Archived: Woodlands

Woodlands is a residential care home, registered to support six people in an adapted building over two floors. It provides personal care and accommodation for people with learning difficulties. On the day of our visit five people were using the service.

The service has been developed and designed in line with the principles and values that underpin 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 to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The providers quality monitoring systems were not fully effective to drive improvement. The provider lacked oversight in reporting all incidents and ensuring staff were up to date with training. Some areas of the environment were in a state of disrepair. For example, windows in communal areas had mould round them

Risk guidance to keep people safe was not consistently followed by all staff to minimise identified risks. Hazards to people were not managed safely, putting people at risk of scalding. Access to and from the building did not ensure people would be safe if left unsupervised. Some staff and relatives felt their were not enough staff to support people.

We have made a recommendation about staffing levels.

Medicine systems and processes were in place to ensure people received their medicines as prescribed. However, there was no clear audit trail where medicines had been soiled. The registered manager addressed this by starting to record on the reserve of the medication records when medicines had been soiled during administration.

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.

The service applied the principles and values consistently of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff understood their responsibility to safeguard people from harm and knew how to report concerns.

People were supported to maintain relationships with people important to them. Staff were caring in their approach and had good relationships with people. Staff treated people with respect and their dignity and privacy was respected.

Promoting independence was a part of the ethos of the service and people were supported by staff to maintain their independence.

People were supported to maintain their health and well-being and had access to healthcare professionals such as GP's when required. People were supported to eat and drink enough to maintain a balanced diet. Refreshments were available to people throughout the day

People and their representatives were involved in their care to enable them to receive support in their preferred way. People were supported to access local community facilities to enhance their well-being.

The provider’s complaints policy and procedure was accessible to people who used the service and their representatives. Peoples representatives knew how to make a complaint.

Lessons were learnt when things went wrong. Relatives and staff felt they could approach the registered manager if they had any concerns.

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 good (published 27 October 2016).

Why we inspected

This was a planned inspection based on the previous rating.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvements. Please see the Safe and Effective sections of this full report.

Enforcement

At this inspection we found a breach of Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Woodlands is a residential home which provides care to people with learning difficulties. It is registered to provide care for up to six people. At the time of our inspection there were four people living at 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 and associated Regulations about how the service is run.

Relatives we spoke with said they thought the home was safe for their family members. Staffing levels were sufficient to protect people's safety. Staff had been trained in safeguarding (protecting people from abuse) and understood their responsibilities in this area.

People's risk assessments provided staff with information on how to support people safely but these were not always followed. People's prescribed medicines had been supplied to them to support their health needs.

Staff had been trained to ensure they had the skills and knowledge to meet people's needs.

Staff understood their main responsibility under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have an effective choice about how they lived their lives. The provider had followed proper procedures to ensure decisions were made in people's best interests.

People had plenty to eat and drink and their choices and preferences were taken into account when providing food to them.

People's health care needs had been protected by referrals to health care professionals when necessary.

Relatives thought staff were caring and friendly to their family members. We saw many examples of staff working with people in a friendly and caring way, although we witnessed a situation where this had not been the case.

People and their representatives were involved in making decisions about their care, treatment and support.

Care plans were individual to the people using the service and covered their health and social care needs.

Activities were organised to provide stimulation for people and they took part in activities in the community if they chose.

Relatives told us they would tell staff if they had any concerns and were confident these would be followed up.

Relatives and staff were satisfied with how the service was run by the registered manager.

Management carried out audits and checks to ensure the home was running properly to meet people's needs, though not all essential issues had been audited.

We found the service had policies and procedures in place to safeguard people from abuse and their finances were properly managed.

We found there were enough staff to meet individual needs and people's views were taken into consideration when assessing and monitoring the quality of the service.

We found that people were involved in discussions about their needs and care. One person said that they like to get up in the morning at 7am and have bacon and eggs for breakfast. We found that people's views and experiences were taken into account in the way the service was provided and delivered in relation to their care. The privacy, dignity and independence of people using the service were respected.

People experienced care, treatment and support that met their needs and protected their rights. A visiting health professional told us that they 'had no concerns. The people are looked after well'.

We found that people were cared for, or supported by, suitably qualified, skilled and experienced staff. People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.