Archived: Woodlands Court Care Home

Woodlands Court Care Home is a care home providing personal care to older people and people living with dementia. The service accommodates 40 people in one adapted building. At the time of the inspection 33 people were using the service

People’s experience of using this service and what we found

Staff were trained to recognise potential risks and signs of abuse. Risks to people's safety and wellbeing were assessed and reviewed by managers. Staffing levels were safe. The provider managed medicines safely. Staff used personal protective equipment (PPE) appropriately when supporting people.

Managers ensured systems were in place to monitor the running of the service. The provider had procedures in place to receive feedback on how to improve support. Managers audited support records, including accidents and incidents to assure themselves of quality. Lessons were learned when concerns were raised, and these outcomes were communicated to staff. Staff worked well in partnership with other agencies to deliver effective support.

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.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was good (published 13 January 2020).

Why we inspected

We undertook this inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed. This was to seek assurance about this decision and to identify learning about the DMA process.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has not changed. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Woodlands Court Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Woodlands Court is owned by Minster Care Management Limited and is located in the New Springs area of Wigan. Woodlands Court offers accommodation for up to 40 people who require assistance with personal care and support.

At the time of the inspection there were 32 people living at the home.

Woodlands Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At our last inspection of Woodlands Court in June 2017, the home was rated as ‘Inadequate’, with multiple breaches of the regulations identified. These were with regards to person centred care, dignity and respect, safe care and treatment, safeguarding people from abuse, premises and equipment, good governance and staffing. Warning notices were issued due to the concerns relating to safe care and treatment and good governance.

Since then the home had entered a Service Improvement Plan (SIP) with Wigan local authority which involved a series of multi agency meetings to support the home to make the improvements needed. This comprehensive inspection checked to see if the concerns from the previous inspection had been addressed. We found significant improvements had been made across all areas of the home.

There was 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 who used the service and their relatives told us they felt the service was safe. There were appropriate risk assessments in place with guidance on how to minimise risk. Staff recruitment was robust with appropriate checks undertaken before staff started working at the home.

Everybody we spoke with told us there were sufficient amounts of staff working at the home. There was a dependency tool used and this determined how many staff were required to care for people safely. During the inspection we observed staff attending to people’s care needs in a timely way.

We found staff received sufficient training, supervision and induction to support them in their role. The staff we spoke with told us they were happy with the training they received and felt supported to undertake their work. Appraisals had not yet been undertaken, however these were scheduled at the time of the inspection to be completed in April 2018.

The home were working within the requirements of the mental capacity act (MCA), with applications for deprivation of liberty safeguards (DOLS) made where people had been deemed to lack the capacity to consent to their care and treatment.

The people we spoke with said the food served at the home was of good quality and we saw people being supported to eat by staff at meal times. People were weighed on a regular basis and more frequently if they were identified as being at risk of losing weight.

We found the home worked closely with other health professionals and made appropriate referrals if there were concerns. Details of any visits from other professionals was recorded within people’s care plans.

We received positive feedback from people we spoke with about the care provided at the home. Visiting relatives said they they had no concerns with the care being delivered at the home. People said they felt treated with dignity and we observed staff treating people with respect during the inspection.

Each person living at the home had their own care plan in place which provided an overview of their care requirements and any associated risks. People’s life histories were documented which provided details about their life prior to living at Woodlands Court

There were a range of different activities available for people to participate in. We observed a game of bingo during the inspection and people told us there was plenty going on at the home.

We found complaints were responded to appropriately. A policy and procedure was in place and was displayed near the main entrance for people to refer to.

There were systems in place to monitor the quality of service being provided to ensure good governance, with a range of audits being undertaken by the registered manager and at provider level.

Staff meetings took place on a regular basis, giving staff the opportunity to discuss their work and raise any concerns about practices within the home. We also observed a handover taking place where team leaders provided an update on people’s care needs from that shift.

Staff spoke positively about management at the home and said the manager was supportive and approachable.

Policies and procedures were in place and were being reviewed regularly.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration. For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Woodlands Court Care Home is registered to provide accommodation for up to 40 people who require assistance with personal care and support. There were 34 people using the service at the time of the inspection.

There was 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 were not always being safeguarded from abuse as not all incidents of suspected abuse had been referred to the safeguarding authority for further investigation. Risks of harm were not always minimised following incidents and accidents and staff did not always follow people's risk assessments to keep them safe from harm.

People's medicines were not stored and managed safely and medication audits had been ineffective in ensuring continuous improvement.

There were insufficient suitably trained staff to support people safely. The registered manager was in the process of recruiting to new positions. New staff were employed though safe recruitment procedures.

Infection control measures were not sufficient to ensure the environment and equipment in use was clean. As a result of this people were not protected from the risk of infection.

Health care advice was gained when people became unwell or their needs changed, however people's health care records were not always up to date and reflective of people's needs.

People were offered choices of food, however when people required their food and fluid monitoring this was not always completed. Some people were at risk of choking as they were being given food and drink which put them at risk of harm.

People were not always treated with dignity and respect and their right to privacy upheld. People were not always receiving care that met their needs and reflected their individual preferences.

People were not regularly asked their views on the service they received. Some people did not know who the registered manager was and who to complain to.

Staff felt supported by the manager to fulfil their roles, however poor staff practise was not being identified and improved through observations of competency.

The systems and audits in place to monitor and improve the quality of the service were ineffective. Action had not been taken to improve the service when areas that required improvement had been identified.

The principles of the MCA 2005 were being followed to ensure that when people lacked mental capacity they were supported to agree to their care and support in their best interests.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

We looked at the staff training matrix which showed staff had completed training related to the safeguarding of vulnerable adults. This helped ensure staff had the skills and knowledge to keep people safe at the care home.

We spent time walking around the care home and found it to be safe, clean and hygienic. All equipment, including lifts and hoists were regularly inspected and maintained which minimised any possible risk to people who used the service.

Deprivation of Liberty Safeguards (DoLS) become important when a person is judged to lack the capacity to make an informed decision related to their care and treatment. The provider told us no applications for DoLS had been made recently but knew the procedure to be followed if an application needed to be made.

Is the service effective?

People who used the service had undergone a pre-admission assessment. We observed care plans and consent forms had been signed which showed people had been involved in developing them. People`s choices and preferences had been recorded which helped ensure their care needs were met in accordance with their wishes.

People`s needs were taken into account with appropriate signage and the layout of the care home. This helped ensure people could move around the care home freely and safely. We spoke to two family visitors who told us they could meet people in private or in communal areas.

Is the service caring?

During our inspection, we observed staff members treating people in a dignified and caring manner. Staff were patient when caring for people and offered encouragement when they thought it was needed which promoted the person`s independence.

We saw staff who supported people with their personal needs. At lunch time, staff assisted people who needed help to eat their meals. One person who used the service told us, "All the staff are so kind and friendly."

Is the service responsive?

The activities co-ordinator was not on duty on the day of our inspection and we did not observe any activities taking place. However, the manager told us about a buddy system which helped ensure people were regularly involved in community activities. Each Sunday, a church service was held for all who wished to attend at the care home. One the day of our inspection, we noted one person going out into the community and another person who was supported to attend a hospital appointment.

Accidents, incidents and complaints were recorded and responded to appropriately. One person who used the service and a family member who was visiting told us, "We would just go and see the manager if there was a problem."

Is the service well-led?

We saw the care home worked well with other professional agencies. This included recording any visits from doctors and community nurses. This helped ensure people who used the service received care and support when they needed it.

The provider had quality assurance procedures in place which were aimed at continually improving the quality of service being provided to people who used the service. We saw records of both internal and external audits and checks that had been completed on a regular basis.

Comments such as“this is a very nice place,”“It is a good place to live ”I like it here it is smashing” were made.

People spoken with said "staff are really nice" "the people who look after me are great."

People spoken with said that they knew who to speak with if they had any problems Comments such as "I can talk to any of the staff and they will sort out stuff for me" "you can speak to Jeanette any time you like" were made.

People told us that they were happy with the care they received at the home. We were told “the staff are lovely”; “The girls are smashing”; “staff help me every way they can” and “staff come as soon as you ring the call bell.” We did not find any evidence that people’s care and support needs were not being met

We found that the home had a system in place to protect vulnerable adults from abuse. People and relatives, who we asked, told us they had no concerns about the home. One person told us “I feel safe here. I have no worries about the staff at all.”

People told us that they had no problems or issues in relation to medicines. There was system in place to ensure that medicines were stored and administered safely. Staff had been trained to give medicines and there was evidence that competency had been checked.

Some people told us that they thought there should be more staff at the home. We found that people had their care and support needs met and we did not find any evidence of the home being understaffed.