Woodlands Home for Older People improved its overall rating from Requires Improvement to Good, though Safe remained Requires Improvement due to PPE non-compliance, an unupdated falls risk assessment, incomplete staff recruitment records, and absence of accident/incident trend analysis. Effective and Well-led were both rated Good, with strong leadership, person-centred care, medicines management, and multi-agency working noted as key strengths.
Concerns (5)
moderateInfection control: “not all staff were wearing face masks appropriately and robust arrangements had not been made to separate people from a person who was self-isolating following a positive test for coronavirus”
moderateRecord keeping: “one person had experienced a fall, but their risk assessment indicated no falls”
moderateIncident learning: “Accidents and incidents had been recorded and entered onto electronic databases; however, an analysis had not been undertaken to identify any patterns or trends.”
minorRecord keeping: “there was a gap in one staff member's employment and the other staff's full employment history was not available”
minorConsent / capacity: “there was limited information in people's care files about why the DoLS application had been made and how people should be supported in the least restrictive way”
Strengths
· People felt safe and were happy with the care received; sufficient staffing levels were maintained and increased since last inspection.
· Medicines were stored, managed and recorded safely with appropriate protocols for as-needed medicines.
· Staff received induction, mandatory training, supervision and annual appraisals supporting competency.
· Registered manager was visible, approachable and responded immediately to inspection findings.
· Provider had robust quality monitoring systems including audits, action plans and senior operations manager oversight.
Quality-Statement breakdown (16)
safe: Preventing and controlling infectionRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Learning lessons when things go wrongRequires improvement
safe: Using medicines safelyGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Staff support: induction, training, skills and experienceGood
effective: Adapting service, design, decoration to meet people's needsGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirementsGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service; promoting a positive, person-centred cultureGood
well-led: Continuous learning and improving care; working in partnership with othersGood
Woodlands Home for Older People declined from Good to Requires Improvement overall, with shortfalls in staffing levels at night, medicines management, consent/MCA compliance, infection control, and governance systems. Caring and Responsive domains remained Good, with staff demonstrating warmth and person-centred approaches, and the registered manager taking prompt remedial action during and after the inspection.
Concerns (8)
criticalConsent / capacity: “Staff had completed and signed best interest decision making forms for people to live in the home irrespective of their ability to consent to their care.”
moderateStaffing levels: “At night, there are not enough staff. A long wait is usual. I've also had to wait in the day when the staff have been dealing with everyone else.”
moderateMedication management: “Staff had not always applied prescribed creams in line with the prescriber's instructions. We also saw there were two crushed tablets on one person's bedroom floor.”
moderateInfection control: “One person and two members of staff told us slings used with the hoists were shared. This meant people were at increased risk of cross infection.”
moderateGovernance: “The quality assurance systems were not always effective in identifying shortfalls.”
minorRecord keeping: “Care staff did not always adhere to one person's specialist diet and did not always calculate the total amount of fluids people had drunk during the day.”
minorPerson-centred care: “On Cedar Grove both the television and music on at the same time. This made the atmosphere confusing and oppressive. We also noted staff had little communication with people and were task focussed.”
minorCommunication with families: “People spoken with felt they were not fully informed about any actions from the meetings.”
Strengths
· Staff treated people with kindness, dignity and respect; multiple people and relatives gave positive feedback about caring approach.
· Appropriate recruitment procedures ensured prospective staff were suitable to work in the home.
· Staff understood safeguarding responsibilities and people felt safe.
· Effective complaints procedure in place; all nine complaints over the last 12 months were investigated and resolved.
· End of life care was well managed, with advanced care planning and relevant training completed by all management team.
Quality-Statement breakdown (21)
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safelyRequires improvement
safe: Preventing and controlling infectionRequires improvement
safe: Assessing risk, safety monitoring and managementGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Learning lessons when things go wrongGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietRequires improvement
This was a targeted IPC inspection of Woodlands Home for Older People (50-bed residential care home) conducted on 8 December 2020 in response to the COVID-19 pandemic. The CQC was assured across all eight IPC domains assessed; no rating was applied as this was a focused compliance check rather than a full inspection.
Strengths
· Robust IPC procedures implemented and understood by all staff, with plentiful PPE supplies carefully monitored
· All staff completed PPE training and participated in weekly COVID-19 testing programme
· Temperature checks and health screening for all entering the home
· Essential visits conducted safely based on individual risk assessments
· Creative approaches to maintaining family contact including video calls, telephone and window visits
Quality-Statement breakdown (1)
safe: S5 How well are people protected by the prevention and control of infection?Not rated
Woodlands Home for Older People received a Good rating across all five key questions at its inspection on 26–27 September 2016, demonstrating safe, well-managed care with strong staff training, person-centred support planning and effective governance systems. No regulatory breaches were identified and people, relatives and healthcare professionals consistently reported positive experiences of the service.
Strengths
· People felt safe and staff understood safeguarding responsibilities; risks were assessed, recorded and reviewed monthly
· Medicines were managed, stored, administered and disposed of safely by trained and competency-tested staff
· Sufficient staffing levels maintained with dependency-based assessment tool; plans in place to increase night-waking staff
· Safe recruitment practices including enhanced DBS checks and two written references for all new staff
· Staff completed induction, Care Certificate, mandatory and specialist training including accredited dementia training
effective: Supporting people to live healthier lives and access healthcare servicesGood
effective: Assessing people's needs and choices; delivering care in line with standardsGood
effective: Adapting service, design, decoration to meet people's needsGood
effective: Staff support: induction, training, skills and experienceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and controlGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, quality performance, risks and regulatory requirements; continuous learningRequires improvement
well-led: Planning and promoting person-centred, high-quality care; duty of candourGood
well-led: Engaging and involving people, the public and staff; working in partnership with othersRequires improvement