Wood Hill Lodge

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

At the last inspection, the provider had failed to ensure there were effective governance and quality assurance measures in place. At this inspection we found whilst improvements had been made, systems were not always effective in identifying concerns. The provider and registered manager had made lots of improvements since our last inspection, however we identified ongoing concerns in relation to medicines management and IPC practices. A service improvement plan was in place and the registered manager was dedicated to continuing to make and sustain improvements in the service.

This service scored 54 (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 clear visions and values, and the registered manager was passionate about ensuring the staff team implemented these. Visions and values were covered through initial staff inductions and discussed in staff meetings. Staff received supervisions, which covered a range of subjects, such as medicines best practice. A supervision and appraisal matrix was in place to monitor and ensure staff received these. We received mixed feedback from staff regarding how staff were deployed across the units. Some staff told us they weren’t consistently working within the same unit, meaning they couldn’t get to know people well. We received mixed feedback from people regarding consistent staffing, some people told us there was lots of different staff. However, the service did not use agency staff, which had improved the continuity of care people received.

Systems in place for gaining people's feedback on their care required improvements. Feedback surveys were used for people and relatives. However, a small number of people had been involved in providing feedback and where people had shared their views, it wasn't always evidenced what action had been taken to improve people's experience of their care and support.

We received mixed feedback from people and relatives regarding management involvement in their care. Some people told us they knew the manager and that they were responsive, whilst others told us they did not know who the manager was. However, most people and relatives told us the service was well led, organised and had recently improved. A relative said, “It is a lot better now, more organized, more staff are on and everything is working like clockwork.” People also told us they could speak to the staff if they had any concerns. Staff told us the service had greatly improved under the new management structure. A staff said, “I am much more happy now, and so are the people who live here.” Another staff said, “One of the new managers has the experience and is brilliant, they have brought a fresh and positive perspective.”

The provider had implemented a new management structure, which had focused on driving improvements since our last inspection. This included a quality team, senior management team and a clinical lead. Weekly meetings were in place and included input from the heads of each department, such as maintenance, kitchen and nursing staff. Whilst these assisted the manager to identify and action any current concerns, such as gaps in records and activities on offer, more robust systems were needed to ensure concerns we identified during our inspection were identified and actioned. The manager was keen to drive improvements in the quality and safety of the service and in their own professional development. The manager was undertaking further training and development, to strengthen their leadership skills.

We received mixed feedback from staff regarding finding the managers approachable. Some staff told us they didn't always feel listened to. For example, one staff said, “Depends on their mood” and, “We can make suggestions, but they aren’t listened to”. Whilst other staff said, “The managers are approachable and listen to staff.” And, “The managers listen to us and take action.” Staff meetings were in place and records evidenced staff had the opportunity to raise concerns or suggestions.

Systems were in place to provide staff with the opportunity to whistleblow on poor practice. However , these were not always effective as staff did not always feel able to approach the management team. Staff had access to policies and procedures via online systems and understood their roles and responsibilities to raise concerns.

Most staff told us they treated fairly and had not been subject to any workplace discrimination.

Equality and diversity policies and procedures were in place to ensure equality and inclusion across the workforce. Systems were in place to support all staff with their professional development.

The provider had introduced various governance systems and audits since our last inspection, this included regular input and audits from senior management and quality teams. Monthly governance meetings were in place which covered oversight of accidents and incidents, safeguarding and risks posed to people, such as falls, pressure care, nutrition and weights. Whilst action was taken to address concerns, such as referrals to external professionals and lessons learned, further improvements were required to ensure the service could evidence what action had been taken in a timely manner. Daily flash meetings were in place and had improved the overall day to day communication in the service, evidence was required to ensure the service had taken action when concerns regarding food and fluid intake had been identified. Staff and the management team had worked hard to make changes at the service, these required strengthening and embedding to ensure people received high quality and safe care.

Daily records were regularly reviewed by the management team and any gaps identified were acknowledged, actioned, and discussed at governance meetings. However, audit systems relating to care plans required improvements to ensure discrepancies we found were identified. IPC audits and daily monitoring of IPC were ineffective at identifying the continued IPC concerns we found on the day of inspection. Medicines audits did not identify concerns found during the inspection. 'Resident of the day' systems had been implemented which provided a more organised structure to ensuring people's care was reviewed. These included a maintenance check of people's rooms, review of dietary needs, meal preferences, care records reviews and relatives update's.

Relatives told us they were more involved in their loved ones care. A relative said, “The team at Wood Hill Lodge have worked around [relative], they have been professional, and I can pick up the phone and talk to them at any time. They found a way of working with [relative] that involved us as a family.” Systems had been implemented to improve on community links, such as attending church, dementia clubs and arranging a summer party.

The staff team had worked closely with the local authority and commissioners to improve the service. The registered manager was part of registered manager forums, which shared ideas and best practice.

Whilst partners had told us mostly positive feedback about how the service was improving, a visiting professional told us the staff team did not always respond to their requests for information in a timely manner.

Records evidenced the service worked closely with external healthcare professionals, such as GP's, falls teams and diabetic clinics.

The manager told us they were dedicated to sustaining the improvements made and continuing to develop the quality and safety of the service. This required embedding into practice.

Since our last inspection the provider had taken some action to improve the service and address the concerns found. An ongoing service improvement plan was in place, this would require adding more robust systems, to action the ongoing concerns found during this inspection. The service has undergone various refurbishments, this could be further improved in bedroom areas and so the building feels more homely and less clinical. Complaints and concerns were effectively managed, and compliments were recorded and shared to celebrate positive feedback. Improvements were required to evidence action was taken in response to people’s suggestions.