Archived: Woodlands

Updated 20 August 2019

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 Care Act 2014.

Inspection team

The inspection was undertaken by one inspector, a specialist nurse advisor and one expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service

Woodlands 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.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about. We sought feedback from the local authority. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spent time observing care and support in the communal areas, as people had limited verbal communication. We observed how staff interacted with people who used the service. We spoke with four relatives via telephone. We did this to gain people's views about the care and to check that standards of care were being met.

We spent time with the registered manager during the inspection site visit and spoke with three support workers. We looked at the care records for two people. We checked that the care they received matched the information in their records. We looked at two staff files in relation to recruitment and staff training. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found including the training data.

Updated 20 August 2019

About the service

Woodlands is a residential care home, registered to support six people in an adapted building over two floors. It provides personal care and accommodation for people with learning difficulties. On the day of our visit five people were using the service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The providers quality monitoring systems were not fully effective to drive improvement. The provider lacked oversight in reporting all incidents and ensuring staff were up to date with training. Some areas of the environment were in a state of disrepair. For example, windows in communal areas had mould round them

Risk guidance to keep people safe was not consistently followed by all staff to minimise identified risks. Hazards to people were not managed safely, putting people at risk of scalding. Access to and from the building did not ensure people would be safe if left unsupervised. Some staff and relatives felt their were not enough staff to support people.

We have made a recommendation about staffing levels.

Medicine systems and processes were in place to ensure people received their medicines as prescribed. However, there was no clear audit trail where medicines had been soiled. The registered manager addressed this by starting to record on the reserve of the medication records when medicines had been soiled during administration.

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.

The service applied the principles and values consistently of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff understood their responsibility to safeguard people from harm and knew how to report concerns.

People were supported to maintain relationships with people important to them. Staff were caring in their approach and had good relationships with people. Staff treated people with respect and their dignity and privacy was respected.

Promoting independence was a part of the ethos of the service and people were supported by staff to maintain their independence.

People were supported to maintain their health and well-being and had access to healthcare professionals such as GP's when required. People were supported to eat and drink enough to maintain a balanced diet. Refreshments were available to people throughout the day

People and their representatives were involved in their care to enable them to receive support in their preferred way. People were supported to access local community facilities to enhance their well-being.

The provider’s complaints policy and procedure was accessible to people who used the service and their representatives. Peoples representatives knew how to make a complaint.

Lessons were learnt when things went wrong. Relatives and staff felt they could approach the registered manager if they had any concerns.

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 27 October 2016).

Why we inspected

This was a planned inspection based on the previous rating.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvements. Please see the Safe and Effective sections of this full report.

Enforcement

At this inspection we found a breach of Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.