updates on changes in the COVID-19 national guidance and could access support around their wellbeing.

People’s experience of using this service:

People told us they felt safe and happy. There were positive and caring relationships between staff and people, and this extended to relatives and other visitors. Staff understood the importance of providing person-centred care and treated everyone as individuals, respecting their abilities and promoting independence. Staff knew how to recognise and report any concerns they had about people’s welfare and how to protect them from abuse.

Woking Homes continued to be kept clean, safely maintained and furnished to comfortable standards. People had the equipment they needed to meet their assessed needs. Health and safety checks were carried out to make sure the premises and equipment were safe.

There were enough staff, day and night, to support people’s needs. The provider recruited staff safely to ensure they were suitable for their role. Staff continued to receive ongoing training and support to keep their knowledge, skills and practice up to date.

People needs were fully assessed before moving to the home so the provider knew whether they could meet the person's needs. Care plans were individual and representative of people’s needs, preferences, values and beliefs. Risks to people’s health and wellbeing were assessed and reviewed when needed. Staff took action to minimise these risks and keep people safe.

People were supported to maintain good health and to eat and drink well. Staff involved other professionals when people became unwell or required additional services. People received their medicines when they should. The provider followed safe practice for the management of medicines.

Staff were caring, respectful and made sure people’s privacy and dignity were maintained. People and their relatives were supported with care and compassion during end of life care. People were supported to have choice in their daily lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People enjoyed varied social and leisure activities and had opportunities to try new ones. There were meaningful activities for people living with dementia. Staff understood the importance of social interaction and ensured they offered people support and companionship when needed.

The registered manager showed effective leadership and the home was well run. Staff knew their roles and understood what was expected of them. Staff felt supported by management and each other. People, their relatives and staff told us management were approachable and that they listened to them when they had any concerns or ideas. All feedback was used to make continuous improvements in the service.

The provider had good oversight of the service and used effective systems to monitor quality and safety. Where improvements were needed or lessons learnt, action was taken.

At this inspection we found the evidence supported a rating of ‘Good’ in all areas, and continues to support a rating of ‘Good’ overall. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Good (August 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor the service through the information we receive. We will inspect in line with our inspection programme or sooner if required.

Woking Homes is a care home for retired railway personnel and their families. People without a railway connection are also welcome to live there. It is a registered charity with a board of trustees. The home accommodates up to 51 people, some of whom were living with dementia or complex needs such as Parkinson’s disease, and diabetes. At the time of our visit, there were 45 people living at the home. The home also provides end of life care. All of the accommodation is provided on the ground floor so that all facilities were accessible to everyone. People living at the home had access to a private indoor swimming pool.

There was a registered manager in post. 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.

People and relative told us they were safe at Woking Homes. Staff had a good understanding about the signs of abuse and were aware of what to do if they suspected abuse was taking place. There were systems and processes in place to protect people from harm.

There were sufficient numbers of staff deployed who had the necessary skills and knowledge to meet people’s needs. Recruitment practices were safe and relevant checks had been completed before staff started work.

Medicines were managed, stored and disposed of safely. Any changes to people’s medicines were prescribed by the person’s GP and administered appropriately.

Fire safety arrangements and risk assessments for the environment were in place to help keep people safe. The service had a business contingency plan that identified how the home would function in the event of an emergency such as fire, adverse weather conditions, flooding or power cuts.

Staff were up to date with current guidance to support people to make decisions. Staff had a clear understanding of Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act (MCA) as well as their responsibilities in respect of this.

The registered manager ensured staff had the skills and experience which were necessary to carry out their role. Staff had received appropriate support that promoted their development. The staff team were knowledgeable about people’s care needs. People told us they felt supported and staff knew what they were doing.

People had enough to eat and drink and there were arrangements in place to identify and support people who were nutritionally at risk. People were supported to have access to healthcare services and were involved in the regular monitoring of their health. The provider worked effectively with healthcare professionals and was pro-active in referring people for assessment or treatment.

Staff treated people with compassion, kindness, dignity and respect. People’s preferences, likes and dislikes had been taken into consideration and support was provided in accordance with people’s wishes. People’s privacy and dignity were respected and promoted when personal care was undertaken.

People’s needs were assessed when they entered the home and on a continuous basis to reflect changes in their needs. Staff understood the importance of promoting independence and choice. People were able to personalise their room with their own furniture and personal items so that they were surrounded by things that were familiar to them. People had the right to refuse treatment or care and this information was recorded in their care plans.

People were encouraged to voice their concerns or complaints about the service and there were different ways for their voice to be heard. Suggestions, concerns and complaints were used as an opportunity to learn and improve the service people received.

People had access to activities that were important and relevant to them. People were protected from social isolation through systems the service had in place. There were a range of activities available within the home and the community.

People’s care and welfare was monitored regularly to ensure their needs were met. The provider had systems in place to regularly assess and monitor the quality of the care provided.

People told us the staff were friendly and management were always approachable. Staff were encouraged to contribute to the improvement of the home. Staff told us they would report any concerns to their manager and felt supported by the management.

Senior management liaised with and obtained guidance and best practice techniques from external agencies, professional bodies and experts in their fields.

People we spoke with said "Very happy here, we have no complaints at all" and "Staff are great" and "We get good choices and can do what we want to do". Observations during our inspection showed us that people were able to make their own decisions and choices.

We saw that people had consent forms in place and that people's care plans and risk assessments had been reviewed on a regular basis.

Staff training records that we looked at showed us that there were enough qualified and skilled staff to meet the needs of people that use the service. We saw that staff had attended mandatory training as well as brain injury training. We saw that staff had all of the required checks in place.

People were provided with a well-balanced and nutritious diet. People that we spoke with said that the food was great and that there were always plenty of choices.

We saw that the home managed complaints well and that there were detailed investigation and correspondence records in place. We also saw that the home had received a variety of compliments.

Records that we looked at, discussions with the manager and staff showed us that the home worked alongside professionals to ensure that the care and welfare of people that use the service were met.

We concluded that people were indeed supported in promoting their independence and community involvement.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We found that people who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We concluded that there were enough qualified, skilled and experienced staff to meet people's needs on the day of our inspection.

We found that people's complaints were fully investigated and resolved, where possible, to their satisfaction.