Woodlands

We found the following examples of good practice.

People were admitted to the home safely and isolated for 14 days after their arrival. People and staff had participated in whole home testing for COVID-19, for staff this included a daily test. Risk assessments had been completed for all aspects of people's care and support including risks associated with COVID-19. Staff had individual risk assessments in relation to their own health and support needs.

Handwashing stations had been installed outside the home for staff and visitors to use. Visitors were asked to complete a health form and had their temperatures checked. Visitors who were visiting inside the building were asked to take a COVID-19 test and wait a short time in the car park for the result. People were provided with appropriate personal protective equipment (PPE).

Chairs in communal lounges had small side tables placed between them to ensure social distancing were maintained. Outdoor areas had been utilised in good weather and there were further plans for this to be used again once the weather improved. Touch points were cleaned regularly. The provider had researched and invested in several products designed to minimise the spread of COVID-19 using ultraviolet light. The service had good supplies of PPE that were readily available in stations throughout the service. Clinical waste bins were positioned so that staff could access them when required.

The provider had ensured that relatives could visit their loved ones in complete safety. There was a visiting area where people could meet, as well as a visiting pod. Both were located on the ground floor and could be accessed via the courtyard. The visiting pod was ventilated and fitted with a floor to ceiling screen and a hearing loop. People were also supported to contact family and friends through the use of technology.

The provider had developed policies and procedures in response to the coronavirus pandemic. These policies had been adapted to reflect the changes throughout the last 12 months. The guidance and information for staff was clear with detailed safe systems of work for the home.

Woodlands is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Woodlands can accommodate a maximum of 40 older people in one adapted building. At the time of our inspection there were 37 people living at the home, some of whom were living with dementia.

The home had a registered manager. A registered manager is a person who has registered with the 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.

People’s experience of using this service:

People received exceptionally high quality care from staff who were passionate about delivering personalised care in a dignified and respectful way.

Without exception everyone we spoke with told us staff were professional, compassionate and caring.

The provider’s philosophy of care placed people at the heart of the service. People and their families’ experience of care and wellbeing was enhanced by staff who had fully embraced this philosophy and frequently went above and beyond what was expected of them.

The home was extremely well led by a management team who had a clear, positive and open culture, which encouraged engaged and feedback from people, their families and staff.

Without exception family members were extremely positive regarding the care and support they and their relatives received at the end of their life.

People received care and support in a home that was safe. Risks related to their healthcare needs and the environment, the management of their medicines and infection control were all managed safely. Staff had received training in how to safeguard people and knew what action to take if they had any concerns.

There was enough staff to meet people’s needs and ensure they had enough time to engage with people in a sociable and unhurried way.

People were cared for by staff who felt supported by their managers and had received training focused on the needs of the people they were supporting.

People’s rights and freedoms were upheld. Staff acted in the best interests of the people they supported. People were empowered to make their own choices and decisions, and were involved in the development of their personalised care plans.

People were supported to live healthier lives; they were supported to have regular access to healthcare professionals; and their nutritional and hydration needs were met.

The provider was fully engaged in the running of the home and there were effective management processes in place to monitor and improve the quality of the service.

The provider and senior managers were fully committed to working with other organisations in the development of high quality care within the home and sharing ideas and best practice.

The home has been rated Outstanding overall as it met the characteristics for this rating in two of the five key questions. More information is in the full report, which is on the CQC website at: www.cqc.org.uk

Rating at last inspection: The home was rated as outstanding at their last full comprehensive inspection, the report was published on 9 November 2016.

Why we inspected:

This was a planned inspection based on the previous inspection rating.

Follow up:

We will continue to monitor the intelligence we receive about this service and plan to inspect in line with our re-inspection schedule for those services rated as outstanding.

Woodlands is registered to provide care (without nursing) for up to 40 older people. The provider has two other care homes in the area. Some people may be living with dementia or other conditions associated with the ageing process. There were 38 people resident on the day of the visit. The building offers accommodation over two floors. There were a number of shared areas within the service which afforded people choice to pursue activities individually or in small groups.

The service has a registered manager running the service. 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.

People benefitted from an exceptionally well-managed service. The registered manager was very approachable and very well supported by a general manager and the provider. The service ensured that very high quality and up-to-date care was provided. People's views and comments were listened to and proactively used as part of the quality assurance process. The service made sure they acted on the findings of the various processes and people’s views to improve the quality of care they provided.

The service was highly responsive to the needs, preferences and wishes of people who live in the home. The care provided is totally person centred and meets people’s individual and diverse needs. They along with people and their families, continually review people’s needs. When people’s needs change they take action to ensure they provide the best care possible for the individual. The service is extremely good at helping people to enjoy their lifestyle.

The service kept people, staff and visitors to the service as safe as possible. Risks were identified and managed to make sure that people and others were kept as safe as possible. Staff were provided with training in the safeguarding of vulnerable adults and in health and safety policies and procedures. They were able to describe how they kept people safe and were very committed to protecting people in their care. Adequate numbers of appropriately trained and skilled staff were available to provide people with safe care. The service’s recruitment procedure ensured that as far as possible, all staff employed were suitable and safe to work with vulnerable people. People were given their medicines in the right amounts at the right times by staff who had been trained to carry out this task.

People received kind and compassionate care. Staff built strong and caring relationships with people and their families and friends. People were treated with dignity and the greatest respect at all times. Staff treated people as individuals and respected their lifestyle choices. People were given compassionate end of life care.

The management team and staff protected people’s rights to make their own decisions and people were asked to consent to their care. The staff team understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care. The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision. The service made DoLS applications to the appropriate authorities, as necessary.

People’s health, well- being and spiritual needs were met by staff who were very well trained and supported to meet people’s overall and individual needs. The service worked closely with other professionals and assisted people to make sure they received effective health and well-being care. Staff were trained in specific areas so they could effectively meet people’s diverse and changing needs.

A relative told us "The home is tremendous" and "Great care, complete peace of mind". Observations during our inspection showed us that people were able to make their own choices and that staff gave people the opportunity to make these choices.

Staff records that we looked at showed us that staff had received mandatory training as well as additional training to meet the needs of people using the service. Staff felt supported and told us "Were a great team we work together really well". Observations during our inspection confirmed this.

People were provided with a well-balanced and nutritious diet. People that we spoke with said that the food was good and that there were always plenty of choices. Staff that we spoke with had good knowledge around the importance of providing a healthy and well-balanced diet for people that use the service.

We saw that the home worked alongside a variety of professionals, who regularly visited the home to assess and monitor the health and wellbeing of people that use the service. We saw that all of these visits had been recorded and signed off.

People told us they liked living at this home and the staff always respected their privacy and choices. People said "The staff are lovely here they look after me very well." "I can choose what to do and there are activities available." We found that the staff treated people with respect and that they had included and consulted people when they planned their care.

People told us the staff met their care needs and encouraged them to remain as independent as possible. We found that people's needs had been met through the delivery of appropriate care.

People said "I feel safe here." "I am safe and I could speak to the staff if I was worried." We found that staff had received training with regard to how to protect people from abuse or harm.

People told us they had opportunities to give their views during regular residents' and review meetings and through their representatives on the residents' committee. People said that staff responded positively to their views. We found the provider had an effective system for assessing the quality of the service and they valued people's views and acted on these to improve the service.

People said "I know how to complain." "I would speak to the staff if I had any complaints and they would help me." People had been given written guidance about complaints. When people had made complaints these had been resolved to their satisfaction.