The Woodlands Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question inadequate. At this assessment the rating has remained inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes. The provider was in breach of the legal regulation in relation to person centred care.

This service scored 38 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them. Assessments were not reliable, and care planning records did not consistently provide a clear, accurate or up-to-date picture of people’s needs. Care records contained widespread contradictions across different areas of care. For some people, documentation gave conflicting information about needs relating to mobility, personal care, continence, nutrition, communication and medicines. There was no single, clear assessment of need for staff to follow. Assessments were not always updated to reflect current needs or risks. Where people had experienced changes in health, repeated incidents or deterioration, care plans had not always been reviewed or updated. Review processes were not effective in keeping assessments accurate or up to date. Records contained duplicated information, inconsistent wording and, in some cases, inappropriate or incorrect language. Some care plans were not dated, so it was not possible to determine when assessments had been completed or last reviewed. Staff described care planning systems more positively. For example, staff told us, “Care plans and risk assessments are detailed and helpful,” and “Care plans are updated regularly.” However, this was not reflected in the records we reviewed, which lacked consistency, clarity and evidence of regular, meaningful review.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Care and treatment were not always delivered in line with people’s current risks, clinical needs or recognised good practice. Care planning documentation was often generic and relied on template-based wording rather than clear, person-centred guidance. Falls prevention and mobility support were not consistently managed in response to known risks. Although actions were recorded following incidents, there was no assurance that these had been implemented. Communication systems did not ensure staff had clear, accurate or up-to-date information to support safe care. There was a risk that care was provided based on incomplete, inconsistent or outdated information. This meant care was not always adjusted in response to changing risk or delivered in line with best practice.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. Although handovers and verbal updates took place, care records staff relied on were not consistently accurate or reliable. This limited the effectiveness of handovers, and staff could not always depend on care plans to guide decision-making. Staff described communication processes more positively. For example, staff told us, “We get updates during handover and from the manager if there are any changes,” and “The manager and care staff keep me informed about any changes in residents’ needs.” Staff also said, “Care plans and risk assessments are updated, and we have time to read them,” and “Care plans are developed and updated with involvement from the whole team.” However, this was not reflected in practice.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. Care records did not always provide clear guidance about nutrition, hydration, long-term conditions or how staff should support people to maintain their health. For example, records relating to diabetes did not clearly describe dietary support, monitoring arrangements or when concerns should be escalated. Staff did not always have practical guidance to support people safely. Nutritional support was not always delivered effectively. We observed some people were served meals and desserts at the same time, and staff did not always explain what food was being provided. We observed one person who was visually impaired using their hands to guide food onto cutlery without adaptive equipment in place. There was no clear evidence of assessment or provision of appropriate aids to support safe eating. There was limited evidence that changes in people’s health led to timely review or improved support, which meant opportunities to promote health and wellbeing were not consistently identified or acted on. Some relatives gave positive feedback about outcomes for people. One relative told us,“[Name] is really happy there. They have thrived there. They have become so much healthier.”Another relative said,“They have gotten [Name] eating since they moved in which was difficult to do before.”Staff described supporting people’s nutritional needs, with one staff member stating,“I support residents by ensuring their meals meet their individual needs, preferences, and dietary requirements,”and“I take feedback about the food, and they usually give very positive feedback.”

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. Systems to ensure consent to care and treatment were obtained and managed in line with the law were not effective. Records relating to mental capacity, consent and decision-making were not consistently clear, up to date or compliant with the Mental Capacity Act 2005. There was limited evidence that mental capacity assessments were reviewed or updated to reflect people’s changing needs. Records relating to consent for specific decisions were not always supported by appropriate capacity assessments or best-interest decision-making processes. For example, consent for CCTV monitoring had been signed by a relative, but there was no evidence that a capacity assessment had been completed for this decision or that a best-interest process had been followed. The consent policy did not include reference to best-interest decision-making, and staff did not have clear or accurate guidance to follow in practice.