Archived: Woodlands - Care Home

Woodlands Care Home is part of the HICA group of homes. It is purpose built. It provides accommodation for up to 54 people some of whom may be living with dementia. At the time of this inspection there were 44 people living at the home and receiving a service.

The home is situated on the outskirts of Driffield, within walking distance of local community facilities. There are 46 bedrooms for single occupancy (15 with en-suite toilet and wash hand basin facilities) and four bedrooms for double occupancy with wash hand basin facilities. Bathrooms and toilets are shared. There is a lift to the upper floor. There are various communal areas including lounges and dining rooms for people to use. People have access to outside gardens and seating areas, which are provided in secure settings. There is car parking for staff and visitors to the front and side of the service.

There was a registered manager in post. 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 will be referred to as 'manager' throughout the report.

At the last inspection in November 2016 the overall rating for the service was Requires Improvement. This was because the provider was in breach of two Regulations under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The breaches were in Regulation 11 Need for consent, and Regulation 17 Good governance. We asked the provider to submit an action plan regarding the breaches identified. During this inspection we checked and found the actions were met and no further breaches were identified.

People were protected from the risk of harm or abuse because there were effective systems in place to manage any safeguarding concerns. Care workers were trained in safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm.

The service was working within the principles of the Mental Capacity Act 2005 (MCA). Care workers understood their responsibilities under the MCA and were actively promoting people’s independence. The manager and care workers had an understanding of Deprivation of Liberty Safeguards. They had made appropriate referrals to the relevant authorities to ensure people's rights were protected.

Further work was being completed by the provider to ensure that, where a relative had told the service they had a Lasting Power of Attorney, this was validated and the scope of the decision making was recorded.

Care workers were only recruited after checks had been completed to ensure they were of suitable character to work with vulnerable people. A staff dependency tool was used to ensure sufficient skilled care workers were employed to meet people’s needs. On the day of the inspection we saw that there were sufficient numbers of staff employed to meet people's individual needs.

Support plans were person centred and reflected individual's preferences. Information recorded was reviewed and evaluated as a minimum every month and more often where people’s needs changed. This meant care workers had access to up to date records that were reflective of people’s current needs.

Assessments of risk were carried out to ensure any care and support activities were safe and with minimal restrictions. Assessments were carried out around the home environment to ensure it was safe for everybody. Where any concerns were highlighted action plans were implemented and reviewed for their effectiveness.

Care workers were supported to complete training, learning and development that enabled them to fulfil the requirements of their role and meet people’s individual needs and support their preferences. The provider was improving staff records to ensure they were up to date and accessible.

People benefited from an enthusiastic activities coordinator who supported people to pursue interests and activities of their choosing. Activities were provided on a group basis or one to one depending on people’s preferences. People could participate as much or as little as they choose to.

People had access to a healthy variety of food and drink. We received mixed feedback regarding the meal time arrangements. The provider was taking action to address the concerns raised and discussed plans to employ a chef and cook meals in the home.

People had access to a range of health professionals who they could visit or who visited the home to provide care and support to maintain people’s health and wellbeing.

The provider completed quality assurance checks that included regular audits of service delivery, activities of care and support and checks on the home environment. We identified some areas that required further improvement. The provider was aware of concerns we raised and had an action plan in place to ensure the home was appropriately maintained for everybody.

Everybody spoke positively about the manager and the deputy. The manager had a clear understanding of their role and responsibilities with regards to their registration with the CQC. The provider, manager and staff were committed and enthusiastic about providing a person centred service for people.

Woodlands Care Home is part of the HICA group of homes. It is purpose built. It provides accommodation for up to 54 people some of whom may be living with dementia. It is situated on the outskirts of Driffield, within walking distance of local community facilities. There are 46 bedrooms for single occupancy (15 with en-suite toilet and wash hand basin facilities) and four bedrooms for double occupancy with wash hand basin facilities. Bathrooms and toilets are shared. There are lifts to the upper floor. There are various communal areas including lounges and dining rooms for people to use.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager 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 able to demonstrate they had an understanding of Deprivation of Liberty Safeguards (DoLS) and The Court of Protection. However, we found that Mental Capacity Act (2005) guidelines were not always followed. This was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The registered provider had a quality assurance system in place, but the system was not effective in assessing, monitoring and improving the quality and safety of the service. We also found record keeping at the service to be inconsistent. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People had their health and social care needs assessed and care and support was planned and delivered in line with their individual care needs. Care plans were individualised to include preferences, likes and dislikes and contained detailed information about how each person should be supported. However, not all care plans were fully reflective of people’s current needs.

People enjoyed a good choice of food and drink and were provided with snacks and refreshments throughout the day. Health care professionals were consulted when concerns had been identified in respect of people's weight loss.

We saw that staff completed an induction process and they had received a wide range of training, which covered courses the home deemed essential, such as safeguarding, medication and Mental Capacity Act 2005 (MCA).

Staff had been employed following appropriate recruitment and selection processes. We found that staff had a good knowledge of how to keep people safe from harm. Accidents and incidents were recorded appropriately and we found that the recording and administration of medicines was being managed appropriately.

Assessments of risk had been completed for each person and plans had been put in place to minimise risks for most people. The service was clean, tidy and free from odour and effective cleaning schedules were in place.

People told us they were well cared for and we found people were supported to maintain good health and had access to services from healthcare professionals.

People were offered a variety of different activities to be involved in. People were also supported to go out of the home to access facilities in the local community.

The registered provider had a complaints policy and procedure in place and there were systems in place to seek feedback from people and their relatives about the service provided.

You can see what action we told the provider to take at the back of the full version of the report.

People were asked for their consent before staff provided any support. Where people did not have capacity to consent clear protocols were in place to ensure staff worked within agreed boundaries, and in accordance with legislation.

Care records were detailed and were reviewed regularly to ensure care records accurately reflected people's current needs. People told us they were satisfied with their care.

Staff told us that equipment used to support people was appropriate for people's individual needs. We saw that regular checks took place to ensure equipment remained safe.

Recruitment processes ensured people were protected from the risks of being supported by unsuitable staff.

The manager explained the staffing levels in place at the service and that the needs of potential new people were assessed prior to their admission to the service to ensure their needs could be met within the staffing structure.

Staff records showed staff had received appropriate training and were supported through supervision and staff meetings.

The manager worked in accordance with the provider's quality assurance policy to ensure they monitored the quality of the service provided.

We observed that people were interacting with staff very positively and their care plans were detailed and person centred. People were tended to with patience and care and they reported that they were happy with the care they received. One relative told us 'My relative has been a different person since coming into the home and we are very happy with the care they have received'.

We looked at safeguarding processes and procedures in place and found these to be robust. Staff understanding was good and the service was responding appropriately to incidents. The home was clean and hygienic. All areas of infection control policies were being followed effectively.

Staffing and recruitment was handled professionally and there were robust processes in place to manage this. Staffing levels were good and people reported there was always enough staff.

The home was undertaking a large amount of quality assurance and people who used the service and their relatives were given chances to participate and feedback comments. The organisational processes in place ensured that the quality of care was high.