Woodlands

Updated 5 March 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was 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.

This comprehensive inspection took place on 21 November 2018 and 7 January 2019. The first day of the inspection was unannounced. This meant the provider and staff did not know we would be visiting. The inspection was carried out by one adult social care inspector.

Before the inspection we reviewed information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales.

We contacted commissioners and other health and social care professionals who worked with the service to gain their views of the care provided by Woodlands. During the inspection we spoke with two health and social care professionals who were visiting people who used the service.

The provider had completed a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help plan for the inspection.

During the inspection we reviewed a range of records. This included two people’s care records including care planning documentation and medicines records. We also looked at three staff files, including recruitment, supervision, appraisal and training records, records relating to the management of the service and a wide variety of policies and procedures.

During the inspection we spoke with the registered manager, deputy manager, operations manager, therapy co-ordinator, two senior support workers and six support workers. We spent time observing staff interactions with people throughout the inspection. In addition, we spoke with five people who used the service and three relatives.

Updated 5 March 2019

We inspected Woodlands on 21 November 2018 and 7 January 2019. The first day of the inspection was unannounced. When we last inspected the service on 29 December 2016 and 12 January 2017 we found the provider was meeting the legal requirements in the areas that we looked at and rated the service as good with an outstanding rating in caring. At this inspection we found that the service had improved further and was outstanding overall.

Woodlands is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Woodlands provide care, support and accommodation for up to 14 people who have a brain injury. The aim of the service is to support people to regain their social, cognitive, and independence skills and to develop people's confidence to enable them to return to independent living. At the time of the inspection there were 13 people who used the service.

A registered manager was in place. 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 service provided outstanding care, emotional support and rehabilitation to people following their brain injury. The registered manager and staff were exceptionally caring and encouraged people to do well in achieving their goals. Staff demonstrated a real empathy for the people they cared for. The service's visions and values promoted people's rights to make choices and live a dignified and fulfilled life, this was reflected in the care and support that people received.

There was a strong recognition that people were individuals and the care and support provided ensured their needs were met and resulted in positive and improved outcomes for people. People received a service that was extremely responsive and based upon a person-centred approach and best practice. They had achieved exceptional results with people’s rehabilitation and improved people's emotional and psychological wellbeing.

The registered manager and staff worked extremely hard to find ways to ensure people were engaged and stimulated. Activities were meaningful and people had regular holidays. People were provided with choice and opportunities dependent on their needs or interest. There was a dedicated activities room with people’s art work proudly displayed.

The registered manager and staff worked in a way that put the needs of people first. Care plans were extremely informative and reflected people’s likes and dislikes in detail. The registered manager and staff knew every person they cared for in depth, what was important to them and the best way to provide care to them.

The registered manager displayed exceptional leadership qualities, drive and enthusiasm. They empowered staff to provide care that was tailored to individual's needs. Staff were highly motivated by the registered manager and showed pride in their work and the support they gave to people.

Without exception people, their relatives and professionals told us they experienced compassionate care from staff. This ensured the service was run in the best interest of people who used the service.

A comprehensive programme of audits and checks was in place to monitor all aspects of the service, including care delivery, accidents and incidents, health and safety, infection prevention and control and medicines. Audits resulted in clear action plans to address shortfalls or areas of improvement.

We observed care delivered in a way that truly reflected the provider's values of empowering people, sharing and engaging together, listening, honesty, outstanding leadership and support. The registered manager led by example and they had a pride and passion for the service that was reflected in everything they did. This in turn inspired staff to do their best to deliver the extremely high standard of care that was observed throughout the inspection.

Staff understood the procedure they needed to follow if they suspected abuse might be taking place. Risks to people were identified and plans were put in place to help manage the risk and minimise them occurring.

Medicines were managed safely with an effective system in place. Staff competencies around administering medicines were regularly checked.

The home was clean and tidy and communal areas were well maintained. Appropriate personal protective equipment and hand washing facilities were available. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety was maintained.

There were enough staff employed and on duty to ensure people’s needs were met. We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. People were supported by a team of staff who were extremely knowledgeable about people’s likes, dislikes and preferences. A training plan was in place.

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. The registered manager and staff promoted positive risk taking to increase people’s independence.

Staff supported people to maintain a healthy and nutritional diet. People were encouraged and supported with their rehabilitation, to maintain their health and attend routine health care appointments.

At the time of our inspection no one was receiving end of life care. However, the support of health care professionals was available to ensure people could remain at the home at the end of their life.