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Inspection Summary

Overall summary & rating

Requires improvement

Updated 1 May 2018

An unannounced inspection took place on 20 & 21 March 2018.

At the previous inspection in August 2017 the provider was found to be inadequate and the service was placed in 'special measures' by CQC. We found that the provider was in breach of 2014 Regulations with regard to meeting nutritional and hydration needs and safe recruitment, as well as Regulation 18 of Registration Regulations 2009, failure to notify of incidents.

The purpose of 'special measures' is to:

Ensure that providers found to be providing inadequate care significantly improve.

Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

Services placed in 'special measures' are inspected within six months of the publication of the inspection report.

At this inspection we found improvements had been made. This meant the service was no longer rated inadequate and could be removed from 'special measures' by the Care Quality Commission (CQC).

Following the inspection in July 2017 we served an urgent Notice of Decision imposing urgent conditions on the Provider's registration because the provider remained in breach of regulation 12 safe care and treatment and regulation 18 good governance and we found the provider in breach of regulation 15, failure to maintain and ensure that the premises for its intended purpose.

Woolston Mead is a ‘care home’. People in care homes receive accommodation and nursing 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.

Woolston Mead provides accommodation and personal care for up to 28 people. It is a large Victorian property with accommodation located over four floors. Steps provide access to the front of the building. Level access is available at the rear of the building. The lower and upper floors are accessed via a staircase and a passenger lift. The upper floors can also be accessed using a stair lift. There is a dining area to the ground floor and a lounge. A garden area is located at the front of the building. At the time of this inspection 18 people were living in the home.

There was 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.’

We found that medicines were administered and managed safely in the home. Despite efforts to reduce the temperature in the treatment room, medicines were still stored in a room at was above 25 degrees centigrade. This increased the risk of medicines not working properly if they are stored out of the required temperature range. We have made a recommendation about the safe storage of medicines.

Regular daily stock checks and weekly medication audits were completed and any issues were being addressed promptly. All staff that administered medication received medicines administration training and we saw competency checks were completed every six months.

There were no gaps in records indicating that people in the home were receiving medicines as prescribed. A person had missed five doses of a medicine as it had been returned to the pharmacy in error. This could have been managed better to ensure the person did not miss their doses.

Some medicines have specific instructions to ensure that they are taken properly and at the right time. These instructions were not present on the medicines record or on the dispensing label for a specific medicine. Immediate action was taken to make the information available to all staff.

At our last inspection in August 2017, the registered provider had been issued with an enforcement notice from the fire service and urgent work was required to be completed. Since then the registered provider has worked with the fire service and this work is nearing completion. Safety checks, including fire alarms, emergency lighting and water temperatures were completed each week. Personal emergency evacuation plans (PEEPs) were completed for the people living in the home to help ensure effective evacuation of the home in case of an emergency.

The registered manager had instigated a programme of quality assurance checks, audits and procedures since our last inspection which were used to improve the quality of care provided.

There was a sufficient number of suitably trained and qualified staff on duty to meet the needs of the people who lived at the home. The staff presented as caring, kind and knowledgeable about people’s needs.

Safeguarding systems processes and practices helped staff to understand how to protect people from abuse, neglect, harassment and breaches of their dignity and respect. Risk assessments were undertaken to support people safely and in accordance with their individual needs. They were updated each month to reflect any changes in people's needs monthly to ensure they received the appropriate care and support.

The home was odour free, clean and there were provisions for hand sanitizer on the walls. Personal protective equipment (PPE) such as aprons and gloves were available and used when supporting people with personal care and administering medication.

At our last inspection in August 2017, we found that people did not have sufficient choice regarding meals and a varied diet was not provided. At this inspection improvements had been made and people enjoyed a varied diet that met their needs and preferences. Staff were monitoring people’s dietary intake and weight. People’s food allergies and intolerances, likes/dislikes and requirements were recorded.

Care staff respected and promoted people’s privacy, dignity and independence. They were caring and compassionate in their approach and encouraged people to express their views. People were actively involved in making decisions about their care and support. Managers and staff acted in accordance with the Mental Capacity Act and ensured that people received the right kind of assistance to support them in making decisions.

Healthcare professionals were involved in people's care.

People living in the home and relatives were able to share their views and were able to provide feedback about the service. People’s concerns and complaints were listened to respond to.

Staff were aware of the need to support people approaching the end of their life and care planning arrangements were person centred to ensure their wishes and needs were respected.

Urgent conditions imposed upon the registered provider's registration had been met; the registered provider and registered manager had completed training relating to governance.

The home was well managed by the registered manager and staff were well supported.

Inspection areas


Requires improvement

Updated 1 May 2018

We found that action had been taken to improve safety.

We found systems in place to manage medicines were safe but improvements were needed to ensure safe storage.

Risks to people's safety were assessed and control measures were in place to help ensure their safety.

Environmental hazards were identified and measures taken to ensure people lived in a safe comfortable environment.

Staff had been checked when they were recruited to ensure they were suitable to work with vulnerable adults.

There were enough staff on duty to ensure people's care needs were consistently met.



Updated 1 May 2018

The service was effective.

Managers and staff acted in accordance with the mental capacity Act and ensured that people received the right kind of assistance to support them to make decisions.

Healthcare professionals were involved in people's care.

People enjoyed a varied diet which met their dietary needs and preferences.

Staff were supported through induction, regular on-going training, supervision and appraisal.



Updated 1 May 2018

The service was caring.

Staff were kind, caring and caring and compassionate.

People’s privacy, dignity and independence were respected and promoted.



Updated 1 May 2018

The service was responsive.

People received personalised care that was responsive to their needs.

People’s concerns and complaints listened and responded to and used to improve the quality of care.

Staff were aware of the need to support people approaching the end of their life and care planning arrangements were person centred to ensure their wishes and needs were respected.


Requires improvement

Updated 1 May 2018

The service was well led.

On this inspection the changes being made would suggest the service was actively addressing the concerns we found at the last inspection. We did still find some concerns although not as serious as they were at the last inspection.

Systems and process were more robust and were effective in monitoring the service and driving forward improvements.

Staff sought feedback from people and relatives to gain their views about the home.

There was a registered manager in post and feedback regarding the leadership and management of the service was positive.