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Woodlands Ridge Nursing Home Good


Inspection carried out on 10 January 2018

During a routine inspection

Woodlands Ridge Nursing Home is a ‘care home’. People in care homes receive accommodation, nursing and/or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home provides accommodation, nursing and personal care for up to 24 older people some of whom were living with physical health needs. At the time of our inspection there were 15 people living at the home. The accommodation is split over two floors with a staircase and lift to the first floor bedrooms and bathrooms. There is a large lounge and separate dining room on the ground floor. The home was undergoing a planned refurbishment and re-decoration. There are extensive, private grounds providing outdoor seating and eating areas for people to use.

At our inspection in September 2016 we found the provider was in breach of Regulation 9; person centred care. The provider had not always ensured people were supported in a way that met their individual needs and wishes. We asked the provider to tell us how they were going to make the improvements required. We received their action plan outlining the actions they intended to take. These actions have now been completed and the Regulation has been met.

The inspection was unannounced and was carried out on 10 January 2018 by a lead inspector, a bank inspector and an expert by experience. An expert by experience is someone who has experience of using, or caring for someone who uses this type of service. The lead inspector returned on 12 January 2018 to complete the inspection.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

Sufficient staff were deployed to keep people safe and meet their needs. Recruitment procedures were safe and ensured only suitable staff were employed.

People were protected from abuse. Staff had received safeguarding training, knew how to identify abuse and how to report any concerns. People, their relatives, staff and healthcare professionals told us they thought people were safe.

People’s medicines were managed safely and people received their medicines from staff who were regularly checked for their competency to do so.

Risks relating to people’s health and welfare had been identified and assessed and action had been taken to reduce these. Environmental risks were assessed and maintenance issues were attended to promptly. Emergency plans were in place to deal with unforeseen events such as fire or flood. Plans to manage emergency evacuations were displayed and understood by staff.

People’s rights were protected because staff understood and followed the Mental Capacity Act 2005. Deprivation of liberty safeguards had been submitted to the local authority for authorisation when required.

Staff received regular training, supervision and appraisal which included observed practice. This ensured they had the skills and competencies necessary to support people effectively.

People had a choice of nutritious food and drink that met their specific dietary needs and preferences. Staff provided assistance to people to eat in a calm and unhurried manner.

People were supported to maintain their health and well-being and had access to a range of health care services, such as GPs, opticians and chiropodists, when required.

Staff knew people and their relatives well. People were encouraged to maintain family relationships and visitors were made welcome at any time. Staff were kind and caring and treated people with dignity and respect.

Care plans included details of people’s life histories and personal preferences about how they would like to receive their care. Peopl

Inspection carried out on 15 September 2016

During a routine inspection

This service was inspected on 15 and 19 September 2016. The inspection was unannounced.

Woodlands Ridge Nursing Home is registered to provide accommodation and nursing care for up to 24 people. The home is set in wooded grounds on the edge of the New Forest and has accommodation on two floors, the upper floor being accessed by stairs or passenger lift. The home has a large light and airy lounge, a large dining room and pretty gardens. At the time of our inspection 20 people were living at Woodlands Ridge.

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’s needs were assessed before they moved in to the home. Care plans were written in a person centred way although some staff practices were generic, leading to care delivery that was not always person centred.

People said they felt safe. Staff received training in keeping people safe and told us they knew what to do if they had any concerns, including reporting these to outside agencies.

There were sufficient staff deployed to meet people's needs. New staff received an induction which included shadowing other staff which gave them time to get to know people they supported. On-going training was provided and staff were well supported through supervisions and appraisals.

Staff had a good understanding of people's health care needs. They sought and followed advice where necessary from health care professionals so people could maintain their health and wellbeing. Risk to people's health and welfare were regularly assessed and recorded and reviewed regularly.

People were offered a choice of food and drink and were assisted to eat and drink by staff where required. Specialist advice was sought where people had difficulties eating and drinking.

People were protected because staff were aware of and followed the principles of the Mental Capacity Act ((MCA) 2005. Consent was sought from people before care and support was given, although this was sometimes rushed. Where people did not have capacity to make their own decisions, these were made in their best interests.

People were supported to take part in activities they enjoyed. People and their relatives were encouraged to give their views and be involved in developing the service.

Quality assurance processes were in place to help to ensure the care and support provided remained of a good standard and that it met regulations.

We last inspected this home in July 2014 when we found one breach of regulation.

At this inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Inspection carried out on 16 July 2014

During an inspection in response to concerns

We inspected Woodlands Ridge Nursing Home to check that the provider had met the standards required and to check staffing levels following a recent concern we had received. The manager was in the process of applying to register with the Care Quality Commission but was on annual leave at the time of our inspection. However, we spoke with four members of staff, including the new deputy manager (who was also the registered nurse on duty) and quality services manager. We gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking to people who use the service, the staff supporting them and looking at records.

Is the service safe?

We found the service to be safe. People we spoke with told us that they felt safe. Safeguarding procedures were robust and staff understood how to safeguard people they supported.

People told us that they were treated well by staff and that they felt listened to and their wishes respected.

Risk assessments had been completed to guide staff in managing and minimising risks to people.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Relevant policies and procedures were in place and staff were knowledgeable about DoLs. Applications for DoLs had been made when required.

Is the service effective?

We found the service to be effective. People�s health care needs were assessed with them, and they were involved in writing their care plans. Specialist input, such as occupational health, was provided to support the planning and delivery of people�s care.

People�s care plans were developed in line with people�s assessed needs and were updated most of the time to reflect their changing needs. The service involved other health professionals in people�s care when required.

Is the service caring?

We found the service to be caring. We spoke with two people being supported by the service and one relative and asked their opinions about the staff who supported them. Feedback was positive. One person told us that staff �Are very caring� and another said �I�m quite impressed.�

We observed staff speaking to people with kindness and respect. It was clear that staff knew people well and responded to them positively when supporting them. We also observed staff providing re-assurance to people when in pain in a compassionate and sensitive way.

Is the service responsive?

We found the service to be responsive. The service worked well with other agencies and services, such as care management and GPs, to ensure that people received appropriate care and support.

We saw that when people�s needs changed, the service responded in a timely way and communicated this to staff and other agencies on a need to know basis.

People knew how to make a complaint if they were unhappy. The deputy manager was unable to locate the complaints file so we were unable to check how complaints were responded to.

Is the service well led?

We found the service was not always well led. The service had a quality assurance system but audits were not completed in line the frequency documented by the provider. Records showed that any identified issues, or opportunities for improvement were not always addressed promptly and actions were not always followed through. For example, the updating of people�s care plans and risk assessments identified during clinical audits had not always been completed.

Staff meetings took place which enabled staff to discuss and plan improvements within the service. Staff told us they were clear about their roles. They told us that they received training and supervision which supported them to carry out their roles.

Inspection carried out on 27 December 2013

During a routine inspection

We looked at three care plans which showed us the home had involved other agencies and medical professionals in the care of people using the service. This ensured that the health, welfare and safety of people using the service was maintained and information was shared to benefit their individual needs.

People chose how to occupy themselves in the service. We observed that people were spending time in the communal areas singing with staff and interacting with each other. During our inspection we observed people spending time in their bedrooms listening to music, talking to family members and playing with the cat.

People told us they were very happy with the care and support provided at the service. One person told us "they are lovely and very patient and caring". Another told us "the food is wonderful and the staff are very nice".

People's choices and consent to care and support were observed to be respected at all times during our visit. We observed staff supporting people with day to day activities, and the interaction was observed to be sincere, respectful and responsive to individual support needs.

Staff were observed supporting people using the service. They were seen offering people choices and always used their first names. During the inspection we observed one person refusing to eat at lunchtime. The staff were patient and considerate and respected the individuals choice although offered alternatives to try and ensure they had options to choose from.

Inspection carried out on 15 November 2012

During a routine inspection

People expressed their views and were involved in making decisions about their care and treatment. People told us that they had been involved in planning their care and that staff had explained the care plans to them. One person told us "the staff are all very nice and look after me well."

Staff demonstrated a good understanding of people's needs and how they should be met. Each person had an assessment of their needs and a care plan, including risk assessments. One visitor told us that �their relative�s health had improved since coming to live at the home and they were very happy with the care and support given.�

People we spoke with told us that staff treated them well and that they felt safe and secure in the home. The service had written policies and procedures in relation to safeguarding vulnerable people. The registered manager told us that staff received safeguarding awareness training. People we spoke with were confident that staff had the appropriate knowledge and skills to meet their needs and made positive comments about the professionalism of the staff. Staff were supported by clear procedures and appropriate training. We saw the record of planned and completed training.

People that we spoke with said that they had not had to make a complaint but knew how to do so if the needed to. The complaints procedure was on the information board at the entrance to the home and a copy was in the welcome pack that is given to people on admission.

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