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Inspection carried out on 22 October 2019

During a routine inspection

About the service

Woodlands is a residential care home providing accommodation and personal care to 37 people at the time of the inspection. The service can support up to 41 people. The accommodation is provided in a purpose-built building over two floors accessible via a lift with a variety of communal areas. Within the ground floor there is a unit specialising in providing care to people living with dementia. There are extensive accessible grounds and an internal courtyard. The home is situated in a semi-rural area near to King’s Lynn.

People’s experience of using this service and what we found

People using the service and their relatives was highly complimentary about the care and life within Woodlands. All the people we spoke with felt safe and recommended the service.

Staff were aware of how to safeguard people from potential abuse. Systems were in place to ensure risks were suitably assessed and mitigated for. The provider had robust recruitment procedures and had enough staff to ensure people felt safe and well cared for. The provider was thorough when reviewing incidents to ensure appropriate lessons were learnt. People received their medicines when they should and were enabled to access healthcare whenever required.

People's health and well-being were well supported and monitored. People's nutritional intake was well supported. Staff were appropriately trained and understood the individual care needs and preferences of people living in the service. The home was suitably adapted and dementia friendly, with a variety of accessible communal spaces and garden. There were some aspects of the home that required updating but the home already had a development plan to address these issues. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

All the people we spoke with were very complimentary about the kindness of staff. We observed warm and compassionate care which demonstrated strong relationships and understanding of people's needs and preferences. People's privacy and independence were promoted. People were regularly asked for feedback on the care and support they received.

People had individualised care plans which supported greater understanding of the person's life and preferences. There was creative support for individual people to purse their interests and well-being however there was not a consistent provision of meaningful group activities to promote health and well-being. The service was pro-active in seeking and responding to any concerns or complaints people may have had about the service. People had been consulted regarding their end of life care wishes when appropriate and were provided with compassionate end of life care.

The feedback from both staff and people using the service regarding the registered manager was

unanimously positive. The registered manager was seen to be accessible, hard-working and passionate about providing a quality and caring service. There were good quality assurance systems in place and people were regularly consulted on the quality of care provided. Staff were provided with appropriate support and the team spirit was strong.

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

Rating at last inspection

The last rating for this service was ‘Good’ (published 15 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 18 January 2017

During a routine inspection

This inspection took place on 18 and 20 January 2017 and was unannounced. Woodlands is a care home providing personal care for up to 41 people, some of whom live with dementia. On the day of our visit 38 people were living at the home.

The home has had the current registered manager in post since June 2015. 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.

Staff were aware of safeguarding people from the risk of abuse and they knew how to report concerns to the relevant agencies. They assessed individual risks to people and took action to reduce or remove them. There was adequate servicing and maintenance checks to fire equipment and systems in the home to ensure people’s safety.

People felt safe living at the home and staff supported them in a way that they preferred. There were enough staff available to meet people’s needs and the registered manager took action to obtain additional staff when there were sudden shortages. Recruitment checks for new staff members had been made before new staff members started work to make sure they were safe to work within care.

People received their medicines when they needed them, and staff members who administered medicines had been trained to do this safely. Staff members received other training, which provided them with the skills and knowledge to carry out their roles. Staff received adequate support from the registered manager and senior staff, which they found helpful.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The registered manager had acted on the requirements of the safeguards to ensure that people were protected. Where someone lacked capacity to make their own decisions, the staff were making these for them in their best interests.

People enjoyed their meals and were able to choose what they ate and drank. They received enough food and drink to meet their needs. Staff members contacted health professionals to make sure people received advice and treatment quickly if needed.

Staff were caring, kind, respectful and courteous. Staff members knew people well, what they liked and how they wanted to be treated. They responded to people’s needs well and support was always available. Care plans contained enough information to support individual people with their needs. People were happy living at the home and staff supported them to be as independent as possible.

A complaints procedure was available and people knew how to and who to go to, to make a complaint. The registered manager was supportive and approachable, and people or other staff members could speak with them at any time.

Good leadership was in place and the registered manager and provider monitored care and other records to assess the risks to people and ensure that these were reduced as much as possible and to improve the quality of the care provided.

Inspection carried out on 20 and 25 February 2015

During a routine inspection

We inspected this service on 20 and 25 February 2015. The inspection was unannounced and undertaken by two inspectors on the first day, and one inspector on the second.

Woodlands provides accommodation and support for up to 40 older people, many of whom live with dementia. There was a registered manager in post at the home. 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.

The atmosphere of the home was welcoming and the premises were well maintained and designed to meet the needs of the people living there. There were sufficient numbers of staff on duty to meet people’s needs and those staff had been recruited safely. Staff knew how to manage risks to promote people’s safety and were respectful, caring and considerate of people’s specific needs. There had been significant improvement in the management of medicines to ensure that people received them safely and as prescribed.

Staff received appropriate training and support for their role. They also received training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and knew how to protect people who could not make decisions for themselves.

People’s needs were assessed and regularly reviewed, and support was planned and delivered in line with their specific needs. Their health was monitored and they were supported to see a wide range of health professionals if needed. People’s independence was encouraged and activities in the home provided them with regular entertainment and stimulation.

Overall, the home was well managed, with clear lines of accountability and responsibility in place for staff. There were good systems in place to monitor and assess the quality of care people experienced and people’s views were actively sought to develop the service.

Inspection carried out on 4 June 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer the five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, relatives and staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

Risk assessments for care needs were completed and provided appropriate actions for the identified risk to be reduced. We found that records of care provided to people were kept and indicated guidance in care plans was followed.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care services. While no applications have needed to be submitted, the service had policies and procedures in place if this was required. However, relevant staff had an increased level of knowledge to understand when an application should be made, and how to submit one.

Appropriate actions had been taken to make sure that people were safe from infection or to resolve infection prevention and control issues when they were identified.

Is the service effective?

People told us that staff members obtained their consent before supporting them with care or treatment. Care records recorded which decisions people were able to make for themselves and which decisions they did not have the capacity to make.

People told us that staff members helped them with everything they needed assistance with. They were satisfied with the care they received. Care records reflected people's care needs and preferences and provided staff with guidance to meet their needs.

Health needs were responded to and people had access to health care professionals if they needed this. Care records contained information about people's preferences and identified the people who were not able to tell staff or give their consent to care or treatment. We observed that staff told people what they were going to do before doing it and waited for permission before carrying out any care.

Staff members received supervision and training from the provider or from external sources to ensure they had the skills and support to properly carry out their roles and care for people.

Is the service caring?

People said that staff members were polite and kind, they respected people�s privacy and dignity, and involved people in their care. We observed interactions between people and staff that showed staff members were patient and understanding of people's individual needs. Staff members knew people's care needs and their personal preferences.

Our observations also showed that staff members were respectful towards people living at the home. People told us that staff were respectful and that their privacy was maintained.

Is the service responsive?

We saw that people's individual physical and mental support, care and treatment needs were assessed and mostly planned for. Their individual choices and preferences regarding their support and care were valued and respected.

Is the service well led?

People told us about resident meetings and said they could give their view about the running of the home if they wished. The service had carried out a survey in October 2013 and actions had been taken to improve or resolve the identified issues. There were also other systems in place to monitor and assess the quality of the service provided, which meant that any risks to people were identified and acted upon.

Inspection carried out on 6 December 2013

During a routine inspection

Woodlands consisted of two units, the main unit, and another unit where people with a dementia were cared for. We looked at the personal care records of people who lived at Woodlands. We found that the care plans did not always reflect people�s current needs. We observed how people were being cared for and checked people's care records. We found that people�s care needs were being met in most cases. However this was not always in line with what was recorded in their care plan. We checked to see if people were asked to give consent to their treatment, and their medication. We found that although there were consent forms in the care records, these had not always been completed and signed by the people who used the service. We talked with people who used the service, and talked with staff. People told us they were happy generally, although, two people made negative comments about having to wait for staff to assist them, repetitive food choices and �being bored�. We found that generally people were well cared for. We noted that there were gaps in the records and inconsistencies in what and how information was recorded.

During our last inspection we found that the recruitment policy was not being followed and there were gaps in the process. We checked the process this time to ensure that the required improvements had been made. We found that they had addressed the gaps in the process and were now meeting the standard. We reviewed quality monitoring procedures in the home and found that although there were some monitoring procedures in place we were unable to assess how they were implemented, processed, evaluated how they would be used as a means of improving the service.

Inspection carried out on 16 January 2013

During a routine inspection

People told us that staff members obtained their consent before supporting them with care or treatment. Care records recorded which decisions people were able to make for themselves and which decisions they did not have the capacity to make.

People received the care and support they required to improve their health and well-being. Care records were written in detail and provided clear guidance to staff members.

Medicines were stored appropriately and records were maintained to show all storage areas were kept at the correct temperature. Administration records were kept and people received their medicines in a safe way.

Recruitment checks were not all carried out or obtained prior to new staff members starting work with the service.

The service had a policy and procedure to guide people and visitors in how to make a complaint and information about taking complaints further. People told us that they would be able to raise concerns with staff members and have them dealt with.

Inspection carried out on 23 November 2011

During a routine inspection

People we spoke with told us that they found staff to be polite and respectful. They said the staff treated them well; as adults not children. People told us they were involved in making decisions about their care and they had plenty of choices about their daily routines. Staff respected people's wishes to remain independent.

Everyone we spoke with was happy with the care and support they received. They told us that staff were good at making sure they received medical care when they needed it.

People we spoke with told us that they felt safe at the home. They told us that staff were always pleasant and they were never made to feel a nuisance if they asked for anything. People knew who to speak to if they ever had any concerns about how they were being treated.

Everyone we spoke with told us that Woodlands was a nice place. They commented that the home was comfortable, clean and warm. The only negative comments we received were about the lack of en-suite facilities. All of the bedrooms we looked at were personalised with people's own furniture, photographs and ornaments.

People using the service told us that they found there were enough staff on duty to provide the care they needed when they needed it. They confirmed that they did not have to wait long for attention.