Background to this inspection
Updated
15 July 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
One inspector carried out this inspection.
Service and service type
This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 3 people who live at William Wood House. We also spoke with the registered manager, two team leaders and two care assistants.
We reviewed a range of records. This included care records and medication records. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
15 July 2022
About the service
William Wood House provides personal care to people living in specialist 'extra care' housing. Personal care is help with tasks related to personal hygiene and eating, we also consider any wider social care provided. At the time of our inspection there were 26 people using the service. They lived in separate flats with shared areas including gardens and a large lounge and dining room. Not everyone who lived at William Wood House received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
The provider’s quality assurance system had not been effective in identifying the issues we found during the inspection. Audits had not always been completed. Risk assessments were not always in place for known risks to people. Accidents and incidents were not always analysed to see if action needed to be taken to prevent a reoccurrence.
Medicines were administered in a timely manner and in a way that respected people’s preferences. Recruitment procedures had been followed to ensure new staff were suitable.
People told us they enjoyed living at William Wood House and that the registered manager and staff team were caring.
There was a new registered manager in post, they told us they had been concentrating on dealing with staffing issues since their appointment. Staff felt supported to carry out their roles effectively. People and staff were asked their opinions on the quality of the service.
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(report published November 2017).
Why we inspected
We received concerns in relation to staffing and management. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
The registered manager implemented a monthly colour coded incident analyst form so that accidents and incidents could be easily analysed for trends and themes. The registered manager wrote to us after the inspection and told us that they had implemented a risk profile across the service to ensure all risks are assessed.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for William Wood house on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to keeping people safe and identifying when improvements are needed at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.