Archived: Woodlands House

We observed lunch on 12 September 2012. People in the dining room on the ground floor were supported by three staff. Some people were able to eat independently and were given supported to cut up their food. Other people were able to eat with prompting from staff. There was someone in the dining room throughout the meal time.

One person asked;" What do I do?". The member of staff told the person to "Eat your lunch please". The person then put some of their lunch down the radiator. Staff assisted this person following this.

We returned to the home on 2 October 2012 due to further concerns about how people were supported at meal time. We found that one person we had recent concerns about was receiving a soft diet as stated in their risk assessment and their drink was thickened.

We found all bathrooms and toilets had liquid hand soap in dispensers and paper handtowels. Commodes were clean in people's rooms. All equipment in communal bathrooms was clean.

We observed a member of staff giving out medicines at lunch time. They ensured the medicine trolley was locked when they were away from it.

We looked in all the bedrooms and communal areas of the home. We found that improvements had been made. The improvements had been sustained since our last visit on 12 September 2012.

The conservatory had been cleaned and had new chairs. During our visit people came to sit in the conservatory.

We observed staff supporting people with personal care tasks and taking time to talk with people. In the afternoon staff provided an activity in the lounge for people.

We saw people left alone in all three lounges during the morning and afternoon. They were unsupervised.

A new form was in place to record which meals people ate were fortified. However not all the records we looked at in four people's rooms were using this recording method so it was unclear if they had received fortified food or not.

People who needed their food and fluids to be monitored, to ensure they were eating and drinking enough to maintain their health and wellbeing, did not have this information recorded properly.

A person who was cared for in bed was not on a mattress at the correct setting to ensure their skin stayed healthy.

Medicines were not monitored effectively to ensure people had the medicines they needed at the correct time.

The home was visibly clean. All bathrooms and toilets had liquid soap and paper towels to reduce the risk of cross infection. Not all the equipment in bathrooms, toilets and bedrooms had been checked regularly to ensure they were clean.

Some of the people who lived in the home were unable to tell us their views about their care because of their dementia. Therefore, we spent time observing people in the home to help us understand their experience.

We observed that staff spoke positively with people when they were helping them with a specific task, such as using the hoist or supporting them with eating a meal. On those occasions we found that staff were cheerful and encouraging in their approach. However, there were some periods of time when people were sat in the lounges of the home and there were no staff around to interact with them or make sure they were safe. At these times people were observed to either sleep or stare straight ahead. There was no evidence of activities taking place in the home, or things for people to do, to ensure that people were engaged and stimulated during the day.

We spoke with three people about the food provided for them at the home. Two people spoke very positively about the food telling us that it was very good and they got as much as they wanted. One person told us that they did not get a choice of meals. Although the chef told us that people did have a choice of meals, we did not see any evidence of pictures or other aids being used to assist people with dementia in making their choice.

We spoke with the relatives of two people who were visiting the home at the time of our inspection. They told us that staff welcomed them into the home and communicated well with them. One relative told us that staff were always pleasant and they had confidence that their family member's needs were met. They also told us that they felt management and staff at the home at the home listened to what they said and sorted out any problems quickly and efficiently. They had no concerns about the home.

Our inspection identified concerns in relation to the care and welfare of people who used the service, infection control practice in the home, the management of medicines, the home environment and staff training. We identified major concerns in relation to the way the home assessed and monitored the quality of care they provided to ensure people's needs were met. We have told the home to take action in response to our concerns.