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Inspection carried out on 26 February 2018

During a routine inspection

Woodcrofts is a residential care home located in Widnes close to local amenities such as bus routes and shops. It is owned by Woodcrofts residential homes limited. The home is a two storey building with 19 bedrooms, shared bathrooms and three communal lounges. The home specialises in providing accommodation and support for people with mental health needs. At the time of our inspection, there were 16 people living in the home.

At the last inspection on the 16 September 2015, the service was rated Good. At this inspection we found the evidence continued to support the rating of Good however we changed the rating under well-led to Requires Improvement because the governance procedures did not always reflect the quality of care being delivered. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

A registered manager was in post at the service. The registered manager was also the registered provider of the service and was supported by a deputy manager and a senior carer. 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 provider had systems and processes in place to ensure that staff who worked at the service were recruited safely. People were supported by a consistent staff team, many of whom had worked at the home for a number of years. We observed there was enough staff employed to meet people’s needs.

Staff had received training in safeguarding and understood their responsibilities to protect people from harm and abuse. Staff understood the reporting procedures including how to raise concerns with their line manager as well as reporting to other organisations such as the Local Authority or CQC.

A risk screening tool was completed which assessed any risks to people's health, safety and wellbeing. Identified risks were managed in a manner that promoted both independence and safety.

Risks associated with the safety of the environment and equipment were identified and managed appropriately. Medication was stored securely and administered by staff who had received the appropriate training.

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. Staff and the registered manager maintained a clear focus on people’s autonomy to live their lives as they chose. The registered manager described the support they provided as akin to “an invisible safety net to enable people to live as independent lives as possible.”

The service operated within the principles of the Mental Capacity Act 2005 (MCA) and we saw this guidance was taken into consideration when care plans were developed. There was no Deprivation of Liberty Safeguards (DoLS) in place at the time of our inspection.

People were supported to maintain good health and the registered manager often accompanied people to routine appointments. Care records showed that staff sought the input of health and social care professionals when needed. We spoke to two visiting health professionals during our inspection who told us that staff ‘go above and beyond’ and were prompt in recognising any deterioration in health or changes to people’s support needs.

Staff had the necessary skills and knowledge to support people in the way they needed and had a good understanding of the individual needs of the people living at the home. Staff spoken with felt they received sufficient training to enable them to complete their role effectively. The registered provider’s records showed staff required refresher training in some topics and we saw that this was either in process or scheduled.

People told us they enjoyed the food served at the home. Care records showed staff had given consideration to people’s nutritional needs and diabetic diets were catered to.

Everyone we spoke with, without exception, spoke positively about the registered manager and the staff. We observed kind and natural interactions between staff and the people they supported.

People maintained their independence and chose how to spend their leisure time. People were supported to access the local community if they required it but the majority enjoyed frequent access to the local community, pubs and shops without staff assistance. This ensured that people's individuality, choice and freedom was respected and promoted.

People who used the service had experienced enduring mental health conditions which were recognised, understood and supported by staff in a highly person centred way. Records showed and feedback demonstrated that people were supported to live as independently as possible in the local community and this had improved their outcomes and minimised their use of crisis mental health services.

People had access to a complaints policy but those we spoke with told us they had no cause to make a complaint and if they needed to, they would just “knock on the office and speak to [registered manager].” The registered provider’s records showed there had been no recent complaints.

Staff we spoke with were able to describe the visions and values of the service, and felt supported by registered manager in delivering them. One staff member told us their focus was, “To promote independence whilst ensuring people are safe and happy.”

There were opportunities for people and their relatives to provide feedback regarding the home and contribute to service delivery through the use of annual surveys. People told us they could approach the registered manager or staff at any time and felt they would be listened to.

We observed people who used the service approach the registered manager with ease and a sense of familiarity. Staff spoken with told us the registered manager was ‘brilliant’, ‘supportive’ and as someone they could “approach with anything.”

We noted that the registered provider’s documentation was not always reflective of the quality of the care being delivered at the service. We identified that some governance procedures to assess and monitor the quality of the home were not documented. We did not receive a Provider Information Return from the service and identified one incident which had not been notified to us in accordance with our statutory requirements. The registered manager was clearly very 'hands on' in their approach and took an active role in the daily lives of all the people using the service but admitted this sometimes meant that paperwork was not always completed most effectively. The registered manager acknowledged this as an area for further development.

Inspection carried out on 16 September 2015

During a routine inspection

The inspection was unannounced and took place on 16 September 2015. This location was last inspected in July 2014 when it was found to be compliant with all the regulations which apply to a service of this type.

Woodcrofts Residential Home (Woodcrofts) is a residential care home providing accommodation and support for up to 20 people with mental health needs. It is owned by Woodcrofts Residential Homes Limited. The service is situated in a residential area of Widnes close to local amenities. The home is a two storey building which includes a dining room, three lounge areas and 19 bedrooms, none of which have en suite facilities. Parking is available on the main road outside the premises.

There is a registered manager at Woodcrofts. 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.

We found that care was provided by a long term staff group in an environment which was friendly and homely. People who lived in Woodcrofts spoke of it as their home.

Staff knew about the need to safeguard people and were provided with the right information they needed to do this. They knew what to do if they had a concern. There were sufficient staff to meet the needs of the people who lived in the home.

The home was well-decorated and maintained and adapted where required. People had their own bedrooms which they could personalise as they wished.

The registered manager is also the registered provider of the home. He has been registered as manager with CQC since 2013 and was fully conversant with the policies and practices of the home. Staff told us that the management team were transparent, knowledgeable and reliable and that the home was run in the very best interests of the people who lived there.

Inspection carried out on 24 June 2014

During a routine inspection

We considered our inspection findings to answer questions we always ask;

• 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?

Staff had received training in safeguarding and felt confident in being able to maintain people's safety. Staff were confident they would be listened to by the provider and supported with reporting procedures to safeguard people living at the service. They told us they would not hesitate to report any concerns.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The staff had a good knowledge base regarding these safeguards. Staff had access to appropriate policies and procedures including guidance on the Mental Capacity Act. These policies are necessary to ensure the protection of vulnerable people who may lack the ability to consent on various issues.

One staff member told us that staff worked hard to provide a service which maintained people's safety and well-being whilst allowing them to live a life of their choice. They said that "staff provided an invisible safety net".

Is the service effective?

We spoke with ten people who lived in Woodcrofts and they told us they were happy with the care that had been provided and they felt their needs were being met. We observed the support being provided and saw examples of good communication and interaction by staff. Staff discussed the individual needs of people they supported. Staff described the support they provided on a day to day basis including daily choices and they were knowledgeable about people's needs and requests. People told us they were supported to pursue hobbies and interests and live a fulfilling life.

Is the service caring?

The interactions between staff and people who lived in the home were excellent. Conversations were all interspersed with gentle humour and mutual respect was observed at all times. Comments received were all positive and included, "staff are very good and help me a lot", "staff never let me down", "the staff provide very good care" and "they are always around, always helpful, if you need any help they always assist". Observations of staff interactions with people who used the service evidenced that they did this with confidence and skill and good humour and in a relaxed and positive manner.

We saw that the staff were skilled in supporting people whilst encouraging them to maintain their independence. Staff discussed the individual needs of people they supported. Staff described the support they provided on a day to day basis including daily choices and they were knowledgeable about people's needs and requests.

Is the service responsive?

People living at the service had a detailed care plan in place to help to show how their needs would be met while living at Woodcrofts. These records were detailed and showed that people's choices and diverse needs were identified and care plans were regularly reviewed. People told us that they were able to discuss arrangements made for their care and they said that they were happy and content with the manner in which their care and support was provided. Feedback from people's relatives also confirmed that people were pleased with the services provided. One relative told us that they felt the home provided just the right amount of care to enable people to live a life of their choice.

Is the service well-led?

The provider had distributed surveys to people using the service and relatives to obtain their feedback. Positive summary reports had been produced and were available for viewing by any person living or visiting the service. People who lived in the home told us that they had regular residents meetings where they discussed the running of the home and made any suggestions as to how it could be improved upon.

There was a selection of in house audits carried out by the manager with checks on various areas within the service including; pharmacy audits; accidents; weight loss; safeguard referrals; records and health and safety. They showed on-going checks by the manager offering evidence of compliance and actions taken to show good practices in supporting people who lived, visited or worked in the home.

Inspection carried out on 14 November 2013

During an inspection to make sure that the improvements required had been made

During our last inspection we issued a compliance action for outcome four for care and welfare and for outcome 14 for staff training and supervised needs. During our visit we reviewed the various improvements made by the service to their records for training and supervision and in demonstrating how people were supported with their care plans and their needs and requests for social support and activities.

We met most people living at Woodcrofts residential home. They advised us they were happy living at the service. They told us that: "There are books to read and games. I've just bought a new television"; "you can please yourself what you do, which I am quite happy with"; "I've got everything I need in my room"; "I think it's lovely here"; the staff help me like with writing a letter"; "I don't want activities, I like to go to town to the shops" and "I'm quite content with the way things are." People were positive about the staff saying: "I like all the staff they are nice people" and "staff are ok."

The service organised monthly meetings for people living at Woodcrofts residential home. Minutes showed information about a lot of topics discussed at these meetings such as: activities; request for bingo; request for toast in the evenings; refurbishment; baths and hoovering. Regular engagement and feedback offered ways for people using the service to provide their opinions and helped influence the development of the service.

Inspection carried out on 14 February 2013

During a routine inspection

We spoke with most people living at the service and one visitor during our unannounced inspection. They made various positive comments such as; “We are ok, everything’s fine here”and “I’m fine, I’ve been here a long time” and “I’ve got everything I need.”

Some of the people we spoke with told us there wasn’t much to do in the day time. Care files showed no evidence of support or consultation with the individual regarding how their social needs would be met.

Most staff records could not demonstrate whether they had received training in various necessary subjects such as safeguarding; mental health needs; challenging behaviour; food hygiene; medications; fire training and health and safety. The manager/provider advised they would review all staff training needs to ensure that all staff received mandatory training and supervision necessary for their work.

As part of this review we spoke with the provider who advised they had taken steps to recruit a manager for the service. However for the last year the provider had been carrying out the role of the manager but they had not applied to be registered with the ‘Care Quality Commission.’ The provider was aware of the legal requirement to have a registered manager at the service.

Inspection carried out on 14 November 2011

During a routine inspection

We spoke to people who use the service. For the purposes of this review we utilised the services of an Expert by Experience in order to do this. Individuals provided positive comments of the support they received and these are included within this report.

Reports under our old system of regulation (including those from before CQC was created)