We carried out a review of the data available to us about Woodhouse 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 Woodhouse, you can give feedback on this service.
Woodhouse is a residential care home providing personal and nursing care for 16 people. People who live at the home have learning and physical disabilities. At the time of the inspection, there were 16 people living at Woodhouse.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
The home met the characteristics that underpin the right support, right care and right culture and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes.
However, the home accommodated more people than would be the optimum and was larger in scale than a domestic property. This was mitigated to some degree as each person had their own flat or apartment and were allocated staff daily to support them in a person-centred way. Care was tailored to the person. The building was set back from the road in a residential area close to shops. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home.
People's experience of using this service and what we found
Right Support:
People were completely at the heart of the service. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.
The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs.
People were supported by staff to achieve their aspirations and goals. Staff enabled people to access specialist health and social care support in the community.
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.
Right Care:
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.
People were very much supported to take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives.
Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.
The service had enough appropriately skilled staff to meet people’s needs and keep them safe.
Right Culture:
People led inclusive and empowered lives because of the values, attitudes and behaviours of the provider, management, and staff. Staff demonstrated their commitment to the values of the service that put people at the centre of the care and support provided. Staff felt supported and worked as team to ensure people’s care and support needs were met.
Staff placed people’s wishes, needs and rights at the very heart of everything they did. People and those important to them, were involved in the planning of their care. Staff valued and acted upon people’s views.
There were robust quality assurance processes in place that drove improvement.
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 21 November 2021). The service continues to be rated good.
Why we inspected
We undertook this focused inspection due to the length of time since the last inspection. This report only covers our findings in relation to the Key Questions Safe and Well-led.
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 remained good based on the findings of this inspection.
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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Wood House is a residential care home providing personal and nursing care for 16 people. People who live at the home have learning and physical disabilities. At the time of the inspection, there were 15 people living at Wood House.
The home met most of the characteristics that underpin the Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service received planned and co-ordinated person-centred support that was appropriate and inclusive for them.
However, the home accommodated more people than would be the optimum and was larger in scale than a domestic property. This was mitigated to some degree as each person had their own flat or apartment and were allocated staff daily to support them in a person centred way. Care was tailored to the person.
The building was set back from the road in a residential area close to shops. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff did not wear anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
People continued to receive safe care. Staff understood safeguarding procedures and knew what they had to do to keep people safe. People were protected from unsuitable staff because robust recruitment procedures were carried out. Risk assessments were in place to reduce and manage risks within people’s lives.
People had access to other health and social professionals. Safe systems were in place to ensure that people received their medicines as prescribed. People were supported to take part in a wide range of activities based on their interests within the community and in their home. People were consulted on how they wanted to be supported through service user engagement meetings and care reviews.
Staff were trained to support people effectively. Good communication was in place in the form of daily handovers, team meetings and one to one supervision. Staff said they were supported in their roles.
Staff continued to provide people with daily choices on what they wanted to eat, wear and choice in respect of activities. Staff were knowledgeable about the people they were supporting.
Staff were caring and provided people with care tailored to their needs promoting their rights to an ordinary life. People were supported to have 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.
The provider had quality assurance systems in place to monitor the running of the home and the quality of the care being delivered. There was an open and transparent culture within 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
Good (report published April 2017)
Why we inspected
This was a planned inspection based on the previous rating.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.
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 last inspection, the service was rated Good.
At this inspection we found the service remained Good.
People were protected because there were risk assessments in place to guide staff in providing safe support. Staff had been trained in safeguarding vulnerable adults and were confident about reporting any concerns. People were supported to receive their medicines safely.
People were supported to see healthcare professionals when they needed to. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People’s nutritional needs were monitored. Staff were trained and supported to carry out their roles.
The service was caring. People were able to be involved in the running of the home through a service user forum. We observed staff interacting with people in the home in a kind and caring manner.
The service was responsive. There was a procedure in place to manage complaints so that people could be assured their concerns would be listened to. People were given opportunity to engage in activities if they wished to.
There were systems in place to monitor the quality and safety of the service provided. Staff generally felt well supported and told us staff worked well as a team.
Further information is in the detailed findings below
This inspection took place on 22 January and was unannounced. The service was previously inspected in September 2013 and there were no breaches of regulations found at this time.
Woodhouse provides personal care and accommodation for up to 16 people with a learning disability. At the time of our inspection there were 14 people living in the home.
There was a registered manager in place at the time of our inspection. 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 received effective care; however we found that improvements could be made. Staff were inconsistent in how they used visual materials to support their communication with people, particularly when offering choices.
People in the home were safe. Staff were trained in recognising the signs of potential abuse and told us they felt confident in doing so. They were aware of where to locate policies and procedures for reporting concerns if they needed to. People weren’t able to speak with us about their experiences of living in the home; however we observed that people appeared settled and content in the presence of staff.
There were individual risk assessments in place to guide staff in providing care in a safe way. Other checks ensured that risks associated with the building were managed. This included fire safety.
There were systems in place to support people safely with their medicines. Medicines were stored securely and stock checks were taken regularly to help ensure that any discrepancies would be identified and investigated. Any unused or out of date medicines were disposed of safely by being returned to the pharmacy.
There was sufficient staff to meet people’s needs. Our observations showed that care was delivered in a calm and unrushed manner. People’s needs were met and there was sufficient numbers of staff to accompany people to go out in the local community.
People were supported to see other healthcare professionals when needed. We saw that people’s GPs were contacted when concerns were identified about their health.
Staff were aware of and adhered to the principles of the Mental Capacity Act 2005. When a person lacked the capacity to make a decision about their care or treatment, processes were followed to ensure that a decision was made in their best interests. Where necessary, this included involving an IMCA (Independent Mental Capacity Advocate).
People’s nutritional needs were met. Staff responsible for meal preparation had clear guidelines in place about people’s individual dietary needs and preferences. Particular requirements such as a lactose free diet were catered for.
Staff treated people in a kind and caring way. One relative told us that they "couldn’t fault" the service. Staff were aware of the importance of treating people with dignity and respect and encouraged people to be independent where possible. People were encouraged to express their views and opinions about the care they received. The views of relatives and representatives were listened to.
The service was responsive to people’s individual needs. Staffs were knowledgeable about the people they supported and valued people as individuals. Support plans were evaluated regularly to ensure that they were current and updated if a person’s needs changed.
There had been no formal complaints in the last 12 months that had required investigation. However, there was complaints procedure in place and people were given information about how to raise concerns in a format that met their needs.
The service was well led. There were systems in place to monitor the quality and safety of the service. Any shortfalls identified as part of the monitoring was shared with staff so that all were aware of the improvements required. The registered manager was supported by the organisation to make improvements to the home. This included building a sensory room for people to use. A sensory room is a special room designed to develop people's senses, through special lighting, music, and objects.
We viewed the care records of four people who lived in the home and saw that these gave staff clear information about their needs. Risk assessments were in place to ensure that people were cared for safely. We observed people being treated respectfully and spoken to in an appropriate tone by staff.
People's nutritional needs were met because they received meals according to their identified needs. Professional guidelines were in place and staff were made aware of these.
We heard that staff levels had improved recently so that there was less reliance on agency staff to fill shifts. We viewed staffing rotas and these confirmed that expected staffing levels were met. Where necessary, bank staff were used to cover shifts and this helped ensure continuity of care for people in the home.
There were systems in place to monitor the quality and safety of the service provided.
People were able to make decisions in their daily lives. One person, for example, told us that they could choose where to eat their meals. We found that staff had a better understanding of 'consent' and when people would need support with making decisions about their care and treatment.
We found that staff had knowledge about people's needs in areas such as pressure area care, diet and mobility. Health professionals had been involved in producing guidelines which helped to ensure that staff supported people safely. Some people had a special diet and required assistance with eating; at lunch time we observed people receiving support in an appropriate and careful manner. One person told us that they had a diabetic diet and that they enjoyed the meals.
We found that the number of harmful incidents between people at the home had reduced. Staff told us that training in the subject of 'self-harm' had been arranged and that they had found this useful.
Staff said that there had been a lot of training since the last inspection. We found that there was a more planned approach to staff training and a programme of specialist training had been implemented. Overall we found that people were benefiting from some recent developments in the home. Staff felt supported in their work although they were looking forward to a period of stability in the management of the service.
People could make some decisions and choices in their daily lives. A number of people went out on shopping trips on the day we visited. People said they had talked to staff about where they wanted to go. However there was a lack of information about people's capacity to make informed decisions. This meant there was a risk that people's best interests were not being met.
People received support from staff so that their healthcare needs were met. However more needed to be done to make sure that people's care and support were well planned. This was to ensure that people were safe and to reduce the risk of individuals being harmed.
The home was without a permanent manager at the time of our visit. Procedures were in place for supporting staff and monitoring the quality of the service, although these had not been always been well managed and consistently implemented.
Some people were seen relaxing in a communal area with their support workers while others were in their 'apartment' or their 'flat.' We saw some people listening to music and they told us that they they liked their music.
One person said 'I am getting used to Woodhouse' and told us about some of the choices they made about their meals.
We were told: 'I go to Bingo and hydro." (a swimming therapy)
People told us that staff helped them with the different activities they were involved with.
Another person told us "I feel safe"
Concerns were raised by the local authority safeguarding lead during June 2011 when they received numerous incidents relating to the culture of the home in that people living at the home were being hit, and were hitting other people living there.
Although this has led to the home not admitting any new people, it has been recognised that significant action has been taken by the home to address issues.