Woodham House Stanstead

About the service

Woodham House Stanstead is a care home that provides care and support for up to six people with mental health needs, people with learning disabilities and autistic people. At the time of the inspection there were 6 people using the service.

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

Right Support: Risks to people’s health and wellbeing were managed well and people were included in the risk management processes. The provider supported people to take their medicines safely. There were adequate infection control processes in place. Staffing levels were sufficient to maintain people’s safety and ensure their health and social needs were met.

Right Care: Staff understood people’s cultural needs and supported people in line with their needs and preferences. Staff had support and ongoing training to ensure they had the skills to meet the needs of people. However, we have made a recommendation about providing positive behaviour support training. People told us they were supported to achieve goals and their cultural needs were upheld.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people lead confident, inclusive and empowered lives. The provider worked in partnership with other health and social care professionals to review people’s care and support plans. There were processes in place to gather feedback from people, their relatives and professionals. We received positive comments about how the registered manager led the team to provide person-centred care.

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. We have made a recommendation about recording best interests’ decisions.

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 4 April 2020).

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service sustained a serious injury. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk of violence and aggressive behaviours. This focused inspection was carried out to seek assurance that people were being protected from harm.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good. This is based on the findings at this inspection.

Recommendations

We have made recommendations about providing positive behaviour support training and improving the process of recording best interests decisions.

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.

Woodham House Stanstead is a care home that provides care and support for up to six people with mental health needs and people with learning disabilities and those with autistic spectrum disorders. At the time of the inspection there were six people using the service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People and their relatives told us they felt safe using the service. Risks to people’s health and wellbeing were managed well. The provider supported people to take their medicines safely. There were adequate infection control processes in place. Staffing levels were sufficient to maintain people’s safety and ensure their needs were met.

People’s health and social care needs were assessed, and plans put in place to meet these. People were supported with their physical and mental health and care records contained good information on these. The provider met people's hydration needs and supported them to have a balanced diet.

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.

People told us the registered manager and staff were kind and caring and knew people well. People were treated with dignity and respect. People’s religious and cultural needs were met.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. People were supported to attend activities of their choice in their local community. People’s communication needs were considered, and detailed guidance was in place to help effective communication.

We received positive comments about the overall management of the service. There were quality assurance systems in place to ensure care and support were kept to a good standard. The service worked with a range of healthcare and multidisciplinary professionals to achieve good outcomes for people.

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 1 September 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.

At our last inspection in July 2015 the service was rated as 'Good’ overall but ‘Requires Improvement’ in relation to the key question, ‘is the service well-led’? This is because the service did not have a registered manager in post. At this inspection we found the service remained ‘Good’ overall whilst continuing to require improvement within the well-led domain. This was because the provider did not have a registered manager in post and had exceeded the maximum beds condition of its registration with the Care Quality Commission. The service is registered for up to five people to live in it. We found that six people were living in in the service at the time of our inspection. This is a failure to comply with section 33 of the Health and Social Care Act 2008. We are considering the action we will take.

The service did not have a registered manager at the time of the inspection. 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.

The quality of the service was audited and the service undertook partnership working with external organisations.

The service continued to be safe. Staff received training to protect people from abuse and avoidable harm. There was a robust recruitment process in place to ensure staff were safe and suitable. Staff were deployed in sufficient numbers to meet people’s needs in a safe way. People’s medicines were administered safely. Food was stored and prepared hygienically.

The service continued to be effective. Staff training, supervision and appraisal remained on-going. People’s rights under legislation were upheld and they accessed healthcare services as their needs required.

The service continued to be caring. People told us that staff were kind and caring. Positive relationships existed between people and staff. People were supported to maintain and develop their independence and staff treated people with respect.

The service continued to be responsive to people’s needs. People had assessments that identified their needs and care plans which detailed how people’s needs would be met. People were supported to participate in the activities they wanted to and their views were gathered by the provider and acted upon.

We observed that people's privacy and dignity were respected and the interactions between staff and people were kindly and patient.

People were supported to follow activities in the community and at home. There was consideration of people's cultural and religious needs.

A mental health professional told us staff at the service had worked with people they supported, they took on board recommendations made by the mental health professional, and as a result people responded well and experienced positive outcomes.

People were supported to develop and retain relationships with relatives and friends.

Important events affecting people's welfare had not been reported to the Care Quality Commission as required.