10 and 11 March 2015
During a routine inspection
The inspection took place on 10 and 11 March 2015, the first day was unannounced and we arrived at 7.00am. On the second day our arrival was expected. This inspection was carried out in response to concerning information received; a fire had occurred in a bedroom within the home and a person who used the service had died. The circumstances surrounding the fire were still under investigation at the time of writing this report so we have not been able to include information about this incident. The service was due to close on 30 March 2015 for reasons unrelated to the fire.
Wood House is a care home for older people, many of whom live with dementia or mental ill-health. If nursing support is required for an individual this is supplied by local NHS community nurses. The home is registered to provide care for up to 34 people, but it was scheduled to close at the end of March 2015 so there were only 16 people resident there on the first day of our inspection. Of these, nine were long stay residents for whom new homes were being sought (one was in hospital and two moved into new homes whilst we were there), four were in the home for a short period of respite care and three were using the home as a stepping stone prior to returning to their own homes after a hospital stay – this is known as the ‘step down’ service.
The home is located on the ground and first floor of a larger building. Situated on the ground floor are the office, kitchen and laundry, as well as a large lounge, small outdoor smoking area and a bathroom which are used by people who used the service. All the bedrooms are on the first floor which is divided into four units. Each bedroom has its own en-suite toilet and hand basin. The units are not completely self-contained, people can move freely between them. Each unit has its own small lounge, kitchenette, communal bathroom and shower room.
A registered manager was in place. 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.
We found that staff were kind and caring, the food was good and plentiful, cleaning was thorough and people’s medicines were administered correctly, but the standard of care was undermined by the poor systems in place within the home.
In particular we were concerned that staff were not taking full account of people’s individual care plans and associated risks when providing them with care and support. Managers had not picked up on this because some of their monitoring systems did not identify problems. There were breaches of regulations relating to safeguarding, care and welfare and assessing and monitoring the quality of service provision. You can see what action we told the provider to take at the back of the full version of the report.
We also made some recommendations which the provider needs to consider if the home stays open. These related to reviewing the admissions criteria to ensure they match the skill mix of staff and enhancing social and emotional care.