Woodhouse Cottage

Woodhouse Cottage is a residential care home which provides accommodation and personal care for up to six people with a learning disability. At the time of our inspection, five people were living in the home.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture. People were empowered to make their own choices and to maximise their independence, with the support of a highly motivated and committed staff team. People received exceptionally person-centred care, which met their needs and promoted their privacy, dignity and human rights. The home had an exceptionally open, inclusive and empowering culture, which ensured good outcomes were achieved for people.

People were supported by staff who were highly motivated, compassionate and exceptionally caring. Staff had formed trusting relationships with people and encouraged them to live as independently as possible. Care was extremely person-centred and delivered by a staff team who knew people exceptionally well.

The staff team were committed to delivering extremely responsive and person-centred care, which met people’s needs and had a very positive impact on their well-being. Respect for people’s privacy and dignity was consistently promoted and upheld. Activities were individualised to suit people’s personal preferences and staff actively encouraged and supported people to achieve their goals and aspirations. This led to exceedingly great outcomes for people.

People consistently told us they felt safe living at the home. Risks to people’s safety were comprehensively assessed, monitored and managed, and this was balanced against people’s wish to be as independent as possible. Safe recruitment practices were followed, and people received support from staff who were skilled, well-supported and well-trained.

The home was well-maintained, and people were encouraged and supported to personalise their rooms and the communal areas. 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.

People and staff were consistently complimentary of the registered manager and the way the service was run. The registered manager had established and embedded a person-centred culture within the service, which consistently delivered high quality care. The provider regularly sought feedback from people, staff and relatives, in order to continuously drive improvement and develop the ongoing delivery of care and support people received.

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 24 July 2018).

Why we inspected

This was a planned inspection based on the previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

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.

Woodhouse Cottage is a care home which provides accommodation and personal care for up to six people with a learning disability. There were six people who were living at the home on the day of our visit.

Woodhouse Cottage 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.

People continued to receive safe care as they were supported by staff who knew how to protect them from harm. Staff were aware of people’s individual risks and plans were in place to minimise these while maintaining the person’s independence. Staffing was arranged based on people’s individual needs and what activities were happening in the home. Staffing remained flexible to suit the people living at the home.

The registered manager supported staff by arranging training so staff developed the skills to provide care and support to people, which was in-line with best practice. People receive care and support that was agreed with their consent, the policies and systems in the service support this practice.

People were supported by staff who knew their individual dietary requirements and how to support them in the right way. People had access to healthcare professionals when they required them.

People were treated well which had a positive impact on their well-being. People we spoke with told us that all staff spoke kindly to them and they felt happy and comfortable in their home. Staff helped people to make choices about their care and the views and decisions they had made about their care were listened and acted upon.

People were involved in the planning and review of their care and support. People were supported to continue with their hobbies and interests which promoted their independence and confidence. Information was provided to people should they wish to raise a complaint.

Systems were in place to monitor and assess the quality and safety of the care provided. There were opportunities for people and relatives to feedback their views about their care and this was used to improve the service. Staff were supported to carry out their roles and responsibilities effectively, so that people received care and support in-line with their needs and wishes. The checks completed focused on people’s experience of care. Where areas for improvement were identified, systems were in place to ensure lessons were learnt and used to improve the service delivery.

Further information is in the detailed findings below.

Our last inspection took place on 7 January 2015, at that time we found the service was not meeting the regulations relating to consent. The registered person did not have suitable arrangements in place to show they were acting in accordance with the Mental Capacity Act (MCA) 2005. At the last inspection on 7 January 2015, we asked the provider to take action to make improvements for ensure consent, and this action has been completed.

Woodhouse Cottage is registered to provide accommodation for up to six people who have a learning disability. The home has a kitchen, dining area and two lounge areas on the ground floor. There are six single en-suite rooms with showers on the first floor. There is one bathroom on the ground floor. The home has a well maintained garden area and is within easy walking distance to local amenities. At the time of inspection there were five people living at Woodhouse Cottage.

At the time of this inspection the home 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.

At this inspection we found people were happy with the care they received. People felt staff were caring. We saw people received good support during the inspection and enjoyed the company of staff.

People told us they felt safe and did not have any concerns about the care they received.

We found the provider was meeting the legal requirements relating to Deprivation of Liberty Safeguards (DoLS).

The provider was meeting the requirements of the Mental Capacity Act 2005 (MCA). Staff understood how to help people make day-to-day decisions and were aware of their responsibilities under the MCA and Deprivation of Liberty Safeguards (DoLS).

We found that staff had training throughout their induction and also received refresher training in areas such as dementia care, MCA, DoLS, safeguarding, health and safety, fire safety, first aid and infection control. This meant people living at the home could be assured that staff caring for them had up to date skills they required for their role.

Medicines were administered to people by trained staff and people received their prescribed medication when they needed it. Appropriate arrangements were in place for the ordering, storage and disposal of medicines. At the time of inspection a visiting pharmacist was at the home completing their six monthly checks of the homes medication.

People enjoyed a range of social activities and had good experiences at mealtimes. People’s health needs were met.

People told us the food was good and that they had enough to eat and drink. People chose to eat in the home or out in the community.

Robust recruitment and selection procedures were in place to make sure suitable staff worked with people who used the service. Staff felt supported and had regular supervisions and appraisals

We saw the provider had a system in place for the purpose of assessing and monitoring the quality of the service. This showed through audits that this was an effective system.

People told us they would feel comfortable raising concerns or complaints. People provided positive feedback about the registered manager.

We spoke to three people who use the service. People who use the service said that they were given choices about how they spent their days.

People we spoke to were aware that they had a care record containing information about them. One person said ' I see my key worker and we talk'. We looked at three care records which had information on key worker meetings which documented any changes in peoples care needs.

We observed staff being respectful to people by talking to them in a kind and caring way and by knocking on people's doors and awaiting a response before entering their rooms. We observed that people were comfortable in the presence of staff and the atmosphere in the home was pleasant and calm.

We saw from training records that all of the staff had received training in safeguarding and were able to demonstrate a clear understanding of the learning. An up to date safeguarding and whistleblowing policy was in place.

We looked at two staff records which demonstrated that effective recruitment and selection procedures were in place. We did note however, that one record did not have information on an application form being in place nor any references. The manager said she was aware of this and that they were in the process of getting this information from the HR department.

The home carried out monthly audits which covered areas such as staff communication and interaction with service users, respect, privacy and dignity, promoting service user involvement and managing difficult situations and/or challenging behaviour. Records and documentation were also audited and this covered areas such as risk assessment, incident records, and medication and keyworker meetings.