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Archived: Woodcote Grove Residential Care Home Requires improvement

Reports


Inspection carried out on 19 October 2017

During a routine inspection

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 carried out on 15 December 2014

During a routine inspection

We visited the service on 15 December 2014 and the inspection was unannounced.

At the last inspection on 10 September 2013 we found the service was meeting the regulations we looked at.

Woodcote Grove is a care home that provides accommodation, nursing and personal care for up to 32 older people. There were 29 older people residing at Woodcote Grove when we visited. Half the people using the service were living with dementia and 13 people had nursing needs. Some people also had end of life care needs.

Accommodation is arranged over several floors and includes 32 single occupancy bedrooms all with en-suite toilets and wash hand basins. Communal areas include an assisted bathroom, a wet room, two showers, two main lounges, a dining room, and three pantries/kitchens for people who live at Woodcote Grove and their visitors to use, a chapel and a guest room with its own bathroom and kitchen.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (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.

We have made a recommendation about the opportunities people using the service have to participate in meaningful leisure and recreational activities that reflect their social interests. 

People were safe living at Woodcote Grove. Staff knew how to protect people if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing had been assessed and staff knew how to minimise and manage these to keep people safe from harm or injury.

Staff were properly trained to meet people’s needs. People told us, and we saw, that staff had built up good working relationships with people using the service and were familiar with their individual needs and preferences.

People received their medicines as prescribed and staff knew how to manage medicines safely.

People told us they were happy living at Woodcote Grove and staff who worked there were kind and caring. Our observations and discussions with relatives during our inspection supported this. For example, we saw staff treated people with dignity, respect and compassion.

Staff supported people to keep healthy and well through regular monitoring of their general health and wellbeing. Staff also ensured health and social care professionals were involved when people became unwell or required additional support from external services.

People had a choice of meals, snacks and drinks and staff supported people to stay hydrated and to eat well.

People told us Woodcote Grove was a comfortable place to live. We saw the environment was well maintained. People could access all areas of their home and move around it independently.

Each individual was involved in making decisions about their care and had personalised care plans that they had helped create. People had agreed to the level of support they needed and how they wished to be supported. Staff supported people to make choices. Where people's needs changed, the provider responded and reviewed the care provided.

We saw staff encouraged and supported people to be as independent as they could and wanted to be.

When people were nearing the end of their life they received compassionate and supportive care.

People were encouraged to maintain relationships that were important to them. There were no restrictions on when people could visit the home and staff made visitors feel welcome.

The service had a clear management structure and people who lived there, relatives and staff felt comfortable about sharing their views and talking with the manager and staff about any concerns or ideas to improve the service they might have. We observed an open and inclusive atmosphere in the service and the manager led by example. The manager demonstrated a good understanding of their role and responsibilities, and staff told us the managers were competent, supportive and fair.

There were effective systems in place to monitor the safety and quality of the service provided at Woodcote Grove. The provider regularly sought people’s views about how the care and support they received could be improved. Where improvements were needed, action was taken.

The registered manager understood when a Deprivation of Liberty Safeguards (DoLS) application should be made and how to submit one. This helped to ensure people were safeguarded as required by the legislation. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.

Inspection carried out on 18 December 2013

During an inspection to make sure that the improvements required had been made

We reviewed several records, spoke with maintenance staff and management. We also inspected the communal areas and exits. We found that people who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. There were systems in place to ensure that in the event of an emergency such as fire, people would be able to evacuate the building quickly and safely.

There were low levels of asbestos in some parts of the building. We found that since our last visit, systems had been put in place to ensure people were protected from the risks associated with asbestos. Regular checks were conducted and there were systems in place to minimise the risks to people who use the service, posed by Legionella.

Inspection carried out on 10 September 2013

During a routine inspection

We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

We reviewed five care files and saw evidence that people’s needs were assessed before care was delivered. We saw that care and treatment was delivered in line with people's individual care plan. People we spoke with were very complimentary about the staff and the care delivered. The comments we received included, “the carers are always very kind and helpful." “The staff are good, some of them are exceptional." “The staff are attentive and show a great deal of compassion."

We found that people were protected from the risks of inadequate nutrition and dehydration. One person told us, “the food is very good here." A relative told us, “her food intake has improved since she's been here." We saw that appropriate checks were conducted before staff began work.

However, we were concerned that people who use the service, staff and visitors were not protected against the risks of unsafe premises because the provider was not adequately maintained the premises. People were not adequately protected against the risk of Legionella and the risks associated with asbestos. We found that in the event of an emergency such as fire, people would not be able to evacuate the building as quickly and safely as possible.

Inspection carried out on 3 October 2012

During a routine inspection

We spoke to six people who currently use the service. They told us staff looked after them well and there were enough staff to care for them. People we spoke with said staff respected their independence and privacy. One person told us “The staff always do their best and are very accommodating.” Everyone spoke positively about the staff. People were observed to be treated with respect by staff and to have their privacy and dignity respected.

Inspection carried out on 6 September 2011

During a routine inspection

Comments from people using the service were generally positive, indicating that staff are kind and helpful in meeting their care needs. People were observed to be treated with respect by staff and to have their privacy and dignity respected. We spoke to visiting relatives and they were pleased with the care given and were kept well informed and involved in the care of their family members.

Reports under our old system of regulation (including those from before CQC was created)