Woodlands

Woodlands is a residential care home providing personal care to up to 40 people aged 65 and over. At the time of the inspection the service was supporting 35 people some of whom were living with dementia. Woodlands is split over three floors with a garden, and enclosed courtyard.

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

People were safe at the home and people and their relatives told us they felt safe. The provider had robust recruitment policies and staff were well trained and confident in their roles. There were enough staff to support people when they needed help. The home was clean, and risks were regularly assessed and minimised. The home had clear safety policies which staff were trained in and which were followed. Trained staff administered medicines according to clear policies. Effective quality assurance systems were in place to monitor the quality of care.

The décor was dementia friendly and corridors were decorated in themes with input from people that lived at the home. There was space for people to walk about the home easily. People were encouraged to personalise their spaces. A relative told us “Mum thinks of this as her home, she had to go to A&E but she talked about going home [to Woodlands].” People spoke extremely highly of the food. The menus were accessible to all, and the chef was led by people as to what to cook. People told us “I like the food, there’s nothing to complain about here.” And a relative told us “She loves the food, it’s restaurant quality at times. I wouldn’t mind coming here myself.”

Relatives told us that staff were very caring in their attitudes, “I heard staff with mum and they were so patient with her. I was impressed with the care. If everyone was as good as that I’m happy.”

The registered manager was proud of the home and keen to ensure the best individualised care for people. Pre-admission assessments and care plans helped ensure people had person centred care. People’s likes, and dislikes were catered for.

People could choose how to spend their time. There was a dedicated activities coordinator who ensured there were always plenty of things for people to do.

The registered manager was involved in all aspects of the running of the home and provided their team with skilled leadership. They promoted the values of the home and the staff reflected the attitude in their treatment of people. The home was actively involved with the local community, including people in a local dementia choir, hosting a dementia café and having a lunch club that anyone could attend, sharing food and activity time with the people that lived at Woodlands.

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.

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 17 November 2016)

Why we inspected

This was a planned inspection based on the previous rating.

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.

There was a manager in post who was registered with the Care Quality Commission (CQC). 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. The registered manager was supporting a newly recruited manager who had already taken over the daily running of the home. The registered manager was in the process of de-registering with the CQC and the new manager had applied for their registration. We consulted the manager in post during our inspection.

Staff knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm. Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced.

There was a sufficient number of staff deployed to meet people’s needs. Thorough recruitment procedures in place which included the checking of references.

Medicines were stored, administered, recorded and disposed of safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

Staff knew each person well and understood how to meet their support and communication needs. Staff communicated effectively with people and treated them with utmost kindness and respect.

Staff received essential training, additional training relevant to people’s individual needs, and regular one to one supervision sessions.

The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people’s freedom had been submitted and the least restrictive options had been considered. Staff sought and obtained people’s consent before they helped them. People’s mental capacity was assessed when necessary about particular decisions. When applicable, meetings were held to make decisions in people’s best interest, as per the requirements of the Mental Capacity Act 2005.

The staff provided meals that were in sufficient quantity and met people’s needs and choices. People told us they enjoyed the food and their meal times. Staff knew about and provided for people’s dietary preferences and restrictions.

People’s individual assessments and care plans were person-centred, reviewed monthly or when their needs changed. Clear information about the service, the facilities, and how to complain was provided to people and visitors.

People were promptly referred to health care professionals when needed. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. The staff promoted people’s independence and encouraged people to do as much as possible for themselves.

A wide range of meaningful activities and outings were provided. People were involved in the planning of activities that responded to their individual needs.

Staff told us they felt valued and supported by the manager, the management team and the provider. The manager was open and transparent in their approach. They placed emphasis on continuous improvement of the service and promoted links with the community.

There was a robust system of monitoring checks and audits to identify any improvements that needed to be made. The management team acted on the results of these checks to improve the quality of the service and care.

Below is a summary of what we found. The summary describes what people who used the service and the staff told us, what we observed and the records we looked at. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Woodlands was clean and tidy at the time of our inspection. The home employed dedicated cleaning staff who had been trained in infection control and knew how to maintain appropriate hygiene standards.

We saw that staffing levels were based on people's assessed needs and were responsive when these changed. Therefore, people's safety was protected because they received support when they needed it. Through the process of risk assessment and self-auditing the home had identified and taken steps to reduce the number of falls people experienced. This meant that the service was committed to the ongoing improvement of safety standards within the home.

We found evidence that the home had taken steps to ensure that it was compliant with the Mental Capacity Act and Deprivation of Liberty Safeguards. Through staff training and ongoing care plan reviews we found that the home had taken appropriate action to ensure that people received support that protected their legal rights and balanced safety with choice.

Is the service effective?

We saw that people had good relationships with the staff who supported them and observed positive relationships between them. People we spoke with described staff as "Fantastic" and "Lovely.' Feedback from relatives was that the home communicated well with them and always adapted the care to provide the support their relative needed.

Is the service caring?

Throughout the inspection we observed that people were treated with kindness and empathy by staff and management. People told us that they felt 'Well cared for'. They told us that 'The staff are lovely, they will do anything for you.' People went on to say that they would recommend the home to their friends. One person said 'It's not home, but it's the next best thing.' The recent satisfaction survey undertaken by an external company identified that 94% of respondents from Woodlands felt that the were treated by staff with 'Kindness, dignity and respect.'

Is the service responsive?

People's needs were continually assessed. Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and support had been provided in accordance with people's wishes. Staff had a good understanding of people's needs and demonstrated that they recognised and responded when these changed.

Is the service well-led?

The home was in the process of implementing a management change at the time of the inspection. The registered manager was still in post, but had been overseeing another of the provider's locations which meant that they were not currently in day to day charge of the home. The home was being run by a team of people with an acting manager overseeing the home on a daily basis. The feedback received from people was that this management change had been handled well and that staff received clear direction and leadership.

The provider had good systems in place to monitor and improve the services provided. The whole management team demonstrated that they were committed to listening to the people who lived there.

We spoke with seven people who use the service. They expressed they were satisfied with the care and the support they received. One person told us they were "happy at the home'. Another person told us they 'felt very lucky to be at the home and very grateful for the care they had'.

We sampled five care records and found risk assessments and care plans took into account people's preferences. One person told us 'if you wanted any changes, you could ask" and said staff involved them in their care plan.

People were offered choices with their meals and we noted individual needs and preferences were catered for. One person told us the 'food was good'.

The staff rotas we sampled showed us there were adequate numbers of skilled and experienced staff to deliver safe and appropriate care.

We spoke with four staff in addition to the manager. The four staff records we sampled showed us that staff received induction and refresher training which enabled the provider to demonstrate staff were able to deliver care to people safely and to an appropriate standard. We noted that all staff had training in the recognition of and prevention of abuse and protection of vulnerable adults.

The primary purpose of our inspection was to follow-up on a previous compliance action that we set to improve the way care records were maintained. We found that the home had made a number of improvements in this area and each person now had a written plan of care that contained current information about their support needs. This meant that staff had sufficient information to deliver care appropriately.

The home had systems in place to monitor and audit its own quality of care. These included seeking the views of people who lived, worked and visited the home. We saw evidence that these systems had secured improvements in the way the service was delivered.