Woodlands House

Woodlands House is a residential care home. It provides personal care and accommodation for up to 40 older people. There were 37 people living at the service at the time of inspection, some of whom were living with dementia. The home consisted of a residential setting and a separate ‘dementia cottage’, designed to provide higher levels of care.

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

Appropriate risk assessments were conducted in relation to people who were at risk of falls. Investigations into unwitnessed falls were conducted and the systems for monitoring falls highlighted any patterns or trends.

The provider had effective arrangements in place to support people who required assistance with their medicine. Staff were suitably trained and their competence to administer medicine was regularly assessed.

The provider had safe arrangements in place to minimise the risk and spread of infection. Staff wore personal protective equipment when required.

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 14 May 2020).

Why we inspected

The inspection was prompted due to concerns received about medicine and falls management. A decision was made for us to inspect and examine those risks.

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.

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Woodlands House is a residential care home. It provides personal care and accommodation for up to 40 older people. There were 38 people living at the service at the time of inspection, some of whom were living with dementia. The home consisted of a residential setting and a separate ‘dementia cottage’, designed to provide higher levels of care.

People’s experience of using this service:

The provider had fostered an overwhelmingly person- centred approach to delivering care. There was a focus on giving people meaningful occupation, utilising skills and keeping people connected to their local community. Activities at the home were creative, wide ranging and designed with people’s skills and interests in mind. This had clear benefits in improving people’s physical and mental wellbeing.

People, relatives and professionals told us how the provider’s person-centred approach had helped to make improvements to people’s motivation, mood, independence and social interaction. Staff were skilled in their approach to ensure that people’s individual needs were considered in the design and delivery of care.

The service had a record of outstanding practice in delivering end of life care in line with best practice. They worked in partnership with people, relatives and stakeholders to help ensure people receive personalised care which reflected their needs and preferences as they neared the end of their life.

Staff were motivated in their role and were caring. They understood people’s needs and treated them with dignity and respect. There was a positive atmosphere at the home, where people were content, active and well attended to.

There was strong leadership at the home. The registered manager understood the responsibilities of their role and was attuned to people’s needs. There were effective systems in place to monitor the quality and safety of the service.

People’s needs were assessed to ensure they received appropriate support with their nutrition, hydration, medicines and healthcare. Risks associated with the environment were safely managed and the home was clean and hygienic.

The home was a suitable environment for people. There were a range of communal spaces which people could utilise throughout the day. The provider had made adaptions to the home to make it suitable for people living with dementia.

The provider had processes in place to gain appropriate consent to care. 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 provider had safeguarding policies and procedures in place, which helped to reduce the risk of people suffering abuse or coming to avoidable harm. There were appropriate systems in place to gain feedback and respond to complaints.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The service was rated good at our last inspection (published 4 July 2017)

Why we inspected

This was a planned inspection based on the previous rating.

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.

At the last inspection, the service was rated good overall. This inspection found that the service remained good.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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 and associated Regulations about how the service is run.

Improvements were needed to ensure the proper and safe use of medicines.

Staff had received training in safeguarding adults, and had a good understanding of the signs of abuse and neglect. Staff were confident the registered manager would act upon any concerns they raised.

People had risk assessments and where risks had been identified, measures were in place which helped to ensure that the risk was minimised.

Safe recruitment practices were followed and there were sufficient numbers of staff deployed to meet people’s needs.

Staff sought people’s consent before providing care and people were encouraged and supported to make decisions about their care and support. Staff acted in accordance with the principles of the Mental Capacity Act 2005. Where people’s liberty or freedoms were at risk of being restricted, the proper authorisations were either in place or had been applied for.

Staff received training, supervision and an induction which ensured they had the skills and knowledge to support people appropriately.

People told us the food was tasty and that they were supported to have enough to eat and drink.

People were cared for by staff that were very kind and caring and with whom they had developed strong relationships. Staff were attentive, showed people kindness and patience and displayed a genuine interest in the people they supported. Staff delivered care in a compassionate manner and people were treated with dignity and respect.

Care plans contained the information needed to support staff to provide people’s care in a manner that was responsive to their individual needs. People were supported to take part in a range of activities and make choices about how they spent their time.

People spoke positively about how well organised and managed the service was. The engagement and involvement of people and staff was encouraged and their feedback was used to drive improvements.

There were systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving appropriate support.

This is a summary of what we found-

Is the service safe?

We found the service was safe because people were protected against the risks associated with medicines. The provider had appropriate arrangements in place to manage people's medicines safely.

You can see our judgements on the front page of this report.

Medicines were kept safely. Supporting information for allergies, 'how a person preferred to take their medicines', 'variable' and 'if required' medicines and creams and ointments applied as part of personal care were available.

The administration records were complete, including the exact dose administered for 'variable doses'.

We considered all the evidence we had gathered under the outcome we inspected. We used the information to answer one of the five questions we always ask;

Is the service safe?

This is a summary of what we found-

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Systems were in place to receive and administer medicines. Supporting information about 'how the service users took their medicines' was available to support staff administering medicines safely. We observed medicines being safely administered.

Systems and equipment were not in place for the secure storage and segregation of medicines. Supporting information was not available for 'variable dose' and 'if required' medicines. Allergy information was also incomplete for two service users. Where a medicine required additional monitoring the records were incomplete. Following an increase in medication errors the service had increased the frequency of audits. This meant that people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

People appeared relaxed and at ease with staff, we saw people laughing and singing with each other and staff. The people we spoke with told us they got on well with the staff and had good, supportive relationships with them. We were told 'The staff are like angels looking after me'. We observed staff being person centred in their approach to people; they showed sensitivity to people's needs and preferences. We saw that care was centred on the individual and their immediate and long term needs.

We saw that there were policies in place in relation to the control of infection in the home, including the minimising of the spread of infection. People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.

The manager had recently been put into post was endeavouring to maintain the essential standards of quality and safety.

People were happy with the service provided and we saw that staff interacted well with people in their care and talked positively about their work. People were, as far as they were able to do so, involved in making decisions about their care and support and asked for their consent to care.

People's needs were assessed and care was delivered in line with their care plans. There were policies and procedures in place to ensure that the safety and suitability of the premises was maintained, these were understood and followed by staff.

There were enough qualified, skilled and experienced staff to meet people's needs.

There was an effective system in place to deal appropriately with comments and complaints made by people, or persons acting on their behalf.