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Inspection carried out on 4 March 2020

During a routine inspection

About the service:

Woodlands House is a residential care home. It provides personal care and accommodation for up to 40 older people. There were 38 people living at the service at the time of inspection, some of whom were living with dementia. The home consisted of a residential setting and a separate ‘dementia cottage’, designed to provide higher levels of care.

People’s experience of using this service:

The provider had fostered an overwhelmingly person- centred approach to delivering care. There was a focus on giving people meaningful occupation, utilising skills and keeping people connected to their local community. Activities at the home were creative, wide ranging and designed with people’s skills and interests in mind. This had clear benefits in improving people’s physical and mental wellbeing.

People, relatives and professionals told us how the provider’s person-centred approach had helped to make improvements to people’s motivation, mood, independence and social interaction. Staff were skilled in their approach to ensure that people’s individual needs were considered in the design and delivery of care.

The service had a record of outstanding practice in delivering end of life care in line with best practice. They worked in partnership with people, relatives and stakeholders to help ensure people receive personalised care which reflected their needs and preferences as they neared the end of their life.

Staff were motivated in their role and were caring. They understood people’s needs and treated them with dignity and respect. There was a positive atmosphere at the home, where people were content, active and well attended to.

There was strong leadership at the home. The registered manager understood the responsibilities of their role and was attuned to people’s needs. There were effective systems in place to monitor the quality and safety of the service.

People’s needs were assessed to ensure they received appropriate support with their nutrition, hydration, medicines and healthcare. Risks associated with the environment were safely managed and the home was clean and hygienic.

The home was a suitable environment for people. There were a range of communal spaces which people could utilise throughout the day. The provider had made adaptions to the home to make it suitable for people living with dementia.

The provider had processes in place to gain appropriate consent to care. 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.

The provider had safeguarding policies and procedures in place, which helped to reduce the risk of people suffering abuse or coming to avoidable harm. There were appropriate systems in place to gain feedback and respond to complaints.

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

Rating at last inspection:

The service was rated good at our last inspection (published 4 July 2017)

Why we inspected

This was a planned inspection based on the previous rating.

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.

Inspection carried out on 31 May 2017

During a routine inspection

Woodlands House is part of the Hartford Care Group and is an older style residential home located within the New Forest set within large grounds and gardens. The home consists of the main building which has been converted to provide care and accommodation for up to 30 people over two floors. People living in the main house are generally more independent and require support with some daily living tasks such as personal care or support with their medicines management and the provision of meals. In addition there is a newer ground floor extension which provides a nine bedded unit for people living with more advanced dementia known as The Cottage. People living on this unit are more dependent and require support with most aspects of daily living and regular monitoring and supervision to ensure they are safe. Parking is available within the grounds. The home is not registered to provide nursing care but does provide a day care service. There were 37 people living in the home at the time of our inspection.

At the last inspection, the service was rated good overall. This inspection found that the service remained good.

The service had 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 and associated Regulations about how the service is run.

Improvements were needed to ensure the proper and safe use of medicines.

Staff had received training in safeguarding adults, and had a good understanding of the signs of abuse and neglect. Staff were confident the registered manager would act upon any concerns they raised.

People had risk assessments and where risks had been identified, measures were in place which helped to ensure that the risk was minimised.

Safe recruitment practices were followed and there were sufficient numbers of staff deployed to meet people’s needs.

Staff sought people’s consent before providing care and people were encouraged and supported to make decisions about their care and support. Staff acted in accordance with the principles of the Mental Capacity Act 2005. Where people’s liberty or freedoms were at risk of being restricted, the proper authorisations were either in place or had been applied for.

Staff received training, supervision and an induction which ensured they had the skills and knowledge to support people appropriately.

People told us the food was tasty and that they were supported to have enough to eat and drink.

People were cared for by staff that were very kind and caring and with whom they had developed strong relationships. Staff were attentive, showed people kindness and patience and displayed a genuine interest in the people they supported. Staff delivered care in a compassionate manner and people were treated with dignity and respect.

Care plans contained the information needed to support staff to provide people’s care in a manner that was responsive to their individual needs. People were supported to take part in a range of activities and make choices about how they spent their time.

People spoke positively about how well organised and managed the service was. The engagement and involvement of people and staff was encouraged and their feedback was used to drive improvements.

There were systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving appropriate support.

Inspection carried out on 17 & 19 March 2015

During a routine inspection

This inspection took place on 17 and 19 March 2015 and was unannounced.

Woodlands House is part of the Hartford Care Group and is an older style residential home located within the New Forest set within large grounds and gardens. The home consists of the main building which has been converted to provide care and accommodation for up to 30 people over two floors. People living in the main house are generally more independent and only require support with some daily living tasks such as personal care or support with their medicines management and the preparation of meals. In addition there is a newer ground floor extension which provides a nine bedded dementia care unit known as The Cottage. People living on this unit are more dependent and require support with most aspects of daily living and regular monitoring and supervision to ensure they are safe. Parking is available within the grounds. The home is not registered to provide nursing care. There were 32 people living in the home when we inspected.

The service did not have 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 and associated Regulations about how the service is run. A new manager was appointed in August 2014. They have made an application to be appointed the registered manager.

Some areas required improvement. Staff had not always maintained an accurate record of the medicines they administered and we found a number of incidents where people had run out of their prescribed medicines. Some risk assessments needed to be updated to include more detailed and specific guidance to support staff to manage risks in a safe and effective manner.

People told us they felt safe and there were systems and processes in place to protect them from harm. Staff were trained in how to recognise and respond to abuse and understood their responsibility to report any concerns to their management team.

Safe recruitment practices were followed and appropriate checks had been undertaken which made sure only suitable staff were employed to care for people in the home. There were sufficient numbers of experienced staff to meet people’s needs.

Staff received a comprehensive induction which involved learning about the needs of people using the service and key policies and procedures. Staff were supported to provide appropriate care to people because they were trained, supervised and appraised.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which apply to care homes. Where people’s liberty or freedoms were at risk of being restricted, the proper authorisations were in place or had been applied for.

People were supported to have enough to eat and drink and their care plans included information about their dietary needs and risks in relation to nutrition and hydration.

People told us they were happy with the care provided and said they had good relationships with staff. Comments included, “We really like the staff” and “The staff are brilliant, a lovely bunch, flexible and helpful”.

People told us they received personalised care and were encouraged make choices about how they spent their time. People were supported to take part in a range of activities in line with their personal preferences. Complaints policies and procedures were in place. People told us were confident they could raise concerns or complaints and that these would be dealt with.

People spoke positively about how well organised and managed the service was. There was an open and transparent culture within the service and the engagement and involvement of people and staff was encouraged and their feedback was used to drive improvements. There were a range of systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving appropriate support.

Inspection carried out on 18 July 2014

During an inspection looking at part of the service

This inspection was carried out to assess the safe management of medicines.

This is a summary of what we found-

Is the service safe?

We found the service was safe because people were protected against the risks associated with medicines. The provider had appropriate arrangements in place to manage people's medicines safely.

You can see our judgements on the front page of this report.

Medicines were kept safely. Supporting information for allergies, �how a person preferred to take their medicines�, �variable� and �if required� medicines and creams and ointments applied as part of personal care were available.

The administration records were complete, including the exact dose administered for �variable doses�.

Inspection carried out on 8 May 2014

During an inspection in response to concerns

We inspected the home on the 8 May 2014 following concerns raised about the management of medicines in the home.

We considered all the evidence we had gathered under the outcome we inspected. We used the information to answer one of the five questions we always ask;

Is the service safe?

This is a summary of what we found-

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Systems were in place to receive and administer medicines. Supporting information about �how the service users took their medicines� was available to support staff administering medicines safely. We observed medicines being safely administered.

Systems and equipment were not in place for the secure storage and segregation of medicines. Supporting information was not available for �variable dose� and �if required� medicines. Allergy information was also incomplete for two service users. Where a medicine required additional monitoring the records were incomplete. Following an increase in medication errors the service had increased the frequency of audits. This meant that people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

Inspection carried out on 27 November 2013

During a routine inspection

At the time of our visit, Woodlands House Care Home did not have a registered manager in post. The manager at this service is completing the registration process to become the new registered manager.

People appeared relaxed and at ease with staff, we saw people laughing and singing with each other and staff. The people we spoke with told us they got on well with the staff and had good, supportive relationships with them. We were told �The staff are like angels looking after me�. We observed staff being person centred in their approach to people; they showed sensitivity to people�s needs and preferences. We saw that care was centred on the individual and their immediate and long term needs.

We saw that there were policies in place in relation to the control of infection in the home, including the minimising of the spread of infection. People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.

Inspection carried out on 18 March 2013

During a routine inspection

During this visit we spoke with five people who used the service, with four staff, a visitor and with the manager.

The manager had recently been put into post was endeavouring to maintain the essential standards of quality and safety.

People were happy with the service provided and we saw that staff interacted well with people in their care and talked positively about their work. People were, as far as they were able to do so, involved in making decisions about their care and support and asked for their consent to care.

People's needs were assessed and care was delivered in line with their care plans. There were policies and procedures in place to ensure that the safety and suitability of the premises was maintained, these were understood and followed by staff.

There were enough qualified, skilled and experienced staff to meet people�s needs.

There was an effective system in place to deal appropriately with comments and complaints made by people, or persons acting on their behalf.

Inspection carried out on 13 February 2012

During a routine inspection

Some people using the service were able to tell us about their experiences and we also spoke with a visiting health professional.

Many of the people who live at Woodlands House have dementia and therefore not everyone was able to tell us about their experiences. To help us to understand the experiences people had we observed people during the midday meal.

People were positive about the way the staff met their needs. People told us that they felt the staff did a good job and did not have any concerns or complaints.