Woodside Residential Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Requires Improvement. At this assessment the rating has remained Requires Improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety. The registered manager held good records in relation to accidents and incidents. The information contained in these were analysed monthly for themes or trends and any lessons learnt shared with staff through staff meetings or daily staff huddles. Staff told us the daily meetings were useful as it enabled them to hear the most up to date information about a person.

Staff planned and organised care and support with people, working with external professionals. The registered manager explained they would visit the person first to find out about their needs and a staff member would be allocated to the person when they first moved in to look after them initially. This would help ensure a smooth transition into Woodside. A relative told us, “It was a very efficient process, we called a number of homes. It was almost the same day, someone visited her at home, they came to ask questions and the paperwork was done, she was in the next day, they were really helpful.”

Staff understood their responsibility to notify the local authority safeguarding team should they have any concerns or suspect abuse; this knowledge was gained through training and supervision. A staff member told us, “I would tell [registered manager] if I was concerned. Otherwise I would raise it myself with the council.” The registered manager said, “I have a good relationship with the local authority and have raised safeguarding’s myself.” A relative told us, “Someone is with her [their family member] 24-hours a day. If anything happens someone will call me.” Incidents of potential abuse were also notified to CQC in line with registration requirements. Staff told us they, “Had no safeguarding concerns about the service.”

Although staff worked with people to understand and manage risks, and they provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them we identified two areas of concern. We found two people’s thickening agent was not being stored in line with an NHS England safety alert in 2015 that recommended thickening powders should be stored securely and out of reach of people. We found two people who shared a room had their thickening agent sitting on their individual bedside tables. Although there had been no instances of people picking it up and inadvertently ingesting it, people were seen walking around the service without staff presence, which meant there was a potential risk. We raised this with the registered manager who immediately took action and following our visit developed an action plan to help prevent this happening again. We also found an error in the recording of one person’s weight which hadn’t been picked up by senior staff. Risks to other people had been identified and there was guidance in care plans to direct staff in ways to help ensure these risks were mitigated. For example, people at risk of their skin breaking down were repositioned regularly and those at risk of choking were provided with foods in an appropriate consistency. A staff member said, “[Person’s name] needs support with his food. Level 5 moist, we need to make sure he eats the right stuff. We keep an eye on his intake so he doesn’t lose weight.”

Staff assessed the environment for potential risks although we found the floor was very sticky in the communal areas. This presented a potential falls risk to people living at the service. The registered manager said they had spoken with housekeeping staff about this before as it was the result of them using too much cleaning product. However, we did find positive changes in the environment since our last visit. Rooms had been reorganised to give people more options of where to sit and the chairs in the lounge had been arranged so people could sit together in groups, rather than side by side.

The registered manager did not always follow the providers recruitment policy. We reviewed 5 staff recruitment files and found gaps of employment history in 2 (1 was remedied whilst on site). We also found 1 staff member having previously worked in care had no reference from the service they had worked at. The registered manager said, “It was because it was over 3 years ago. That’s our policy.” We reviewed the provider’s recruitment policy which clearly stated there should be no employment history gaps for prospective staff. We did not find any reference to timescales in terms of requesting references for staff members previously working in the care industry. We spoke with the provider who assured us they would rectify the shortfalls and review their policy to ensure it was in line with the requirements of Schedule 3. We had mixed feedback about staffing levels. One staff member said, “There's not enough staff. There is 6 staff and 40 residents, seniors help when they can but it’s not enough. There should be another carer on.” A relative told us, “In the past there was a lack of staff, but things are better now.” They added, “Things could do to be quicker in the mornings. Sometimes when we visit, she is still not dressed and it’s 11:30.” We observed a couple of times during the day when people had to wait to be assisted which resulted in 1 person not being prompted at lunchtime in a timely manner. This meant they sat in front of their lunch for 20 minutes before starting to eat. We spoke with the registered manager who said they had recognised there were times when more flexible deployment was needed. They were looking to introduce a split-shift to cover the busy times during the day. Staff were supported through induction, training and supervision to help ensure they were competent in their role. A staff member said, “The fire and first aid training is really good that’s yearly. I do the moving and handling. We do a module online which is dementia.”

The environment in which people lived was not consistently well cleaned, although relative’s told us, “[Person’s name] room is always clean and tidy” and, “She has a lovely room which is kept immaculate by housekeepers as are her clothes.” We observed a number of areas where the walls were scuffed and marked and some of the floors did not look properly cleaned. At 16:00 we found food on the floor underneath one of the dining tables which had been there since lunchtime. On speaking with the registered manager, they explained the interior had been painted with a non-wipeable paint finish but was currently being repainted with paint that could be cleaned. This would enable staff to help ensure that marks were removed quickly. The building was large and sprawling and 3 housekeeping staff were employed to complete the cleaning tasks, one of whom spent some time in the laundry. A staff member told us, “It’s hard to keep on top of cleaning the bedrooms when there's accidents. There's not 3 (housekeepers) on every day sometimes there's just 2, it’s ridiculous having 2 staff to clean the house.” This meant that although they did a good job with the cleaning, there were not enough of them to help ensure the environment was consistently maintained to a high standard of cleanliness. The registered manager told us they recognised this.

Staff followed good and safe medicines administration practices, although the storage of medicines was not always robust as we found with the thickening agent. We reviewed the medicines charts for several people and found no gaps on their administration records which indicated they had been given their medicines as prescribed. One person said of their pain relief, “I have it as and when required.” A staff member told us, “We make sure people get their medicines on time. We question why people are on medicines and make sure it’s still right for them.” Where people used pain patches (medicines in patch form) there were clear records showing where the patch had been placed to help ensure that staff did not place the patch in the same place at the next change.