Woodbury Court

We found the following examples of good practice.

¿ The registered manager and provider had created a separate area of the home where families could meet with people safely, in a COVID-19 secure area. This involved using clear plastic and speakers to allow people to talk with each other. Visitors were provided with a separate door into the pod and had their temperature taken and recorded when they arrived.

¿ Staff were provided with easy read posters of what Personal Protective Equipment (PPE) staff should wear when supporting people with COVID-19. The laminated posters were attached to the people’s doors and around the home.

¿ The registered manager undertook competency assessments of staff "donning and doffing" PPE and hand hygiene. This ensured staff were correctly following national guidelines when supporting people.

¿ Where people were COVID-19 positive, boxes of PPE were kept outside the their bedrooms to ensure staff had access to the correct equipment.

We were assured that this service met good infection prevention and control guidelines

Further information is in the detailed findings below.

Woodbury Court provides personal care with accommodation for up to 94 people of all ages. They were providing care for 86 people at the time of the inspection. The service is a large two storey building with a small garden courtyard in the middle of the complex. There are five units Rose, Tulip, Ivy, Lotus, and Lavender providing care to older people and those living with dementia and one unit Jasmine, providing short term rehabilitation after discharge from hospital.

Whilst people had a balanced diet, they were not always supported with their meals at lunchtime in a personalised way.

We have made a recommendation to review the arrangements for people’s mealtimes.

There were enough staff on duty to meet peoples needs. The way staff were deployed across the service, especially at lunchtimes, was in the process of review.

We have made a recommendation that the provider look at best practice guidance in relation to the deployment of staff across all units.

Quality monitoring processes were being undertaken. Audits on the quality of people’s mealtime experiences across all the units was in progress.

People told us the service was safe, and they were protected from harm. Staff were knowledgeable about safeguarding adults from abuse and knew what to do if they had any concerns and how to report them. Risk assessments were thorough and personalised.

Staff demonstrated they had the relevant knowledge and skills to support people with their care. Safe recruitment practices were in place. People's medicines were managed and administered safely. The service was clean and infection control procedures in place and lessons were learnt when things went wrong.

Training and supervision were provided on a regular basis and updated. Staff liaised well with health professionals to ensure people were kept as well as could be. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and their family members told us staff were caring and kind. They said they were involved in discussions about their care. Care plans were detailed and contained relevant information about people who used the service and their needs.

People had access to a range of individual and group social and leisure activities which they enjoyed. Concerns and complaints were listened to and fully investigated. People were well looked after at the end of their life.

The service had an established and experienced management team and consistent team of staff. Staff were well supported and spoke highly about working for the service. Good joint working initiatives were in place.

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

Rating at last inspection. The last rating for this service was Outstanding (3 July 2018).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor the 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.

The inspection took place in response to a concern raised regarding the quality of care people receive when they need medical intervention. No risks, concerns or significant improvement were identified in the remaining Key Questions through our on-going monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection and the service continues to be rated Outstanding overall.

Woodbury Court is owned by Runwood Homes Ltd. The service provides care and accommodation for up to 94 people who may need assistance with personal care and may have care needs associated with living with dementia. The building is a purpose-built care home designed around the needs of the older person and in particular those people living with dementia or cognitive impairment and physical impairments. There is a passenger lift and secured staircases to all levels, which mean all parts of the home, are accessible for people with impaired mobility. 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.

The service had 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.

The service had continued to provide care that was outstanding and had made further improvement within the service that had a positive impact on people's lives. Staff cared for people in a kind and compassionate way; and people, relatives and other healthcare professionals remained complimentary of the service.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People’s needs were met by sufficient numbers of staff. People were cared for by staff recruited and employed after appropriate checks had been completed. Medication practices were safe and dispensed by staff who had received training to do so. There were systems in place to minimise the risk of infection.

The registered manager ensured lessons were learnt from any accidents or incidents and had processes in place to review these with staff to mitigate future risks. In addition, the registered manager and provider shared findings with people, family and other stakeholders in line with their duty of candour responsibilities.

The registered manager, deputy manager and nursing team, remained passionate in upholding the values of the service to provide outstanding care to people. They continually looked at innovative ways of improving the service and experience for people living at the service.

The registered manager was supportive to staff and helped in their development and training needs, to ensure people were support by staff with the skills required to perform their role. In addition, the registered manager worked collaboratively with other healthcare providers and the local authority to develop the service provided for people.

The registered manager had a number of ways of gathering people’s opinions and people were actively encouraged to voice their views. They held regular meetings with people and used questionnaires to gain feedback. The registered manager carried out quality monitoring checks to help ensure the service was running effectively and to make continual improvements.

The inspection took place on 23 and 30 January 2017.

Woodbury Court is one of a number of services owned by Runwood Homes Ltd. The service provides care and accommodation for up to 94 people who may need assistance with personal care and may have care needs associated with living with dementia. The building is a purpose built care home designed around the needs of the older person and in particular those people with dementia or cognitive impairment and physical impairments. There is one passenger lift and secured staircases to all levels, which means all parts of the home are accessible for people with impaired mobility.

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. The registered manager provided exceptional leadership and management for the staff team. The service and staff demonstrated their commitment to care for people with dignity, to further improve and to follow best practice for the care of people living with dementia. The service had a good reputation within the local community and also with health and social care professionals.

The service had continued to provide care that was outstanding and had made further improvement within the service that had a positive impact on people’s lives. Staff, relatives, professionals and people living at the service all felt the care at the service was exceptional and people were enabled to have a good quality life. Staff cared for people in a kind and compassionate way, knew them well and people were happy and relaxed at all times.

People received very personalised care which was unique to them. Their care records was an extension of the actual delivery of person centred care in the service. People’s daily lives included activities and hobbies that interested them and their involvement in things they liked was natural and they really enjoyed their days. The service was also decorated and set out in a way that meant that all the people living there had a space that they enjoyed. It was a lovely environment full of unique areas and ideas to keep people engaged.

The manager and the staff team strived for excellence and it was clear from our observations, what people told us and systems in place that they worked tirelessly to ensure people were cared for not only emotionally but physically. Many initiatives implemented had resulted in reduced physical ailments and improved health for people.

The registered manager has continually shown that they are highly committed to improving the service they provide. Their passion and determination to deliver exceptional care for people was clear in the way they spoke about what they did for people and how they tried to meet people’s individual needs. It was evident from the responses we received from people and relatives, staff and volunteers, health and social care professionals that this was a very well-led service.

People were kept safe. This was because any risks to their health and welfare was well managed. The premises were well maintained and staff were trained in how to move people requiring assistance from one place to another safely. Pre-employment checks were robust and ensured that unsuitable workers could not be employed to work in the service. The management of medicines was in line with good and safe practice.

Staffing levels were adjusted regularly and took account of the number of people being looked after and their care and support needs. The staff were well trained which meant they were able to carry out their roles and responsibilities effectively. Staff were well supervised and supported by their colleagues and line managers.

People were provided with an effective service that met their individual needs. They were encouraged where possible to make their own choices and decisions about aspects of their daily life. Where people lacked the capacity to make decisions for themselves the staff knew what to do to ensure that any decisions made on behalf of the person was made in their best interests. We found the service to be meeting the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People were provided with the food and drink they liked to eat. They were provided with choice and given sensitive assistance if they needed help to eat their meals. Arrangements were made for people to see their GP and other healthcare professionals as and when they needed to do so. Feedback for health care professionals was extremely complimentary and all stated the service worked with them to improve people’s lives. People received responsive care. People were looked after with a person centred approach care and where possible had been involved in drawing up their care plans.

People told us that they knew how to complain. The service had a clear complaints procedure in place which was clearly displayed. This provided information on the process and the timespan for response. We saw that complaints had been recorded and any lessons learned from them had been actioned.

People were able to share their views at regular resident meetings or during the regular surveys. Relatives were positive about the care provided and had been given opportunities to give feedback and make suggestions to improve the experience for people who used the service.

The inspection took place on 10 December 2014.

Woodbury Court is one of a number of services owned by Runwood Homes Ltd. The service provides care and accommodation for up to 94 people who may need assistance with personal care and may have care needs associated with living with dementia.

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 were very happy with the care and support provided. They were treated with dignity and respect and we saw staff interacting with people in a kind, caring and sensitive manner. Staff were very tentative to people’s needs and people looked happy.

People felt safe and staff showed a good knowledge of safeguarding procedures and were clear about the actions they would take to protect people. The provider had systems in place to manage risks, safeguarding matters and medication and this ensured people’s safety.

A thorough recruitment process was in place that ensured the staff recruited had the right skills and experience and were safe to work with people living at the service. Staff rotas showed that there was consistently enough staff on duty to keep people safe. The manager ensured that staff received the training and support they needed to deliver a high standard of care to people. Staff told us that they felt well supported to carry out their work and that they had received regular supervision and training.

People who used the service, and their relatives, were involved in planning and reviewing their care. There were sufficient numbers of staff, with the right competencies, skills and experience available at all times, to meet the needs of the people who used the service.

The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and are required to report on what we find. The MCA sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. The DoLS are a code of practice to supplement the main MCA code of practice.

Staff had a good understanding of DoLS legislation and had completed a number of referrals to the local authority in accordance with new guidance to ensure that any restrictions on people were lawful. Records and discussions with staff showed that they had a good understanding of this subject and they had received training in MCA and DoLS. Assessments had been carried out where people were not able to make decisions for themselves to ensure their human rights had been protected.

We found that people’s health care needs were well met. People had access to a range of healthcare providers such as their GP, dentists, chiropodists and opticians. The manager had been proactive in working with health care professionals to help introduce systems which enhanced people’s lives and ensured they were receiving the treatment and care they needed.

Suitable arrangements were in place that ensured people received good nutrition and hydration. People were supported to be able to eat and drink sufficient amounts to meet their needs and were also offered choices during mealtimes.

The manager had developed a strong and visible person centred culture in the service and staff told us that the management team were very knowledgeable and inspired confidence and led by example. The manager continually strived to improve the service and demonstrated that she knew which areas of the service needed attention. Since being in post they had introduced a number of systems to improve the quality of care and enhanced people’s lives. People knew who to raise concerns with. The service had a clear complaints procedure in place which was clearly displayed. The manager is always proactive when contacted by the CQC to investigate any concerns and responded within the required timespan.

Those people who were unable to communicate were observed during the day and their body language and facial expressions were noted. They appeared relaxed with the care worker and no concerns were seen or raised. The care workers were observed speaking with people with dignity and respect and involving them in their care. People appeared relaxed and staff were seen to be helping them to make choices on how they wanted their care provided. Whilst observing the care workers during our visit it was clear that the care workers were caring and people were kept safe. The care workers observed during our visit knew people's care needs and also their likes and dislikes which enabled them to provide appropriate care. One person was heard saying to a care worker 'I don't know how to thank you.'

People told us they knew how to raise any concerns. Relatives spoken with stated that they found the manager to be approachable and could go to her with any concerns. A relative reported 'I have no complaints and when I have concerns the manager has dealt with them.'

One health care professional spoken with stated, 'They are brilliant, we work together and they always call me when needed.'

Staff were observed speaking with people with dignity and respect and involving them in their care. People appeared relaxed and staff were viewed helping them to make choices on how they wanted their care provided. During our visit at no time were people seen waiting for staff to support them.

People we spoke with were complimentary about the care they received at Woodbury Court. Others who were unable to verbally communicate were observed with staff and they appeared relaxed in their company. The home had received lots of thank you cards and comments included 'I would like to praise 'X' for their dedication to the residents of the home' and 'I would like to thank all the carers and staff who looked after 'X' during their stay at Woodbury Court and for the courtesy they showed me and any visitor whenever we came ' which was often.' One relative spoken with stated that they felt the staff were good and always advised them of any changes.

People told us they knew how to raise any concerns. Relatives spoken with stated that they found the manager to be approachable and felt they could take any concerns they may have to her. Staff spoken with also added that they felt that they could raise any concerns they may have with the manager.

During our visit staff were observed speaking to residents with dignity and respect and involving them in their care. At a previous visit it was estabished that staff are well trained and had received regular training updates. They had the skills and knowledge to provide the care and treatment people need.

Each person had an individual personalised care plan, which identified their care needs and choices. The home has a key worker system and those people spoken with stated that the carers provided any care they needed. During our visit staff were observed speaking to residents with dignity and respect and involving them in their care. Staff were well trained and had received regular training updates. They had the skills and knowledge to provide the care and treatment people need.

The home was clean and tidy and people were happy with the cleanliness and decoration. The lounges were appropriately decorated and the furniture was a good quality. Each bedroom had been nicely decorated and people had brought in personal possession, such as pictures and ornaments, to help make it feel homely.

The home has systems in place to consult with people who use the service, relatives and visitors on the quality of the service provided by the home. There are also systems in place for people to use if they have a concern or are not happy with the service being provided to them. Those people we spoke with knew who to speak to if they were unhappy or if they had any concerns.