Archived: Woodside

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

This is a summary of what we found:

Is the service safe?

We found the service to be safe because they had a range of policies and procedures in place to protect the people who lived in the home. The staff we spoke with had a good understanding about how to report any concerns.

We observed that staff were competent and professional in their interactions with people who lived at the home. The atmosphere in the home was relaxed and staff interacted with people in a kind and respectful manner.

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

Staff were able to provide safe, appropriate and personalised care to the people who lived at the home. Each person had a plan which described the care and support they required and how staff should provide it. These plans also included who the important people in their life were, how people communicated, daily routines, preferences and how they made decisions.

The care and support plans we looked at contained clear information about identified risks and how risks should be managed. Examples included supporting people to access the community and maintaining independent living skills. We saw that a plan of care had been developed to manage any identified risks in the least restrictive way. This meant that people could be supported with activities with reduced risks to themselves or to the people who supported them.

We observed that staff supported people to access the community in accordance with their plan of care. We saw that people were supported by appropriate numbers of staff.

Is the service effective?

We found the service to be effective because people's care treatment and support achieved good outcomes. We also found that people's rights and choices were respected by staff.

Staff told us they attended a handover meeting at the start of every shift. They said that this provided them with current information about the people they supported. We saw staff recorded information about each person on a daily basis. Information included how people had spent their day and how they had responded to activities of daily living. This meant the effectiveness of people's care plans could be fully reviewed.

We saw that people's prescribed medicines had been regularly reviewed by their GP or specialist health care professional. This meant that people received medicines which were appropriate to their needs.

Staff used a range of methods to assist people to make choices about their day to day lives. Examples included objects of reference and photographs. We observed staff offering people choices in accordance with their needs and preferences.

The service was effective in promoting people's independence and community involvement. People were supported to engage in the local community in a variety of ways. Examples included trips out, home visits, shopping trips and activities.

Is the service caring?

Staff interactions were kind, patient and professional and people appeared very comfortable with the staff who supported them.

We were able to meet with three people who were using the service. Communication was limited however people made the following comments 'I am happy. I like my flat' and 'Staff kind to me, yes.' We observed that people responded positively to the staff who supported them. For example one person smiled and gave a thumbs up when staff asked them if they would like to go to the pub. Another person made a sound which, staff told us, indicated that they were happy.

The staff we spoke with had a very good understanding about the needs and preferences of the people they supported. They understood and responded to people's needs and requests where individuals were unable to make their wishes known verbally. This demonstrated that staff knew people well.

Is the service responsive?

The service was responsive to people's needs. Staff had up to date guidance on how to support each individual. We read three care and support plans. These contained assessments of need and outlined how needs would be met. The assessments were regularly reviewed to ensure they reflected people's up to date needs and preferences.

Each person was allocated a keyworker who they would meet with on a regular basis. We saw the keyworker was involved in the review of people's care needs and preferences with other professionals.

Staff recruitment procedures had improved and now reduced any risks to people using the service.

The service had taken appropriate steps to ensure staff had the skills and equipment required to meet the changing needs of one individual with a rare and degenerative health condition.

People's health care needs were monitored and responded to appropriately. Information about people's health needs and contact with health and social care professionals had been recorded. We were informed that the service received good support from health and social care professionals and there were no problems obtaining their input for people when required.

Is the service well led?

The service was well led because there were systems in place which monitored the quality of the service provided. The service was proactive in seeking the views of the people who lived at the home and their representatives. We saw that the service responded to any comments or suggestions made.

The service was managed by a person who had been registered by the Commission. The registered manager regularly provided 'hands-on' care. This meant they remained up to date with the needs and preferences of the people who lived at the home. The staff we spoke with told us they received the training and support they needed. The manager had been proactive in seeking feedback from staff on their performance.

We spoke to the manager and three support staff. All were positive about the support they received and they confirmed that they received regular supervision sessions. Staff files contained detailed records of supervision sessions. These showed that staff received regular supervisions where their on-going performance and competencies were discussed.

We saw that staff had the opportunity to attend regular staff meetings. We looked at the minutes from a recent meeting. These showed that a range of topics had been discussed which included policies and procedures, staffing and information about the people they supported.

We found procedures were in place to minimise any risks to the people who lived at the home. Regular internal audits had been carried out which monitored the on-going health and safety of people. Internal audits included checks on the home's fire systems, environment, care planning and the management of people's medicines.

Woodside had been the subject of a whole home safeguarding process due to concerns found by the Somerset County Council Community Team for Adults with Learning Difficulties during care reviews of people using the service. During the safeguarding process the service had been monitored through a combination of visits by social services staff, as well as multidisciplinary safeguarding strategy meetings. During the safeguarding process assurances were received from the provider in relation to the immediate actions to be taken to improve outcomes for people.

Following the inspection, a CQC inspector attended a safeguarding strategy meeting where it was concluded that sufficient improvements had been made at the service to ensure people's safety. The whole home safeguarding process was therefore closed and it was agreed that the care management process would continue to support the home and monitor any outstanding issues.

Since the last inspection in July 2013 there had been a number of staff changes, which had included changes to the management of the service. This meant that people who used the service and the staff team had experienced an unsettled time. Temporary management arrangements had been in place, such as the use of an agency manager and temporary managers from within the provider company. At the time of the inspection we found that a permanent manager and deputy had been appointed and staff spoken with told us the home was more settled and that they were receiving the support needed to deliver the care required.

There were three people living permanently at the home at the time of the inspection. They lived in separate flats independently of the other people to ensure their needs were met in a safe environment. The main house accommodated people for respite care; during the inspection there were two people receiving respite care in the main house. We met with or saw four people using the service during this inspection. During our inspection we observed that staff interacted well with people and involved them in their daily routines and decisions. We saw that staff treated people with respect and their approach was friendly and reassuring. Overall we found that people experienced care, treatment and support that met their needs and protected their rights.

At the time of this inspection there were enough qualified, skilled and experienced staff on duty to meet the current needs of people who used the service. However, we found that the service had not followed their recruitment procedures in relation to one member of staff. This meant that the service did not have a fully effective recruitment process in place that protected people living at the home from staff who may be unsuitable.

At the time of the inspection there were three people living at the service. Woodside also offered a regular respite service to four people who were not at the home during our inspection.

The majority of people could not communicate with us so we observed people's care and their interactions with staff in communal areas. We could see that people were relaxed with the staff and in their surroundings.

Overall interactions between staff and people living at the home were positive and helpful, with staff providing information to people to help with decision making. Staff had a good knowledge of the needs and characters of the people using the service. We found that people were busy with a number of activities outside of the home.

As part of this inspection we spoke with three social workers responsible for placements at the home and a behavioural support nurse from the learning disability rapid intervention team. Visiting health and social care professionals expressed their satisfaction with the service and all told us they had confidence in the manager and that the service was responsive and well managed. Comments included, 'The manager is very responsive and enthusiastic', 'they provide a good range of activities', 'They have managed complex needs well', 'The manager has a 'can do' attitude' and 'They take on board the professional advice given'.

People told us they were happy with the care and support they received at Woodside; comments included, 'I am happy here', 'Everyone is nice' and 'The staff are very flexible. I want to stay here'. People told us they could choose how they spent their time and that there were a number of activities for them to get involved in. Two people told us that they were able to express their preferences or concerns and that staff listened to them and acted on what they said.

We found the atmosphere within the home to be relaxed and we saw positive interactions between staff and people living at the home. Staff were aware of people's communication needs and they showed that they had a good understanding of people's characters and needs. We heard and saw staff offering choices to people, involving them in the plans for the day.

Staff told us they enjoyed their roles and that they were well supported to enable them to work safely.

During this inspection we found some concerns relating to the planning and delivery of health care and we have asked the provider to address these concerns.