Woodpeckers

There are large gardens and patio area’s which provide a safe and secure private leisure area for people living at the home.

There was a registered manager in place. 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.

People felt safe living at Woodpeckers and they were very much at the heart of the service. We received consistent positive feedback from people, their families and health professionals. People received excellent care that was based around their individual needs and that ensured care was personalised and responsive.

Staff working at Woodpeckers understood the needs of people using the service and supported people in an exceptionally personalised way. Staff knew people well and we saw that care was provided respectfully and sensitively, taking into account people’s different needs. The impact this had on people was outstanding and had resulted in people living an active life with choice evident throughout.

The home developed and promoted community involvement within the home. They hosted a

Winter Wonderland event which people were involved in and had made products to sell and raise money for the charity of their choice. People, their families and staff took part in the local carnival procession. The home had built strong links with the local primary school and children visited the home weekly and worked with people through a buddy system.

The provider employed an Admiral Nurse to support staff, people and their families living with dementia. The service recognised and responded to people’s needs for social interaction and mental stimulation. The registered manager also promoted community involvement and supported a student from a special needs school with work experience, where one person especially enjoyed the interaction.

People were cared for by a motivated and well trained staff team, who always put people first. Staff had the specialist knowledge and skills required to meet people’s needs. Staff were encouraged to develop their careers and increase their skill set.

The home was responsive to people’s needs and wishes. People were able to choose what activities they took part in and suggest other activities they would like to complete.

Relevant recruitment checks were conducted before staff started working at Woodpeckers to make sure they were of good character and had the necessary skills. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. There were enough staff to keep people safe. People involved in the recruitment process and had an input in staff employed at the home.

People received a high standard of care because staff were led by an experienced and proactive registered manager .The provider continued to seek to improve people’s care and treatment by working in partnership with other health providers to implement best practice.

Staff worked closely with the local college supporting new students into care which benefited the college and people at the home.

Regular governance meeting were held which promoted strong leadership of continuing improving and continually learning to improve quality of care.

The risks to people were minimized through risk assessments. There were plans in place for foreseeable emergencies and fire safety checks were carried out.

People received varied meals including a choice of fresh food and drinks. Mealtimes were positive and sociable experiences. Staff were aware of people’s likes and dislikes and offered alternatives if people did not want the menu choice of the day.

Creative ways had been introduced to encourage eating for people who were nutritionally at risk in the shape of smoothies and savoury cereal bars. People were listened to for meal preferences and as a result a winter menu was brought in with an extra hot meal in the evening and people chose different guest ice creams and were imaginative in their ideas.

A nutrition folder had been introduced with the guidance of the NHS professionals in dietetics.

The provider worked in partnership with other health organisations and were involved in a pilot on National Early Warning Score to identify early warning signs of deterioration in people.

Staff received regular support and received regular one to one sessions of supervision to discuss areas of development. New staff completed an induction programme before being permitted to work unsupervised.

People felt they were treated with kindness and said their privacy and dignity was respected. Staff had an understanding of the Mental Capacity Act (MCA) and were clear that people had the right to make their own choices. Staff sought consent from people before providing care and support. The ability of people to make decisions was assessed in line with legal requirements to ensure their rights were protected and their liberty was not restricted unlawfully. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

The home maintained a good level of communication with people through a range of newsletters and meetings. ‘Residents meetings’ and surveys allowed people and their families to provide feedback, which was used to improve the service. People felt listened to and a complaints procedure was in place.

Regular audits of the service were carried out to assess and monitor the quality of the service. There were appropriate management arrangements in place.

At the last inspection in October 2015 the service was rated good. At this inspection we found the service was outstanding.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Woodpecker's is registered to provide accommodation and nursing care for up to 41 people, some of whom may have dementia. During our inspection we looked at care plans, policies and procedures, training records, staff records, surveys and quality and audits. During the inspection we spoke with six people using the service and 2 relatives. We also spoke with the registered manager, four members of the care staff and chef. This is a summary of what we found.

Is the service safe?

At our last inspection of the home in September 2013 we found inconsistent information in three care records the home kept about each person.

During this inspection we looked at six peoples care plans and saw that they were person centred and individualised. They provided staff with clear information on how people needed to be supported.

We saw that when required, mental capacity assessments had been undertaken by the home and we were able to see that relatives and medical professionals, where necessary, were involved in the assessments. Although the registered manager had not submitted any applications to the local authority for the Deprivation of Liberty Safeguards (DOLs), we saw that the home had a process in place should the need arise.

We looked at records which showed the provider had emergency evacuation procedures and had completed fire drills. Fire and smoke detection systems were also in place and regularly tested, as were all electrical and gas installations. This meant that the home was safe and that people had been protected against the risks associated with unsuitable premises.

Care plans and risk assessments were reviewed monthly or as people's needs changed. This showed that information about people was current and relevant. We saw how information was recorded on a daily basis and that this information was included in the reviews of people's care.

Is the service effective?

We saw evidence that people who were at high risk of developing pressure areas, had been assessed using a 'waterlow' risk assessment form. A care plan for skin care was in place for staff to follow in order to minimise the risks of skin damage.

We saw menu plans were shared with people on a daily basis to allow them to

choose their meals. This meant that people were provided with a choice of suitable and nutritious food and drink. One person who used the service said: 'The food is very good here. The chef is marvellous and cooks the most delightful food'.

Is the service caring?

We saw that people moved freely around the home and that staff knew people by their names. People's bedrooms were clean, tidy and included small personal items of furniture and photographs that people had taken into the home with them. One person who used the service said: 'This is a lovely place to live'.

After lunch table tennis was the afternoon activity. This was played between 16 people living at Woodpeckers. The game had been adapted by the activities coordinator to ensure that people of all abilities could join in. For example, three different size balls and three different size bats were used. This ensured that people with, for example, impaired vision were able to take part and enjoy the activity with everyone else.

Is the service responsive?

There were arrangements in place to deal with foreseeable emergencies. Each person living at Woodpeckers had a detailed Personal Emergency Evacuation Plan (PEEP). This gave details of people's mobility and staffing requirements needed to evacuate people safely in the event of an emergency, such as fire.

Is the service well led?

The home had a system in place for people who did not wish to join in with activities, or for those people who had specific welfare and social care needs. A period of time was made available daily by the home for one to one personal support by a member of the care staff. People we spoke with found this to be of great comfort especially with helping people to write letters or to have someone to talk with.

We saw that regular audits of the quality and safety of the service took place and were recorded. A services manager for the provider visited the home monthly and carried out a Monthly Home Performance Review. We looked at the monitoring of accidents in the home and saw that monthly audits had been completed. The audit consisted of a summary of accidents, analysis and action required.

People who used the service said they felt safe in the home and were confident that staff would respond appropriately to any concerns they raised. One person we spoke with said, 'I definitely feel safe. If I was worried about anything I would speak with the matron, who I feel is very fair.' People were cared for by suitably qualified, skilled and experienced staff. The provider thoroughly checked staff before they started work at the home.

The provider had systems for storing records safely; however, records were not always fully completed. This lack of information in the records did not always protect people from the risk of receiving unsafe or inappropriate care and treatment.

People we spoke with told us they were able to get their medicines when they needed them. One person said they could get pain relief when needed, adding: 'They always ask whether I have any pain'. People said they were able to raise concerns with the staff or manager and were confident that action would be taken to address the issue.