Archived: A Woodlands House

Updated 29 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 inspection site visit took place on 18 and 23 July 2018 and was unannounced. The inspection team consisted of two inspectors and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by experience at this inspection had experience of dementia and elderly care.

Prior to the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give key information about the service, what the service does well and any improvements they plan to make. We reviewed the PIR and other information we held about the service including previous inspection reports. This included statutory notifications sent to us by the registered manager 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 used all this information to decide which areas to focus on during our inspection. On the day of inspection, we spoke to a visiting health professional.

During the inspection, we observed the care given by staff to people including how medicines were administered to people and the lunchtime experience. We met and spoke to everyone living at the service and spoke in more depth to one person and four relatives. Due to the nature of people's needs, we were not able to ask everyone direct questions, but we did observe people as they engaged with their day-to-day tasks and activities.

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

We spoke with the registered manager (who was also one of the providers), deputy manager, three care staff and the cook.

We looked at care plans and associated records for four people and ‘pathway tracked’ two of them to understand how their care was being delivered in line with this. We reviewed other records, including the registered manager's internal checks and audits, medicines administration records (MAR), health and safety maintenance checks, accident and incidents, compliments and complaints, staff training records and staff rotas. Records for three staff were reviewed, which included checks on newly appointed staff and staff supervision records.

The service was last inspected on 28 and 29 January 2016 and was awarded the rating of Good.

Updated 29 September 2018

This inspection site visit took place on 18 and 23 July 2018 and was unannounced.

A Woodlands House is a residential care home which provides care and support for up to 14 older people living with dementia. At the time of our inspection there were 14 people living at the home. Accommodation was arranged over three floors with stairs and a passenger lift to the first floor, people with better mobility stayed in rooms on the second floor and had been assessed as being able to use the stairs. The ground floor had a dining area and two communal lounges. 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.

The service had a registered manager. 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 registered manager is also one of the providers of 29 years; they were in day to day charge and worked alongside a deputy manager and care staff team to provide care for people.

The service was last inspected on 28 and 29 January 2016 and was rated Good across all questions. At this inspection 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 of the service has not changed since our last inspection.

Staff were aware of their responsibilities in relation to keeping people safe and knew who to contact externally should they feel their concerns had not been dealt with appropriately.

Systems were in place to identify risks and protect people from harm. Risk assessments were in place and reviewed monthly. Where someone was identified as being at risk, actions were identified on how to reduce the risk and referrals were made to health professionals as required.

Policies and procedures were in place to ensure the safe ordering, administration, storage and disposal of medicines. Medicines were managed, stored, given to people as prescribed and disposed of safely.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and people were encouraged to make decisions about their care and treatment. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. The members of the management team and care staff we spoke with had a full and up to date understanding of DoLS. These safeguards protect the rights of adults by ensuring that if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. Appropriate DoLS applications had been made, and staff were acting in accordance with DoLS authorisations.

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.

There were sufficient staff to meet people's needs and keep them safe. The registered manager told us that they did not use agency staff as they liked to ensure that staff had a good understanding of people’s needs and the care they needed. Safe staff recruitment procedures ensured only those staff suitable to work in a care setting were employed.

Staff had undertaken appropriate training to ensure that they had to skills and competencies to meet people’s needs. Staff attended regular supervision meetings with the registered manager.

People were supported to maintain good health and had access to health professionals. Dietary needs and nutritional requirements had been assessed and recorded. Weight charts were seen and had been completed appropriately.

Staff were caring, knew people well, and treated people with dignity and respect. Staff acknowledged people's privacy and had developed positive working relationships with them. Relatives spoke positively about the staff at the home.

The care that people received was responsive to their needs. People’s care plans contained information about their life history and staff spoke with us about the importance of knowing people’s backgrounds.

Complaints were listened to and managed in line with the services policy and procedures.

People, relatives and staff were involved in developing the service through meetings, annual surveys and quality assurance audits.

Staff and relatives continued to speak positively about the registered manager and said there was an open-door policy.