Woodlands Residential Care

We found the following examples of good practice.

We observed staff undertaking activities with people and getting ready for a party. We observed how the home was going to facilitate this in a safe way for residents and staff. We observed people moving about the home freely and safely, maintaining social distance.

Residents were able to spend time seeing and speaking to their visitors in different ways. On-site visits were facilitated by pre-booking and visitors went straight to people’s rooms. They did not interact with any other people at the home and visiting times were not restricted. There were also extensive gardens where visits could take place when the weather allowed.

The home monitored the vaccination status of residents and staff and undertook risk assessments where staff had exemptions. The majority of staff and residents had been vaccinated and had received their boosters. COVID-19 testing was undertaken twice weekly by all staff and lateral flow testing was required before each shift. Staff were incentivised to cover, and the use of agency staff was kept to a minimum.

Stocks of appropriate personal protective equipment (PPE) were well-maintained and staff used and disposed of it correctly. Staff had been trained in infection control practices.

Woodlands Residential Care is a care home that provides personal care and accommodation for up to 34 older people. Twenty-seven people were living at the service at the time of this inspection.

People's experience of using this service:

Improvements had been made since the last inspection so that more robust systems were in place for cleaning and management of the kitchen.

We have made recommendations about the recording of medicines; information needed when applying for Deprivation of Liberty Safeguards (DoLS) and the management of records.

People's needs and wishes were assessed and planned for. Care plans identified the intended outcomes for people and how their needs were to be met. People received care and support from appropriately trained staff. People were offered a nutritious and balanced diet and their healthcare needs were understood and met.

People and healthcare professionals described managers as approachable and supportive. Systems were in place to gather people's views on the service. People were treated with kindness and respect by staff who knew them well. Staff provided care and support in a calming, relaxing manner with positive outcomes for people.

People were protected from abuse and the risk of abuse and staff understood their role in relation to this. People told us that the service was safe. Risks to people and others were identified and measures put in place to minimise harm. Infection control practices were followed to minimise the risk of the spread of infection. Checks were carried out on the environment and equipment.

Staff were knowledgeable about people's needs and how they were to be met. People told us they received care and support in line with their care plan. People knew how to raise a concern or make a complaint about the service.

Details are in the key questions below.

Rating at the last inspection: Required Improvement (report published on 22 December 2017).

Why we inspected:

This was a planned inspection based on the rating of the last inspection. The rating for this service has improved to good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

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

Woodlands Residential Care is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home is registered to accommodate and provide care and support for up to 34 people. At the time of our inspection, there were 23 people living in the home. The accommodation is in a mansion style, older property, with large rooms and areas, over four floors, including a lower ground floor where the kitchen, a lounge and dining room were situated. People’s bedrooms and a further lounge, were in the three floors above. The office and reception area was on the ground floor. On the top floor was an administrative office. The home is surrounded by its own grounds and was close to local amenities and transport links.

The home required a registered manager and one had been in post for several years. 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.

At this inspection, we found that there were breaches of regulations 12 (safe care and treatment)

and 17 (good governance). This was because we found the kitchen in a dirty state, with foodstuffs inappropriately stored and records inadequately completed. The management processes had not identified these concerns.

At our last inspection we had commented that there were insufficient staff available to meet people’s needs. At this inspection, we observed that there appeared to be enough staff to meet the needs of the people living in Woodlands

We looked at records relating to the safety of the premises and its equipment, which were mostly, correctly recorded.

People received sufficient quantities of food and drink and had a choice in the meals that they received. Where people had lost weight this was recognised with appropriate action taken to meet the person’s nutritional needs. Menus were varied and alternatives were always provided for anyone who didn’t want to have the meal on the menu for that day. People we spoke with said they always had plenty to eat. We observed the lunch time meal where staff were observed to support people to eat and drink with dignity.

The provider had complied with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and its associated codes of practice in the delivery of care. We found that the staff had followed the requirements and principles of the Mental Capacity Act 2005 (MCA).

We found that the care plans and risk assessment monthly review records were all up to date in the files looked at and there was updated information that reflected the changes of people’s health

People told us they felt safe with staff and this was confirmed by people’s relatives who we spoke with. The registered manager had a good understanding of safeguarding. The registered manager had responded appropriately to allegations of abuse and had ensured reporting to the local authority and the CQC as required.

Accidents and incidents were recorded and monitored to ensure that appropriate action was taken to prevent further incidences. Staff knew what to do if any difficulties arose whilst supporting somebody, or if an accident happened.

People were able to see their friends and families when they wanted. Visitors were seen to be welcomed by all staff throughout the inspection.

Records we looked at showed that the required safety checks for gas, electric and fire safety were carried out.

You can see what action we told the provider to take at the back of the full version of the report.

The home was situated in a large period building and has registered to provide accommodation to up to 34 people who required personal care. The home had 29 bedrooms, five of which were able to have double occupancy.

At the time of our inspection there were 28 people living in the home and each person had their own room.

The home required a registered manager and there was a registered manager in post who had been there for since 2011. 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 had some concerns about the staffing levels. We also found that many of the care records although they were person centred, were incomplete or difficult to follow.

We observed that staff were caring and that they treated people as individuals and respected their need for privacy and dignity.

The home operated safe recruitment practices. Staff had been trained in safeguarding procedures and able to tell us how to contact someone if they were concerned about abuse.

Staff had also been trained in other aspects of their job, such as medication administration and moving and handling. The home followed the appropriate guidelines in relation to the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards.

The home had been maintained well and had the required certification to say that such things as gas and electrical installations were safe and that fire safety had been checked.

We found that the food was tasty and nutritious.

The management was seen to be open and transparent and the provider was accountable. Plans were in place to further improve the service.

Below is a summary of what we found.

Is the service safe?

The one relative and five people who lived at the home told us they had no concerns over the safety or welfare of anyone who lived there. We saw evidence that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan and was intended to ensure people's safety.

The way in which staff were recruited was found to be correct and safe. Staff showed evidence of previous experience and continuing professional development within healthcare.

We saw the provider had policies and procedures in place for safeguarding and emergency events. All staff were aware of where to locate them if need be. We saw staff using correct manual handling techniques and explaining procedures clearly before assisting them. The three staff members we spoke to were all able to confidently and correctly tell us what they would do in an event of a person suffering a fall.

Is the service caring?

We spoke to five people who lived at the home and one relative. They all said that they were 'Very happy' at the home and described the staff as 'Helpful', 'Friendly' and 'Courteous'. The one relative told us that the staff liaise well with them and that the staff were 'Always happy to help'. During our observations we saw staff as being polite and caring. We saw the staff continuously engaged with people in a friendly manner and reassured those who were confused.

Is the service responsive?

We saw the provider conducted annual 'relatives and residents feedback' questionnaires. We saw the results from the August 2013 questionnaire was very positive. All of the people who completed this noted the care, staff and food as 'Excellent'.

Is the service well-led?

Staff told us they were able to openly raise any ideas for improvement and they felt they would be heard. One staff member told us they were like a 'family'. When asking people who lived at the home and staff about the providers and managers they all said they were 'Approachable', 'Friendly and 'Easy to talk to'.

Is the service effective?

We saw from the results of the August 2013 'relatives and residents feedback' questionnaire all the people who completed the form had said they were confident in raising complaints and felt that the provider would deal with complaints promptly. When we spoke to the people who used the service they all told us they were confident in raising complaints to staff. One person we spoke to said they raised a complaint and it was dealt with very quickly and they were happy with the outcome.

People who used the service and a relative told us they were very satisfied with the care and support given to them. They said:

'I like it here, staff treat me well and look after me',

'It's a lovely home, I am well looked after',

'It's a very friendly place and there is plenty to do to keep us happy'.

Care and support plans identified people's needs and how their needs were to be met. Risk assessments and care plans were seen to be individualised and covered all aspects of a person's needs including physical, behavioural, mental health and social. Risk assessments and care plans had been completed in full and reviewed every month.

People were protected from the risks of abuse as staff were knowledgeable in safeguarding of vulnerable adults. Appropriate guidance and support was available.

There were sufficient numbers of suitably qualified and experienced staff in order to care and support people. Records were found to be held securely and were accurate.

People spoke highly of the care, support and treatment choices that they had received and were given. They told us they had been listened to and had been involved in decisions about their care and treatment. One person told us, 'All the staff and the owner go out of their way to help us.'

We observed a good rapport between the people who used the service and staff. Our observations indicated that staff were attentive and had a caring attitude towards the people who used the service.

The information we gathered from people, relatives and carers indicated that they were happy with the care and support provided. They described the staff as caring and attentive.

We saw evidence that Woodlands had acted on recommendations in the previous inspection report regarding improvements to the environment that were needed to benefit the people who used the service.