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We are carrying out checks at Woodside Care Home. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Inadequate

Updated 25 September 2018

Woodside Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide accommodation for up to 42 people, including older people and people living with dementia. There were 25 living in the home on the first day of our inspection.

We carried out a comprehensive inspection of the home in May 2015. At this inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (HCSA). This was because there were shortfalls in the monitoring of service delivery and people's legal rights under the Mental Capacity Act 2005 were not fully protected. We rated the service as Requires Improvement.

In November 2015 we carried out a focused, follow up inspection to check the registered provider had taken the actions necessary to address the breaches of regulations. We found both breaches had been addressed although the rating of the service remained as Requires Improvement.

In July 2016 we undertook a further comprehensive inspection. We found the progress noted at our November 2015 inspection had not been sustained. We found three breaches of the HSCA. This was because the registered provider was again failing to monitor the quality of service delivery effectively. We also identified concerns about the state of repair of the premises and shortfalls in infection prevention and control practice. The rating of the service remained as Requires Improvement.

In January 2017 we carried out a focused, follow up inspection to check the registered provider had taken the actions necessary to address the breaches of regulations. We found two of the three breaches had been addressed although the registered provider had still not taken sufficient action to address the shortfalls in organisational governance and improve the monitoring of service quality. The rating of the service remained as Requires Improvement.

In September 2017 we carried out a further comprehensive inspection. Again, we found the registered provider had not sustained the progress noted at our January 2017 inspection. We found two breaches of regulations. This was because the provider was still not monitoring the quality of service delivery effectively. We also found the provider was failing to assess and manage potential risks to people’s health and safety and there were shortfalls in the management of people’s medicines. The rating of the service remained as Requires Improvement. Following this inspection the registered provider wrote to us and advised us that action to address the two breaches of regulations would be taken by 31 March 2018.

On 13 and 19 June 2018 we carried out this further focused follow up inspection to check if the registered provider had taken the actions necessary to address the two breaches of regulations found at our September 2017 inspection. This report only covers our findings in relation to these issues. Our inspection was also scheduled in response to information shared with us by the local authority safeguarding and contracting teams. They had visited the home in late May and early June 2018 to investigate concerns primarily relating to the cleanliness of the home and infection control practices. Their investigation was ongoing at the time of our inspection.

At this inspection we were extremely disappointed to find that the quality of service, far from improving, had deteriorated and people were not receiving the safe, well-led service they were entitled to expect. The provider was in continuing breach of both breaches of regulations identified at our previous inspection. This was because of the provider’s ongoing failure to properly assess and mitigate risks to people’s safety and a persistent failure over several years to effectively assess, monitor and improve the quality of the service. We found one further breach of the HCSA. This was because of the provider’s failure to employ sufficient housekeeping and care staff to meet people’s needs and to ensure compliance with regulatory requirements. We also found two breaches of the Care Quality Commission (Registration) Regulations 2009. This was because of the provider’s failure to notify CQC of serious injuries; deaths; allegations of abuse and the outcome of Deprivation of Liberty Safeguards (DoLS) applications.

The overall rating for the home is 'Inadequate' and the home is therefore in 'Special Measures'.

We are currently taking action against the registered provider to ensure that they make the necessary improvements to become compliant with legal requirements. Full information about the CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

In other areas further improvement was also required. We found little evidence that the provider had a systematic approach to responding to significant incidents to reduce the risk of something similar happening in the future. Staff at all levels expressed their concerns at aspects of the registered provider's financial management of the home. There were very few links between the home and the local community.

More positively, since our last inspection we found the provider had taken action to improve the safety of staff recruitment. Staff told us they worked well together in a mutually supportive way. Staff knew how to recognise and report any concerns under local authority safeguarding procedures.

The home had a registered manager in post. A registered manager is a person who has registered with CQC to manage the service. Like registered providers (‘the provider’) 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.

The registered manager had an open, accessible style and was liked by his team. Throughout our inspection the registered manager maintained an open and non-defensive approach, despite the many issues of concern we identified. He also talked about his relationship with the provider with admirable candour.

Inspection areas

Safe

Inadequate

Updated 25 September 2018

The service was not safe.

There were numerous health and safety concerns with the premises and equipment.

Systems to prevent and control infection were ineffective and unsafe.

Some people's medicines were not managed safely.

There were insufficient sufficient housekeeping and care staff to meet people’s needs and to ensure compliance with regulatory requirements.

There were shortfalls in the provider's risk assessment and care planning systems.

Care practice was not consistently safe.

There was little evidence of organisational learning from significant incidents.

Staff were aware of adult safeguarding procedures

Staff recruitment was safe.

Effective

Requires improvement

Updated 5 December 2017

The service was not consistently effective.

Care had not always been provided in an organised way to ensure that people’s legal rights were reliably protected.

Although in practice care workers knew how to care for people in the right way, they had not received all of the training the registered persons considered to be necessary.

People enjoyed their meals and they had been helped to eat and drink enough.

People had been assisted to receive all the healthcare attention they needed.

Caring

Good

Updated 5 December 2017

The service was caring.

People received kind and compassionate care.

People’s right to privacy was respected and their dignity was promoted.

Arrangements had been made to enable people to be supported by lay advocates if necessary.

Confidential information was kept private.

Responsive

Good

Updated 5 December 2017

The service was responsive.

People had been consulted about the care they wanted to receive and had been given all of the assistance they needed.

Care staff promoted positive outcomes for people who lived with dementia.

People were supported to pursue their hobbies and interests.

Complaints had been properly investigated and quickly resolved.

Well-led

Inadequate

Updated 25 September 2018

The service was not well-led.

Systems to monitor and audit service provision remained ineffective.

The provider had failed to take effective action to address areas for improvement highlighted at previous inspections.

The provider had failed to notify CQC of serious injuries sustained by people living in the home and other notifiable issues.

There were few links between the home and the local community.

Staff at all levels expressed their concerns at aspects of the registered provider's financial management of the home.

The registered manager was well-liked by his team and displayed an admirably open and candid approach.

Staff enjoyed their job and worked together in a mutually supportive way.