Archived: Woodlands Nursing Home

At our inspection on 23 April, we found that the provider was not meeting the regulations with regard to cleanliness and infection control. We found that people were not protected from the risk of infection nor were they cared for in a clean, hygienic environment. The provider was also not meeting the regulations with regard to supporting workers. People were cared for by staff who were not always supported to deliver care and treatment safely and to an appropriate standard.

An adult social care inspector carried out this inspection. We spent time looking around the home, spoke with six residents, the provider, an administrator, a registered nurse and one member of care staff. We also reviewed records relating to the management of the service. These included three staff supervision records, policies and procedures, staff training documentation and audit reports. At the time of our inspection there were 25 residents living at the home, which is registered for 27.

We found that the provider had met the compliance actions set with regard to cleanliness and infection control and supporting workers.

Our inspection was undertaken by an inspector. We considered our inspection findings to answer questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary, please read the full report.

Is the service safe?

We saw that potential risks to people were appropriately assessed and planned for. The service routinely screened for risks associated with mobility, falls, eating and drinking. These risk assessments were reviewed regularly to determine if any changes had occurred.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made and how to submit one.

In the downstairs bathroom, we observed that plaster had either broken or had been affixed unevenly around the wall tiles. This meant that the tiled area could not be cleaned effectively or hygienically. In another ground floor en-suite, we saw a dirty toilet plan, stained with faecal matter. On the top floor, we discovered that an armchair in one person’s bedroom had an extensive stain on it which smelled like stale urine.

We asked the manager for a copy of their policy and procedures in relation to cleaning and infection control. Whilst they produced a large manual full of various policies, they were unable to locate the relevant policy.

We have asked the provider to tell us what they are going to do to ensure that the service is kept clean and hygienic to protect people against the risk of acquiring healthcare associated infections.

Is the service effective?

One person told us that they did not think they were involved in their care planning, but that they were, “Quite happy the way things are done”. One of the relatives we spoke with said that they had been involved when their family member had moved into Woodlands Nursing Home and that they were able to talk about their family member’s interests and background. They felt that the information they provided at admission would be useful to enable staff to get to know their family member.

We saw a questionnaire had been sent out by management on 9 April. These showed that generally people were satisfied with the quality of the service being delivered. For example, all the families and relatives who responded felt they were kept informed about their relative’s health and were aware of the care plan.

Is the service caring?

During the lunch period, we observed staff assisting people to eat their lunch. One person was struggling to stay awake and we saw care staff encouraging them gently to have something to eat. People were able to eat at their own pace. For example, we saw that some people were eating their desserts, whilst others were still eating their main course.

A relative we spoke with told us, “Overall, I’m very pleased. They’re very caring”. Another relative told us that their family member was very pleased with the care they received, that they felt safe and that Woodlands Nursing Home had been recommended to them by a neighbour.

Is the service responsive?

We saw that assessments of cognition had been completed. We spoke with one of the nursing staff who told us that they involve people with their care planning as much as possible. One person told us that they could make choices about whether they wanted a shower and said, “If I don’t feel like having a shower, I can put it off until the next day.” They also told us that they were encouraged to do things for themselves.

Quarterly meetings were organised for residents, relatives and friends to attend and we were given a copy of the newsletter for March/April 2014 which invited people to a residents’ meeting on 7 May 2014.

We saw the complaints book which showed that two complaints had been received recently and that these complaints had been responded to promptly and appropriately.

Is the service well led?

We saw that care records were completed in a person centred way.

We were told that all staff were currently training under the Gold Standards Framework Foundation in Palliative Care and that this had meant that other training had not always been completed as a result. We have asked the provider to tell us what they are going to do to ensure that all staff have completed mandatory training and are suitably equipped to meet the needs of people who use the service.

We saw that people who lived at the home received care and support in a calm and relaxed manner. We observed that staff were able to spend time and interact with people in a positive manner.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We looked at staff records and other records relevant to the management of the home. They were up to date and well maintained.