We carried out a review of the data available to us about Woodland Hall 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 Woodland Hall, you can give feedback on this service.
Woodland Hall is a residential care home providing personal and nursing care to up to 72 people. The service provides support to older people, people living with dementia and people on reablement. At the time of our inspection there were 72 people using the service. Woodland Hall provides support on five units over two floors.
People’s experience of using this service and what we found
Environment and individual risks had been assessed, incident and accidents were investigated, and we saw evidence reviews had been carried out and lessons learnt. People told us they felt safe and systems were in place to act on allegations of abuse. Staff were recruited safely. We saw sufficient staffing on duty during the day of our inspection. Medicines were managed safely.
MCA and DoLS assessments had been completed, staff were observed asking for consent before undertaking any activity. 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. Admission assessments had been undertaken, and we saw evidence of the involvement of professionals in people's care. Staff told us, and records confirmed, training had been undertaken.
We received positive feedback about the registered manager and the staff team. We saw evidence of meetings taking place and surveys from people and professionals. Information was available on the actions taken from the surveys. A range of audits and monitoring was taking place. This included the findings and actions taken as a result. The provider had developed a detailed electronic system which supported the monitoring and oversight of the service
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update - The last rating for this service was good (published 7 April 2018)
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
When we completed our previous inspection on 24 January 2017 we found concerns relating to person centred care and staffing. We found treatment or care provided did not reflect people’s needs and people were not provided with stimulating activities. Staff were not provided with appropriate training, supervisions and appraisals, which meant they did not have the right skills and knowledge to meet people’s needs. At this time these topic areas were included under the key question of effective, responsive and well-led. We reviewed and refined our assessment framework and published the new assessment framework in October 2017. Under the new framework these topic areas are included under the key question of effective, responsive and well-led. Therefore, for this inspection, we have inspected these key questions and also the previous key questions of safe and caring to make sure all areas were inspected to validate the ratings.
The provider sent us an action plan in May 2017 and told us that they had addressed the shortfalls highlighted during our inspection in January 2017 and told us that they were no longer in breach with regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We found during this inspection that the provider had taken appropriate actions and people’s health care and social care needs had been assessed and formed part of the person’s care plan. People who used the service were offered a variety of activities and the provider planned to provide activities during the evening and also at weekends. Staff had access to different training as part of their induction and regular refresher training was provided to ensure staff kept up their knowledge and skills of supporting people who used the service. Staff had also opportunities to meet the registered manager or their supervisor to discuss their development and performance, which they told us was valuable and helped them to understand people’s needs better.
Woodland Hall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Woodland Hall accommodates 72 people across three separate units, each of which has separate adapted facilities. One of the units specialises in providing care to people living with dementia.
A new manager started in June 2017 and registered with the Care Quality Commission (CQC) in December 2017. A registered manager is a person who has registered with the CQC 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.
Staff at Woodland Hall told us that people’s safety and security was taken seriously. Staff told us that they would report any allegations of abuse and the service had demonstrated over the past twelve months that they notified the CQC of any allegations of abuse, which had been dealt with and responded to appropriately. Risk to people’s health and wellbeing in relation to carrying out treatment or care had been assessed and appropriate risk management plans were put into place to minimise such risks. People who used the service, relatives and staff told us that there were sufficient staff deployed to meet people’s needs. The service followed safe recruitment procedures and ensured that new prospective staff were assessed and vetted appropriately to ensure their suitability to work at Woodland Hall. People’s medicines were managed appropriately and safe medicines administration procedure ensured people could be confident to receive the correct medicines on time. Woodland Hall followed appropriate infection control procedures and ensured people who used the service were protected from the spreading of infections and spreadable disease. Accidents and incidents were monitored and systems were in place to ensure lessons were learned to minimise the risk of similar incidents and accidents happening in the future.
People who used the service told us that they were satisfied with the meals provided. The provider carried appropriate nutritional assessments and ensured people who used the service were provided with appropriate nutrition and hydration. The service had excellent links with health care specialists and a new innovative reablement service supported people to be discharged when required and supported to gain greater independence. People who used the service lived in a well maintained and spacious home, which was conducive to their needs. The registered manager and staff understood their responsibilities in relation to obtaining consent under the Mental Capacity Act (MCA) 2005; and their actions to be taken if people lacked capacity to make their own decisions.
Staff were kind and compassionate towards people. We observed they had warm and caring relationships with them. The service was organised around people’s needs by staff who knew each person, about their life and what mattered to them. People’s views were actively sought, listened to and acted on.
People and relatives were consulted and involved in developing and reviewing care plans. Care records were regularly reviewed and updated as people’s needs changed. Most people were assisted to maintain their interests and hobbies and to try new things, through a varied programme of activities. People and their relatives told us they were aware of how to express concerns or make complaints, and that any complaints they had made had been dealt with in a satisfactory manner. People were also given the opportunity to feedback their views of the service provided.
The feedback we received about the registered manager was positive. We were told the registered manager led the team with a pro-active and transparent style of management and that she went 'over and above' her duties and responsibilities. Woodland Hall carried out audits to ensure people received good quality care that enhanced their general well-being.
At our last inspection on 16 and 21 July 2015 the service was rated good overall.
Woodland Hall provides nursing care for up to 72 people who have a range of care and nursing needs associated with old age, including dementia. On the first day of the inspection there were 58 people using the service. The number of people varied slightly during the other days of the inspection.
The service does not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission [CQC] 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. At the time of the inspection the service was being managed by an operations manager who had support from other management staff in the running of the service. We were told that the provider was taking steps to recruit a manager who once appointed would register with us.
Systems and processes were in place to safeguard people. Staff knew how to recognise abuse and how to respond to concerns. People’s individual needs and risks were identified and managed as part of their plan of care and support to minimise the likelihood of harm. Accidents and incidents were addressed appropriately.
The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS ensure that an individual being deprived of their liberty is monitored and the reasons why they are being restricted is regularly reviewed to make sure it is still in the person's best interests. The home had made necessary applications for DoLS and we saw evidence that authorisations had been granted.
People were treated with respect. We saw examples of staff engaging with people in a positive kindly manner. People were supported and encouraged to make choices in their day to day lives. Staff told us they enjoyed working in the home providing people with the support and care they needed.
People's social needs were not fully met. Not all areas of people’s care plans were person centred and people lacked the opportunity to take part in activities to promote their well-being and minimise social isolation. People told us there was not much to do. The service needed to improve in this area and was in breach of regulation.
Staff received some training to enable them to be skilled and competent to carry out their roles and responsibilities. However staff had not received training in meeting some aspects of people specific needs and care workers had not received regular one-to-one supervision to support them to carry out their roles and responsibilities. The service needed to improve in this area and was in breach of regulation.
People were supported to maintain good health. They had access to a wide range of appropriate healthcare services that monitored their health and provided people with appropriate support, treatment and specialist advice when needed. We found systems were in place to manage and administer medicines safely.
Staff were appropriately recruited. They underwent a range of pre-employment checks to ensure they were suitable for the role. Checks had also been undertaken to ensure that all the nurses who worked at the home had a current registration with the Nursing and Midwifery Council (NMC).
There were systems in place to regularly assess, monitor and improve the quality of the services provided for people. These included unannounced spot checks of the service carried out by management staff.
We have made a recommendation that the staffing needs of the service be reviewed as we found during meal times people waited significant periods of time before receiving assistance with their meals. Also we have recommended that the service seek advice and guidance from a reputable source, about supporting people to express their views and involving them in decisions about their end of life care.
The service was in breach of two of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation care plans lack of person centeredness and a lack of opportunities for people to engage in activities. You can see what action we told the provider to take at the back of the full version of this report.
This unannounced inspection took place on the 16 and 21 July 2015. At the end of the first day of the inspection we told the provider when we would be returning to complete the inspection.
Woodland Hall provides accommodation and personal and nursing care for up to 72 people. Most people living in the home have dementia or mental health needs. At the time of this inspection five beds were being used by a local National Health Service [NHS] team for people needing a rehabilitation service. These beds were managed by Woodland Hall. The home is purpose built and located in north west London.
At our last inspection in 02 December 2013 the service was meeting the regulations we looked at.
At the time of this inspection a registered manager was employed at the service. A registered manager is a person who has registered with the Care Quality Commission [CQC] 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.
The atmosphere of the home was relaxed and welcoming. Throughout our visit we observed caring and supportive relationships between staff and people using the service. People were complimentary about the caring nature of staff. Staff understood people’s varied and sometimes complex needs and interacted with people in a courteous manner. People’s privacy and dignity was respected.
Arrangements were in place to keep people safe. Staff understood how to safeguard the people they supported, were familiar with people’s needs and their key risks. People’s care plans and risk assessments included the information staff needed to provide people with the care and support they needed.
Incidents and accidents were recorded, appropriately addressed and monitored to minimise the risk of recurrence.
Medicines were stored and administered to people safely. People were supported to maintain good health, which was monitored closely and referrals made to health professionals when required. People were satisfied with the food provided and had a choice of food and drink which met their dietary needs.
Staff received a range of relevant training and were supported to develop their skills and gain qualifications to be competent in meeting the needs of people they cared for. Staff told us they enjoyed working in the home and received the support they needed to carry out their roles and responsibilities. People were protected, as far as possible by a robust staff recruitment system.
Staff had an understanding of the procedures in place to protect people if due to their needs they were unable to consent and/or make one or more decisions about their care, treatment and other aspects of their lives. Staff knew about the legal requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).
People had the opportunity to participate in a range of activities of their choice, and were provided with the support they needed to maintain links with their family and friends. Views about the service was regularly sought from people, relatives and staff, and improvements made in response to this feedback.
There was an appropriate complaints procedure and people knew how to make a complaint. People were confident concerns and complaints raised by them would be appropriately addressed by the registered manager.
There was a clear management structure in the home. People told us the home was well managed and there were appropriate communication systems in place, including regular staff and resident/relatives meetings and other opportunities for people to obtain advice, support and to be involved in their and/or their relatives’ care.
There were effective systems in place to monitor the care and welfare of people and improve the quality of the service.