Woodlands Care Centre

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 good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 54 (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 always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. Pre-admission assessments were completed; however, the provider acknowledged that, historically, these processes had not always been sufficiently robust, resulting in some people being admitted whose needs could not be fully met by the service. The provider had recognised this risk and was implementing measures to strengthen assessment and admission processes. However, this work was still ongoing at the time of our inspection, and it was therefore too early to assess its effectiveness. In addition, assessments and care plans were not always reviewed regularly. This meant changes in people’s health, wellbeing and support needs were not always identified promptly, increasing the risk that care and treatment did not reflect their current needs and preferences.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Care records did not always provide staff with the information and guidance needed to deliver safe and effective care. People did not always receive care and support in line with recognised good practice. Care plans for long-term health conditions did not consistently provide staff with sufficient guidance on monitoring people's health, recognising deterioration or responding appropriately to changes in their condition. For example, 1 person did not have an epilepsy care plan in place, meaning staff lacked clear guidance on how to support them and respond to known risks. Assessment tools contained errors and we found contradictory information within records, including differing accounts of a person's diabetes diagnosis. As a result, people's care and treatment were not always planned and delivered in a way that reflected recognised best practice and their assessed needs. We raised our findings with the provider, and they included this within their improvement plan.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. People had access to a range of healthcare professionals including GPs, chiropodists, opticians and specialist services. People were also supported to attend hospital appointments. Staff were able to describe how they worked alongside external professionals to support people's health and wellbeing. Feedback indicated staff generally worked positively with external professionals to support people's ongoing health and care needs.

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. People were not always supported to maintain adequate nutrition and hydration. One relative told us, “I’ve noticed residents not drinking and staff are not encouraging them. I chop up [relative]’s food and hope staff do too. I’ve noticed other residents not being helped or encouraged to eat.” Although some relatives gave positive feedback about support with eating and drinking, we found people at risk of dehydration did not always have clear fluid intake targets or escalation plans in place. Whilst people were supported to access healthcare professionals, records of discussions, assessments and decisions were not always accurate or complete. This reduced assurance that changes in people's needs were consistently recognised, communicated and acted upon. We raised our findings with the provider, and they included this within their improvement plan.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. Clinical risk meetings were taking place, and the provider had recently implemented an enhanced clinical risk tracker to improve oversight of key risks across the service. However, these systems were not yet fully embedded, and there was limited assurance that identified risks resulted in timely action or that relevant information was consistently communicated to staff. Communication and handover processes did not always support effective continuity of care. People were not always supported to manage their health conditions effectively. Staff did not always follow guidance within care plans and risk assessments, and records relating to wound care, skin integrity and long-term health conditions were not consistently monitored or reviewed. As a result, the provider could not always demonstrate effective monitoring of people's health or show how care and treatment outcomes were being improved.

The provider did not always ensure people’s rights in relation to consent were understood, promoted and respected when care and treatment were delivered. Systems and records did not always provide assurance that decisions were made in line with relevant legislation and guidance. Staff knowledge of the Mental Capacity Act (MCA) was variable, and some staff were unable to demonstrate a detailed understanding of its principles or how these should be applied in practice. Records were not always clear about whether relatives held the appropriate legal authority to make decisions or sign consent documentation on a person’s behalf, which meant the provider could not always demonstrate decisions were being made appropriately. However, feedback from people and relatives indicated staff generally sought consent before providing care. One relative told us, “They [staff] do ask for consent. [Relative] may say ‘I don’t want it done.’ They wanted [relative] to have a shower. It took them half an hour. They didn’t force [relative] and are very nice.” Staff also described how they routinely explained care and support to people and sought agreement before providing assistance.