Background to this inspection
Updated
13 July 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
This inspection was carried out by an inspector, a pharmacist inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Woodland Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.
Notice of inspection
The first day of the inspection was unannounced, however we informed the staff team we would be returning to the service to complete the remainder of the inspection.
We visited the service on 29 April and 3 May 2022. Further inspection activity was completed via telephone and by email, including speaking with people who used the service, relatives and reviewing additional evidence and information sent to us by the provider.
What we did before the inspection
We reviewed information we had received about the service since the last inspection and sought feedback from professionals who worked with the service, including Oldham local authority. The provider was asked to complete a provider information return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke to five people who used the service, four relatives and five members of staff to obtain their feedback about the service.
We reviewed a range of records. This included five people’s care records, a selection of medicine administration records and three staff’s recruitment files. A variety of other records relating to the management of the service were also considered as part of the inspection.
After the inspection
We continued to seek clarification from the provider to validate evidence found following our site visits.
Updated
13 July 2022
About the service
Woodland Care Home is a residential care home which provides personal care and accommodation for older people and is located in Oldham, Greater Manchester. The home is registered to care for up to 18 people. At the time of this inspection, there were 16 people living at the home.
People’s experience of using this service and what we found
Medicines were not managed safely and we identified similar concerns to those found at our last inspection of the service in 2021. Staff displayed a good understanding of safeguarding and whistleblowing, although some said they didn’t always feel comfortable reporting concerns due to a fear of repercussion. We also received feedback about a poor culture amongst the staff team.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests. The policies and systems in the service did not always support practice. We saw people’s movements around the service were restricted at times.
Record keeping needed to be improved, particularly regarding oral hygiene and some care plans were not always updated when people’s needs changed.
The service has a poor regulatory history with the Care Quality Commission (CQC) and has been in breach of regulations at the previous four inspections with the overall ratings being inadequate and requires improvement on three occasions. Warning notices were served at our last inspection in April 2021, although due to the concerns we identified regarding medication, these had not been met.
Staff wore personal protective equipment (PPE) throughout the inspection and lateral flow testing was carried out. There were enough staff to care for people safely and correct recruitment procedures were followed. Regular checks of the building and equipment were carried out to ensure they were safe to use.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 8 June 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found not enough improvement had been made and the provider remained in breach of certain regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
During this inspection we carried out a separate thematic probe, which asked questions of the provider, people and their relatives, about the quality of oral health care support and access to dentists, for people living in the care home. This was to follow up on the findings and recommendations from our national report on oral healthcare in care homes that was published in 2019 called ‘Smiling Matters’. We will publish a follow up report to the 2019 'Smiling Matters' report, with up to date findings and recommendations about oral health, in due course.
Enforcement and Recommendations
We have identified breaches in relation to people's safety, consent and leadership of the service.
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
The overall rating for the service is requires improvement. This is based on the findings from this inspection.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
Follow up
We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.