28 and 30 September 2015
During a routine inspection
This inspection took place on the 28 and 30 September 2015. The inspection was unannounced on day one and announced on day two.
Woodbury House is a care home which is registered to provide care with nursing for up to 45 people, including people who live with dementia. At the time of our visit 30 people were using the services. The home is a large detached Victorian building in a country location, not far from the shops and amenities of Wokingham, Reading and Camberley. People had their own bedrooms and use of communal areas that included enclosed private gardens.
The people living in the home needed residential or nursing care and support from staff at all times and have a range of care needs. These included dementia care and palliative care.
The home has not had a registered manager since the 23 December 2014. However a manager who works full-time within the home has applied to CQC to become the registered manager. A registered manager is a person who has registered with the Care Quality Commission 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 2008 and associated Regulations about how the service is run.
Staff knew how to recognise and report any concerns they had about the care and welfare of people to protect them from abuse. The recruitment and selection process helped to ensure people were supported by staff of good character and there was a sufficient amount of qualified and trained staff to meet people’s needs safely. There were processes in place to ensure people received support from staff to have their medicine on time and safely.
People were provided with effective care from a dedicated staff team who had received support through supervision, staff meetings and training. Staff were supported to receive the training and development they needed to care for and support people’s individual needs.
People’s care plans detailed how they wanted their needs to be met. Staff were in the process of transferring these to a new person centred format.
There were some omissions within daily monitoring records that had the potential to place people at risk from less effective action being taken from the information that was available. However, other records fully identified people’s needs and how these were being monitored to ensure effective care was provided.
Risk assessments identified risks associated with personal and specific health related issues. They helped to promote people’s independence whilst minimising the risks. Staff treated people with kindness and respect and had regular contact with people’s families to make sure they were fully informed about the care and support their relative received.
The environment had not been designed or adapted to support or enhance the lives of people living with dementia, as it did not assist them to engage, orientate themselves or recognise areas within the home. There were plans to refurbish the home. However, the home was in need of some immediate redecoration and refurbishment and this had been actioned by the provider.
The service had taken the necessary action to ensure they were working in a way which recognised and maintained people’s rights. They understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care. The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision. DoLS provide a lawful way to deprive someone of their liberty, provided it is in their own best interests or is necessary to keep them from harm.
There were not as many activities or outings for people as they would like to see. This had been raised by people at residents’ and relatives meetings. They were confident that action would be taken by the manager who they said, “listens”. An activities assistant had been appointed who was scheduled to attend specialist activity training together with the manager and another member of the staff team to improve the quality of activities for people. Staff were responsive to call bells and peoples requests for support. People’s families told us that they were very happy with the care their relatives received and had noted marked improvements of ensuring they were fully informed since the manager came to the service.
People received good quality care. The provider had an effective system to regularly assess and monitor the quality of service that people received. There were various formal methods used for assessing and improving the quality of care.