Woodstock Nursing Home

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We observed staff to be caring and on the whole alert to people’s immediate needs. Some staff were not always familiar with the people they were supporting or had the necessary skill and experience to recognise and meet people’s immediate needs. The lack of involvement of care team leaders, in the decisions made about who was admitted, had meant staff had not always been able to challenge those decisions. This had led to people with increasingly complex needs being admitted, sometimes at a fast pace, without consideration of the staff teams skills, experience and capacity to meet those needs. Most people’s relatives told us staff did a good job at supporting their relative’s immediate needs, although some relatives had needed to raise questions about the care provided to their family member.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Kindness, compassion and dignity during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

People’s relatives had mixed views about whether the needs of their family member were supported effectively. Several relatives told us their family member needed support when they became distressed. Comments included, “The staff are a mixed bag. The regular ones are very good but there are a lot of supply ones too and some are more empathetic than others.” and “Yes, they always seem to be when I’m there. [Person] gets anxious and can’t communicate and they try to calm [person] down.” Relatives also had mixed views about whether a deterioration in their relatives’ health was effectively responded to. A relative told us they had needed to point out a health concern to staff, who once informed of this, acted immediately and it resulted in their relative being prescribed antibiotics to treat an infection. The relative said, “I was surprised that nobody had picked this up before.” Another relative described how the staff worked collaboratively with them to try and meet their relatives immediate personal care needs. They said, “The staff do try to calm [person] down or distract [person]. It works sometimes but not always. Sometimes they phone me, and I speak with [person] on the phone to calm them down.”

Staff told us they were not always made aware of the backgrounds and support needs of those moving into the service, in time for them to prepare for the admission. During the assessment a new admission was due to arrive and staff on duty that day told us they were unaware of the person’s needs. Information about the person had been handed to a senior member of staff late the evening before, they had shared it with the night nurse and the limited information was handed over to the staff team in the morning staff handover meeting. Staff told us this gave them no time to prepare for the person’s admission. Staff told us they had an issue with the decisions made to admitted a person without first discussing whether the staff team, at that time, was in a position to support the person's needs. They told us this was resulting in too many people, with complex and nursing needs, being admitted when the care team had limited capacity to meet these needs. Staff were aware of which people required close monitoring so they could be ready to respond immediately to any safety needs. A member of the night staff told us there were several people, who for various reasons, staff needed to be aware of their movements and to be ready to provide immediate support. They said, “We need to do cleaning at night now, but care has to come first, so difficult to sometimes complete [the cleaning]."

We observed staff on numerous occasions responding to people’s immediate need for help or reassurance. One person was struggling to hold a new beaker and staff immediately responded to help the person. We observed people walking with purpose and getting lost and staff immediately provided them with reassurance. However, at other times we observed people not getting the immediate support they required. One person was having difficulties in communicating with a member of staff. The person, who lived with dementia, had declined their main meal and instead of taking the time to understand why this was and support the person to choose an alternative meal, the member of staff removed the meal and asked the person if they wanted a pudding. We later asked the kitchen staff if the care staff had been in to discuss an alternative meal for this person and we found they had not. After we reported this observation to a nurse, they spoke with the person, found out what they would like to eat and had that organised for them. We observed another person continually pacing the corridor. On approaching them we could see they had obviously been incontinent, but staff who we had observed passing this person had not explored the reason for their pacing or identified the problem.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.