Woodlands

Updated 4 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The comprehensive inspection took place on 4 and 5 June and 2 July 2018. The first day was unannounced, second and third were announced. The inspection team on day one consisted of one adult social care inspector, two assistant adult social care inspectors, one specialist advisor and two experts by experience; day two, two adult social care inspectors, one specialist advisor and one assistant inspector and day three by one adult social care inspector. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. The specialist advisor was a nurse.

Before the inspection we looked at the information we held about the service. This included the statutory notifications sent to us by the provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We also contacted the local authority quality assurance team to gain their views and they told us that all actions identified during their last visit had been completed.

We used this information to plan how the inspection should be conducted.

We spoke with the registered manager, area support manager, deputy manager, 20 people using services, eight visitors, 17 care/nursing staff, maintenance person, chef, kitchen assistant and one housekeeping staff.

We looked at the care files of five people receiving support from the service, four staff recruitment files, medicines administration records and other records relevant to the quality of the service. We also observed the delivery of care at various points during the inspection.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk to us.

Updated 4 September 2018

Woodlands is a care home located in Poynton, which is situated between Macclesfield and Stockport, and is part of Methodist Homes (MHA). People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. People who live in the home are accommodated on both floors of the two-storey building, access between floors is via a passenger lift or the stairs. Woodlands is registered to accommodate 80 people, at the time of the inspection 77 people lived at the home.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 the last inspection the service was rated Good. At this we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating has not changed since our last inspection.

People told us that the food was good and that they had plenty to eat. The first and second days of the inspection were very hot. Although we could see that people had drinks with meals and afternoon tea, and that hydration stations were located on each of the units, we queried the availability of drinks for people who remained in their rooms. The management team provided additional guidance to staff regarding availability and recording of fluid intake.

Applications had been made under the Deprivation of Liberty Safeguards (DoLS) as required and detailed records were maintained. We found that when people received their medicines covertly (hidden) consideration had not always been given as to whether medicines administered this way resulted in a deprivation. When we returned on the third day of inspection the registered manager demonstrated that they had liaised with the relevant authorities and that action had been taken to address where necessary.

A wide range of training was available for staff including around specific health needs such as Diabetes although from the training matrix provided we found that some sessions were overdue for renewal. Champions had been nominated for specialist roles such as continence, dementia and end of life.

When agency staff were used the provider did not always obtain a profile or carry out an induction with the member of staff to ensure that safe recruitment checks had taken place and that the person had received training and had all of the information they would need.

We reviewed four staff files and saw that satisfactory recruitment and selection procedures were in place.

Records showed that the provider had generally followed the principles of the Mental Capacity Act 2005 and that, where appropriate, decisions were made in people’s best interests.

There were effective and established systems in place to safeguard people from abuse and individual risk was fully assessed and reviewed. Accidents and incidents were recorded and appropriate actions taken.

Medicines management and administration processes were reviewed during the inspection and found to be safe.

Checks were made to ensure that the environment was a safe place for people to live. These included electric, gas, Legionella compliance and fire safety.

Policies and procedures were in place to prevent and control the spread of infection. We saw that staff used gloves and aprons appropriately. The home had undergone refurbishment since our last inspection.

We found that staffing levels were adequate to meet people’s needs. A dependency tool was used to determine staffing levels and we saw that staff responded quickly to people when they needed attention.

People’s needs were assessed before they moved to Woodlands and care plans were in place to inform staff of their needs and how they should be met. Staff worked with other health care professionals to maintain people’s health and wellbeing.

People who lived at the home and their relatives told us that staff were kind and treated them well. During the inspection we saw that staff were attentive and treated people with dignity and respect. Staff were skilled in de-escalation techniques and quickly calmed people who had become upset.

There was a policy in place to ensure that people were treated fairly and without discrimination and consideration was given to protected characteristics such as sexual orientation and religion.

There was a policy and procedure in place to manage and respond to complaints. We saw that any received had been well documented, investigated and responded to in line with the policy.

Activities were provided by activity co-ordinators and care staff. Feedback around activities available was mixed and staff felt they would like to see more outings and trips.

We were told that the management team were supportive, approachable and fair to all staff.

There was a well-developed performance framework which assessed the safety and quality of the service. The recently implemented electronic care management system, Megabase, had further enhanced robust quality assurance procedures.

Staff spoke with enthusiasm about their roles and were clear about their responsibilities. There was an open and transparent culture and one relative informed us that they were impressed that they had been informed when things went wrong and therefore had confidence that actions were taken ins such circumstances. The registered manager was clear about their plans to continually improve the service.

People who lived at the home, relatives and staff could express their views in a variety of ways including regular meetings, questionnaires and directly to management.