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Archived: Woodcote Grove Residential Care Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 7 December 2017

This inspection took place on 19 and 23 October 2017 and was unannounced.

At our last inspection of 15 December 2014, we found that people did not have enough opportunities to take part in activities of their choice and we made a recommendation about this. We carried out this inspection on 19 and 23 October 2017 and found that the registered manager and provider had taken sufficient action to address this. However, we found the service was in breach of regulations of the Health and Social Care Act 2008 (Regulated Activities) 2014 relating to providing safe care and treatment, person centred care, staffing and good governance and a registration regulation about notifications.

Woodcote Grove Residential Home provides accommodation, personal and nursing care for up to 32 older people and those living with dementia. At the time of our inspection, 27 people were using the service.

People's accommodation was over several floors and included 32 single occupancy bedrooms all with en-suite toilets and hand basins. People had access to communal areas that included two lounges and a dining room. There was a kitchenette on each floor and a main kitchen that was used by a company contracted to prepare meals for people living at the service. People had access to a hairdressing salon on site and a guest room was available for the use of family and friends.

The service had 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 were at risk of receiving unsafe care and treatment. The provider had not ensured staff had the competency to support people in the event of a fire. Staff were not fully supported in their roles and did not receive a regular appraisal of their performance. The provider did not provide staff with an opportunity to identify learning and development needs to improve their practice. Information and records about people were not securely stored at the service and their storage posed a risk of unauthorised access.

The quality of the service was regularly audited and action plans were put in place to make the necessary improvements. However, the provider and registered manager did not act in a timely manner to address shortfalls identified. Audit reports repeatedly identified some of the shortfalls. The registered manager investigated and resolved complaints. However, people using the service and their relatives continued to raise concerns about some aspects of the service. The registered manager did not always submit notifications as required by law.

People received support from staff who understood how to identify and report potential abuse. Risk assessments of people’s health and well-being enabled the registered manager to provide guidance to staff about how to deliver safe and appropriate care. Staff followed guidance to manage identified risks to people’s health and well-being while they respected their freedom. People were supported safely by a sufficient number of staff who had undergone appropriate recruitment checks.

People received support to take their prescribed medicines. Staff competently administered and managed people’s medicines.

People had their care and support delivered by trained and skilled staff. Staff received regular training and refresher courses, which equipped them with the knowledge and skills to undertake their roles effectively. The registered manager undertook supervisions and reflective sessions with staff to develop their practice.

People were supported by staff who understood and followed the requirements of the Mental Capacity Act (MCA) 2005. Staff obtained people’s consent before providing care and support.

Staff delivered people’s care with kindness and comp

Inspection areas

Safe

Requires improvement

Updated 7 December 2017

The service was not always safe. People did not have adequate protection in the event of a fire. The registered manager did not ensure that staff carried out fire drills to understand how to support people to evacuate safely.

Medicines were not securely stored at the service. People received their prescribed medicines safely. Staff were trained and assessed as competent to manage people’s medicines.

People were concerned about the regular change of staff who provided their care. The provider ensured there were sufficient numbers of staff deployed to meet people’s needs.

People were safe from the risk of harm. Staff knew how to identify abuse and the safeguarding procedures to follow to keep people safe.

Risk assessments identified concerns about people’s health and well-being. Staff followed the guidance in place and managed the known risks to people’s health appropriately.

Effective

Requires improvement

Updated 7 December 2017

The service was not always effective. People received care from staff who did not receive full support to carry out their roles. Although staff received training and supervision to develop their skills and knowledge, the registered manager did not undertake an appraisal of their performance.

People had support and care provided in line with the requirements of the Mental Capacity (MCA) Act 2005 and Deprivation of Liberty Safeguard (DoLS).

People received sufficient food and drink in line with their preferences, nutritional and hydration needs. Staff supported people to maintain their well-being and to access healthcare services when needed.

Caring

Requires improvement

Updated 7 December 2017

The service was caring. People were not always involved in planning their care and support. People using the service and their relatives told us staff were compassionate and caring. People received care that maintained their privacy and dignity.

People at the end of their lives were comfortable and staff respected their wishes about care delivery.

Responsive

Requires improvement

Updated 7 December 2017

The service was not always responsive. Staff did not consistently carry out reviews and updating of people’s care and support plans.

People had an assessment of their needs before they started to use the service. The registered manager used this information to develop care plans.

People took part in a variety of activities at the service but had limited choices of going out into the community.

People using the service and their relatives had opportunities to share their views about the quality of care and knew how to make a complaint. The registered manager investigated and resolved complaints.

Well-led

Requires improvement

Updated 7 December 2017

The service was not always well-led. The registered manager did not submit notifications as required by law. The provider and registered manager did not use the quality assurances systems effectively to improve the standard of care.

The quality of care provided was not consistent and varied between members of staff. Whilst the provider addressed complaints about the service, staff did not learn from the incidents which arose repeatedly.

People using the service, their relatives and staff found the registered manager approachable but not always available to discuss their welfare.

People’s information and records were not kept confidentially at the service. Information about people was kept on two separate services, which increased the risk of unauthorised access to the records.

The provider had strengthened the leadership and management of the service and had a plan of action to improve the quality of care.