The Woodlarks Centre

We found the following examples of good practice.

People were supported to host visitors in a COVID-19 secure pod in the garden. Visiting arrangements to the service were discussed with people who took part in making decisions for the service. People were supported to participate in a range of in-house activities meeting their interests. We observed staff knew people well and reassured them around COVID-19. People told us this support minimised the impact the pandemic had on their wellbeing. People were also supported to maintain contact with the local community, for example via a pen pal club with one of the local schools.

The management team ensured staff, people and visitors to the service had ongoing access to COVID-19 testing. The management outsourced a mobile COVID-19 testing unit and hosted the army on their premises, supporting the national testing program and other services to access drive-through testing for COVID-19. Staff confirmed they had ongoing access to testing and were aware of how to recognise COVID-19 symptoms and how and when to self-isolate.

The management team reviewed the home environment and made a range of changes to enable effective self-isolation in people’s rooms, easy access to personal protective equipment, handwashing facilities and sanitising products for staff and visitors. For example, hand sanitising rub dispensers were placed outside each person’s room and PPE storage cupboards or sanitising wipes were available in key points of the service. Signage around effective IPC was visible throughout the home, with hand sanitisers available in communal areas for people to use.

The home was clean and hygienic. We saw specialist equipment was used to filter the air and for disinfection of the service and people’s rooms were deep cleaned regularly. We saw staff undertook cleaning on the day of our inspection.

People’s experience of using this service:

Risks to people were appropriately recorded and managed, and staff were aware of their role in safeguarding people from abuse. People and their relatives told us they felt safe, and there were enough staff to meet people’s needs. Accidents and incidents were recorded and analysed for trends.

People’s rights were protected in line with the principles of the Mental Capacity Act 2005. Although some people had lived at the service for a long time, the premises was designed to meet the needs of the people who lived there. Staff had the knowledge and training to deliver their role effectively, and ensured people maintained their hydration and nutrition throughout the day.

People and relatives told us staff were kind and caring. People were involved in reviews around their care, and were promoted to be independent where possible by completing tasks. Staff respected people’s privacy and dignity.

People’s care plans were person centred, and their rooms personalised and decorated to their own taste. There were a wide range of activities available to people, who were encouraged and supported to take part in college courses and employment opportunities. People’s end of life wishes were recorded if they were happy to talk about this topic.

People, relatives and staff felt the management team were approachable and were asked for feedback in order to improve the quality of the service. Regular audits took place to identify issues to be resolved which the service took a proactive approach to. The registered manager had already made changes and had more plans in place to improve the service.

Rating at last inspection:

At the last inspection the service was rated Good. The inspection report was published on 5 July 2016.

Why we inspected:

This was a scheduled comprehensive inspection. We inspect all services rated as 'Good' within 30 months to ensure that we regularly monitor and review the quality and safety of the service people receive.

People had varied communication needs and abilities. Some people were able to express themselves verbally; others used body language, gesturing, vocalisations or a few key words to communicate their needs.

The service was run by a registered manager, who was present on the day of the inspection visit. ‘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 and associated Regulations about how the service is run.

Risks to people were identified, but staff did not always have written information about how to manage the risks to people, although no harm came to anyone. We recommend that the registered manager to review people’s risk assessments in line with current guidance to ensure that there is a clear management plan in place.

People’s needs and preferences were not always recorded in people’s care plans. Care plans were not always personalised. We recommend that the registered manager reviews peoples care plans in line with current guidance to ensure that they are more personalised.

There were sufficient staff to keep people safe. There were recruitment practises in place to ensure that staff were safe to work with people. However some employment records had gaps in people’s employment history.

People were protected from avoidable harm. Staff received training in safeguarding adults and were able to demonstrate that they knew the procedures to follow should they have any concerns.

People’s medicines were administered stored and disposed of safely. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

People’s human rights were protected as the registered manager ensured that the requirements of the Mental Capacity Act 2005 were followed. Where people were assessed to lack capacity to make some decisions, mental capacity assessment and best interest meetings were evidenced. Staff were heard to ask peoples consent before they provided care.

Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

People had sufficient to eat and drink. People were seen to be offered choice of what they would like to eat and drink.

People were supported to maintain their health and well-being. People had regular access to health and social care professionals.

Staff were trained and had sufficient skills and knowledge to support people effectively. There was a training programme in place and training to meet people’s needs. Staff received regular supervision.

Positive and caring relationships had been established. Staff interacted with people in a kind and caring manner.

People and their relatives were involved in planning peoples care. People’s choices and views were respected by staff. People’s privacy and dignity was respected.

People enjoyed the activities on offer.

The service listened to people, staff and relative’s views. The management welcomed feedback from people and acted upon this if necessary. The management promoted an open and person centred culture.

Staff told us they felt supported by the registered manager. Relatives told us they felt that the management was approachable and responsive.

There were robust procedures in place to monitor, evaluate and improve the quality of care provided. Staff were motivated and aware of their responsibilities. The registered manager understood the requirements of CQC and sent appropriate notifications.

We spoke with two members of staff and one person who used the service who told us that their new en suite wet room had “Made a difference” to them.

We found that the provider had responded to most of the issues raised during the assessor’s visit. We noted that maintenance checks had been carried out and that the premises were fit for purpose.

We found that staff were trained and alert to the possibility of abuse. People told us that they felt safe at Woodlarks and trusted the staff to protect them. One person said, “Not just in Woodlarks. We go out quite a lot to our different activities and the staff always look after us then too”.

We saw that resident’s bedrooms had undergone a substantial upgrade. People were positive about the changes. We found the property was suitable in design and layout for the purpose to which it was being put and was safely maintained.

We found that the service had an effective staff selection process in place and that staff were trained and supported in their roles. One member of staff told us, “I found the interview quite difficult, but when you meet the manager they are so passionate about Woodlarks that you want to be part of the team”.

People and staff confirmed that their feedback was sought regarding care and support provided by the service. We found that the provider had processes in place to assess this information and act on it to make improvements.

We found that an effective and accessible complaints system was in place and that staff were happy to support people to make complaints if they wished to.

On the day of the site visit there were seventeen people in residence. The regulated activity, Accommodation for persons who require nursing or personal care was inspected on this site visit. No nursing care was offered at this service.

People told us staff consulted with them, and they signed their care plans. We saw in the three care files we reviewed that people who used the service signed their reviews, supported by people who attended the reviews.

We found that the service sought people’s consent prior to providing them with care and support. The registered manager said, “The majority of the people who use the service have capacity to make decisions and to sign their care plans. People who use the service whom we have assessed as lacking capacity, we hold best interest meeting to gain permission from the next of kin".

We saw systems in place that ensured medicines were administered safely. We found complaints and their outcomes were documented.

People told us they were able to eat and drink adequate amounts of food and fluid to meet their needs. One person said, “I have choices in the food and drink I receive and I can have what I like”.

We saw that the provider had not undertaken the relevant checks on staff prior to commencement of employment