We carried out a review of the data available to us about Woodlands Park Care Centre on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Woodlands Park Care Centre, you can give feedback on this service.
Woodlands Park Care Centre is a residential care home providing personal care to 26 people aged 65 and over at the time of the inspection. The service can support up to 35 people. The care home supports people living with dementia, mental health conditions, those with sensory impairments of physical disabilities.
The care home is set in rural Buckinghamshire and overlooks country fields. There is an extensive garden around the entire building. The care home accommodates people across two floors, each of which has separate adapted facilities. The ground floor has communal areas such as lounge areas, dining rooms and conservatories, as well as people’s bedrooms. The first floor has more people’s bedrooms.
The care home is part of the Forest Healthcare group.
People’s experience of using this service and what we found
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were protected from abuse, neglect and discrimination. Risk assessments were appropriately completed for both people's care risks and any arising from the premises. Incidents and accidents were correctly recorded, investigated and acted upon. There was good evidence that incident and accident trends and themes were detected and shared within the care home and the larger care home group. There is an ongoing staff recruitment drive, but all shifts are filled with regular (agency) workers. People’s needs were met with the number of staff deployed on each shift.
People had enough food and drinks provided to them. Staff were knowledgeable, skilled and experienced. They received a good level of training, support and had regular checks of their competency. There was some training in more current topics such as sepsis. The care home was nicely decorated for the people who lived there. It was equipped to be dementia friendly, promote reminiscence and had tactile, visual and sensory experiences throughout. The service was compliant with the requirements set for gaining consent and restricting people’s liberty. People's preferences, likes and dislikes were recorded and respected. We made a recommendation about community healthcare professionals’ record-keeping.
Staff were caring and kind with people they supported. Relatives provided positive feedback when asked about care at the home. People were asked for their opinions, but some could not communicate to us their feedback. For those that could express their comments, they told us they liked living at the home, they liked the food and they "loved" the care staff. People's dignity and privacy was respected. People's independence, as far as possible, was maintained and promoted.
Care plans were very person-centred. There was good evidence of people's life history and their stories. There was a very active social life and a passionate and energetic activities coordinator who liked to explore new ideas and provide people with social inclusion. This ensured that they had a good lifestyle, even where they did not leave the premises. There was an appropriate complaints mechanism in place. The service checked for people's end of life preferences and ensured that they had a dignified and pain-free death.
There was a positive workplace culture. Staff were satisfied and happy, smiling and working hard to ensure people received good support. The registered managers and team leader were knowledgeable, experienced and took their responsibilities seriously. The service demonstrated transparency when things went wrong. There was a good governance and audit system in place, and an action plan was used to capture and mitigate risks and work through improvements. There was good evidence of partnership working. People, relatives, health or social care professionals and staff were involved in and had a say in how the service was operated and led.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 13 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
However, the inspection was prompted, in part, due to concerns received about people’s night time care, provision of adequate food and people’s access to drinks or fluids. A decision was made for us to conduct the inspection as originally scheduled, but to further examine those risks.
We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe and Effective sections of this full report for further details.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
At the time of our inspection the registered manager had been absent from the service. The service was being managed by the deputy manager with support from the regional manager. The provider notified us of the registered managers absence.
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.
Our previous inspection carried out in December 2015 found several breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we checked whether the service had achieved compliance with the associated regulations. Following our findings the provider submitted an action plan to ensure improvements were made. We found that improvements had been made at the service.
People were protected against abuse and neglect. Staff we spoke with told us they had completed training in safeguarding and would not hesitate to report any concerns. However, we continued to have some concerns in relation to the gate at the top of the main staircase. Our previous inspection identified this risk and we asked the provider to review the risks in this area. The provider has done this although we would like them to continue to assess the potential risk on an ongoing basis.
Risk assessments were in place for people living at the home. For example, people who were identified at risk of falling down the stairs. Risks were taken into account and risk assessments were in place to protect people. On two occasions we saw that the gate was left open at the top of the stairs. We pointed this out to the deputy manager, who said they would address this with the maintenance staff. The risk assessments we saw informed staff to monitor and assist when people used the stairs.
Medicines were not always administered in line with policy and procedure however; this had been picked up by the audit procedures that the home had in place. Where there were missing signatures on the Medicine administration record (MAR) sheets these were in the process of being investigated. Where there were no printed MAR charts, hand written charts were completed. The home was meeting with the pharmacy to discuss how this practice could be minimised.
We found staffing levels in the home to be appropriate to the needs of people living in the home. The service used agency staff to maintain safe staffing levels. Records showed that agency staff had received a thorough induction on the first day they worked at the service.
The environment was cleaned to a high standard and was tailored for people living with dementia. For example, ‘old-time’ memorabilia and items of interest such as old-fashioned sewing machines.
The home had a ‘daily sparkle’. This was printed information for people to read that had stories about famous film stars from the past that encouraged conversations with people.
Relatives told us how happy they were with the quality of the service and that staff were kind and considerate. One relative told us, “This has been the happiest four years of my life. I can appreciate the care the staff give to my relative.”
Staff received supervision and told us they felt supported. However, the frequency was not in line with the company policy which stated six sessions per year.
People’s social needs were being met. There was an activity coordinator who provided social activities for people who wanted to take part. At the time of our inspection there were outside entertainers playing music and singing to people.
Quality audits systems were in place to assess and monitor the service.
We have made a recommendation in relation to the potential risks associated with people using the staircase.
The inspection took place on 26 27 November and 7 December 2015.
These were unannounced visits The previous inspection took place on 9 May 2013 when the service was found to be compliant.
Woodlands Park Care Centre provides care and accommodation for up to 35 older people who have dementia. At the time of our inspection 26 people were living in the home.
The service had a registered manager. 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.
Woodlands Park had been without the registered manager for several weeks at the time of our visit and was managed by the senior care staff with support from regional managers. The registered manager was on leave at the time of our visit.
There were several staff vacancies at the time of our inspection. Agency staff were being used to maintain safe staffing levels. We received mixed feedback from staff and relatives. Staff reported that there was insufficient competent staff to ensure people were cared for to appropriate standards. Relatives we spoke with praised the staff and could not fault the care. One relative whose family member had passed away during our visit told us: “I was so relieved when I found this place; the staff are wonderful and work so hard”.
The environment was clean and specifically tailored for people with dementia, for example, memorabilia around the home and sensory and tactile items such as rummage bags and textured fabrics.
People were not given care and support that was responsive to their needs and this placed them at risk.
Complaints were not listened to or acted on and this led to a failure to use this information to improve the quality of care received.
We identified areas of concern in relation to records, medicine practice, supporting staff, safety of premises, meeting people’s identified needs and poor standards of care in relation to end of life care.
Health and safety audits did not identify safety risks, for example the safety gate at the top of the stairs was left open and people who were mobile were at risk of falling down the stairs.
During the first day of our visit there were only five staff on duty and four of them were agency staff.
People were not always supported by staff who received appropriate induction, training and supervision. The agency staff that were on duty at the time of our inspection had not had an induction. One of the staff members had not worked in the home before, and another one had only worked the previous day at the service.
People’s social needs were not being met. The activity organiser told us that due to staffing issues, they worked as a member of the care team and were not able to focus on activities. We did not observe activities during our visit apart from a birthday celebration for a small group of people.
We could find no evidence of effective quality assurance systems in place to assess and monitor the service.
We recommend that further measures are put in place at the service to increase the staffs knowledge of action to take in relation to abuse being suspected.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
People's needs had been assessed before a placement at the home had begun and included risk assessments. This ensured their needs could be met appropriately.
Care plans addressed people's individual needs, were detailed, reviewed and updated regularly. People had access to healthcare professionals and specialist support to ensure they kept healthy and well. The care and support was planned and delivered in line with their care plan.
We found people were treated with dignity and respect. We observed people in the dining room during lunch time. We saw staff offered people choice of food and people were not rushed and enabled to eat their lunch at their own pace.
Daily activities were provided to ensure people's social care needs were met.
The home was comfortable, clean and warm and was in the process of being redecorated. Each person had their own bedroom which they had personalised to their own taste.