Woodleigh House

Woodleigh House is a ‘care home’. 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.

Woodleigh House is registered to provide accommodation and personal care for up to eleven adults who live with a learning disability. At the time of the inspection, there were 10 people accommodated in the home.

The care service is aware of the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. We found on this inspection that the service was delivering these values.

At the last inspection in May 2016 the service was rated 'Good'. At this inspection we found the service remained 'Good'.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required. Recruitment checks were carried out to ensure suitable people were employed to work at the service.

Staff skills, knowledge, training and support demonstrated a commitment to providing high standards of care which was embedded into the practices of the staff and the management team. The service put people's views at the forefront of the service and designed the service around their needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Risk assessments had been developed to minimise the potential risk of harm to people who used the service. These had been kept under review and were relevant to the care and support people required.

Care plans were in place detailing how people wished to be supported. People who received support, or where appropriate their relatives, were involved in decisions and consented to their care. Improvements were required to the process for assessing mental capacity. People’s independence and choice was promoted.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. We noted some improvements were required to the documentation for medicines such as thickening powders and ‘as required medicines’. The registered manager took immediate action to rectify this.

We found people had been assisted to have access to healthcare professionals and their healthcare needs were met and reviewed regularly.

People had been supported with various activities of their choice. There was a strong emphasis on maintaining people’s independence and ensuring people remained active members of their local community.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available, and people said they were encouraged to raise concerns. Staff had received compliments from people's relatives.

The registered manager used a variety of methods to assess and monitor the quality of service provided to people. These included regular internal audits of the service, surveys and staff and peoples’ meetings to seek the views of people about the quality of care being provided.

The service was last inspected in December 2014 and was found compliant in all areas inspected.

At the time of this inspection there was a registered manager employed. 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.

During this inspection we received positive feedback from people who used the service, visitors and health professionals. People expressed satisfaction with the service provided and spoke very highly of the staff that supported them. Relatives told us they felt staff were very professional and had a sound knowledge of the needs, wishes and feelings of the people using the service.

We saw the service had robust processes and procedures in place to maintain a safe environment for people using the service, staff and visitors. Detailed monthly health and safety checks were done which covered all rooms and the outside space of the property. These checks covered areas such as windows, flooring, home furnishings, electrical and gas appliances.

People told us they felt safe living at the home. Safeguarding referral procedures were in place and we noted appropriate notifications to the local authority and the Commission had been made. Staff showed a good understanding around recognising the signs of abuse and had undertaken safeguarding training.

Adequate staffing levels were observed over the two day inspection and staffing rotas we looked at showed a consistent level of staffing was maintained. People indicated their needs were met appropriately and restrictions were not made on activities. Staff told us they did not feel rushed with their daily routine and this enabled them to spend time conversing with people and supporting with activities. We observed regular staff interaction to support this.

We found a good recruitment system in place and a thorough induction process for all new staff. Staff told us they felt the induction process equipped them well to undertake their role as a support worker.

Processes were in place for appropriate medicines management and staff were adequately trained. We observed safe administration of medicines and noted individual risk assessments in people’s files to support medicines prescribed ‘as necessary’ and variable doses’.

We saw the service had created detailed individual risk assessments for all people using the service to promote positive risk taking. These risk assessments considered the persons wishes and feelings.

We saw detailed care plans which gave clear information about people's needs, wishes, feelings and health conditions. These were reviewed monthly and more often when needed by the person’s key worker.

We saw evidence of detailed training programmes for staff. People we spoke with indicated that staff had the correct knowledge and skill base to effectively support people with a learning disability. In addition to this, staff were working towards the QCF Qualifications and Credit Framework. This is a diploma in health and social care, formally known as an NVQ (National Vocational Qualification).

Staff spoken with were aware of the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). These provide legal safeguards for people who may be unable to make their own decisions. The manager also demonstrated their knowledge about the process to follow should it be necessary to place any restrictions on a person who used the service in their best interests.

We saw that people's nutritional requirements were being met and choices were offered throughout the day around meals. We observed people making themselves snacks and drinks throughout the day and contributing to the preparation of meals. Individual risk assessments had been created when necessary and weight monitoring charts were in place. We noted appropriate referrals had been made to dieticians and instructions were strictly followed in cases where people had known dietary requirements.

We saw positive staff interaction and engagement with people using the service. Staff addressed people in a respectful and caring manner. The service had a calm and warm atmosphere. We observed people laughing and conversing. People using the service gave positive examples of staff interaction.

People using the service indicated they were happy with the service. We saw positive feedback from people using the service by means of ‘service user questionnaires’ and feedback at service user meetings. We also noted positive feedback from relatives and staff about the registered manager. People told us they were happy to approach management with any concerns or questions. We saw evidence that an 'open door' policy was followed.

Opportunities for staff to discuss events within the home were limited as there were no regular staff meetings being held by the registered manager and very infrequent individual supervision meetings being held.

During this inspection we spoke with four service users, three support staff and the registered manager. We checked a random sample of people's records, staff supervision and appraisal records the minutes of staff and residents' meetings and a random selection of risk assessments and service records. We found the records we looked at were accurate and up to date. Records were kept securely and could be located promptly when requested.

The summary is based on our observations during the inspection, discussions with people using the service, the staff supporting them and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they were satisfied with the quality of care and support they received. We were told the staffing levels were sufficient to meet the needs of people living in the home and that the staff were professional, caring and friendly. People said they felt safe living in the home and were able to discuss any concerns or issues with the staff if they wished to and felt that the staff would respond appropriately.

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

Is the service effective?

People were provided with care plans which were reviewed regularly and updated when required. Staff we spoke to demonstrated they had a good knowledge of the individual needs of people and the philosophy of care that the service promotes. We were told that people generally worked well as a team, with good levels of support and communication.

Several staff said how much they enjoyed working in the home and were proud of the level of care that was provided.

Whilst staff felt that they were supported in their roles they were not given the opportunity to attend staff meetings and members of staff spoken with told us they had not received supervision for sometime. We checked a sample of the staff supervision records and found the staff had not received individual supervision for several months. Individual supervision is important to ensure staff are well supported in their role and they are given regular opportunities to express their views in a formal confidential setting. A compliance action has been set for this and the provider must tell us how they plan to improve.

Is the service caring?

People made various positive comments about the staff team. Comments supporting this view included: "They talk to me and ask if anything has changed or do I want things doing differently." "I feel really well looked after here."

Each person's care plan we looked at set out clearly their health, personal and social care needs and people had signed their plans indicating their agreement to its content.

Is the service responsive?

We saw that care plans are frequently reviewed so information is up to date and discussions take place with GPs, relatives and advocates when care is reviewed and this can be on a weekly basis if required by a person's healthcare needs. There is evidence of prompt referral to health services and support agencies such as dental, chiropody and nursing services and of effective working practices with these different agencies.

Is the service well-led?

None of the staff we spoke with had received regular supervision meetings with the manager for several months. There was no record of any staff or service user meetings being held.

The service does not have a robust quality assurance system, to ensure that staff, service users and their relatives are able to provide feedback to the managers, so their knowledge preferences and experience are not being properly taken into account. A regular audit would identify the shortfalls in the quality of the environment. A compliance action has been set for this and the provider must tell us how they plan to improve.

The service worked in partnership with key organisations, including the local authority and safeguarding teams..