Woburn Care received an overall 'Requires Improvement' rating following a focused inspection of safe, caring and well-led domains, driven primarily by a governance breach (Regulation 17) after the registered manager's departure in December 2022 left quality monitoring, staff training and supervision in significant arrears. The caring domain remained Good, with people and relatives consistently praising the kindness and compassion of care workers.
Concerns (7)
criticalGovernance: “Systems were not used or were ineffective for assessing and monitoring the quality of care, safety and personal needs of people using the service. Breach of regulation 17(1).”
moderate
Supervision / appraisal
: “We found shortfalls in the staff training provision and staff supervision. This meant the provider could not be assured care workers had the necessary skills.”
moderateStaff training: “Care workers advised they did not receive effective or regular training. One said, 'The only training we ever got was online training which wasn't suitable as it was talking about care homes.'”
moderateMissed or late visits: “People, their relatives and care workers told us of staff shortages that had resulted in some people not receiving their scheduled care visits.”
moderateIncident learning: “The provider did not have a system in place to identify lessons learned and cascade the learning through the staff team to help improve practice and safety.”
moderateLeadership: “The registered manager left the service in December 2022. Since the registered manager had left some care workers had found the lack of leadership was unsettling.”
minorConsent / capacity: “No training had been provided for care workers to give them an understanding of how to support people when their mental capacity declined.”
Strengths
· People and relatives praised the kind and caring nature of care workers, with consistent positive feedback about compassion and dignity.
· Medicines were managed safely with appropriate training and competency assessments for staff.
· Risks to people's health and safety were assessed and regularly reviewed, with measures to mitigate identified risks.
· Care workers had been safely recruited with robust systems introduced by the new manager for monitoring staff files.
· Care plans were detailed and person-centred, supporting personalised care delivery.