Woodlands View Care Home

Woodlands View Care Home is a residential care home providing personal and nursing care to 59 people in three bungalows at the time of the inspection. The home can support up to 120 people when all four bungalows are open.

People’s experience of using this service and what we found

People felt they were safe and well supported by the service. Individual risks were assessed, and staff were aware of these. Reviews of events and accidents were carried out and any actions needed were taken. Medicines were managed well, and staff knew how to report any concerns about a person’s safety or welfare. People told us staff were mostly available when they needed them. Infection prevention and control was managed safely.

Staff received the appropriate training for their role and people felt they had the right knowledge and skills. Staff felt supported by the management team. Some staff felt at times there needed to be more of them. The management team were actively recruiting, and agency staff were used when needed.

People and relatives told us care was delivered in a way they liked. Care plans included information needed to support people safely and in accordance with their wishes and preferences. These were reviewed regularly. There were activities and events available to help reduce social isolation and promote people’s well-being.

People, relatives and staff were asked for their views about the service and felt listened to. There were effective monitoring processes in place to help ensure a good standard of service. Quality assurance systems identified any areas that needed further development. There was refurbishment in progress which people and their relatives were happy about.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for the service was requires improvement,( published on 28 August 2021).

Why we inspected

We carried out an unannounced focused inspection of this service on 27 July 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when. This was to improve safe care and treatment.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, responsive and well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this 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 coronavirus and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Woodlands View Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Woodlands View Care Home is a care home providing accommodation for up to 120 people older people, some of whom are living with dementia. At the time of the inspection there were 52 people living at the home.

People’s experience of using this service and what we found

Infection control practice was not always robust. This was in relation to using the appropriate Personal Protective Equipment (PPE) if people were isolating and ensuring risk assessments were in place when needed. Training relating to infection control and COVID-19 had been delivered. Staff knew how to reduce the risk of transmission of COVID-19.

Governance systems were in place to monitor the service and identify concerns. These were used regularly. However, the issues relating to infection control practice had not been identified.

People felt safe and told us the staff were kind and friendly. Relatives felt the staff team were good and the management team ran the home appropriately. People’s safety and welfare was monitored. If an incident or concern arose, the management team identified and resolved it. Incident, events and unexplained injuries were recorded and investigated. Where needed, incidents were reported appropriately. Medicines were managed safely, and these were checked through an audit system.

Records were reviewed to help ensure people’s needs had been met. Staffing was monitored and call bells audited to ensure staffing numbers were effective. Some staff felt that staffing needed to be increased to enable them to spend more time with people, chatting and reassuring them. However, they said care needs were able to be met.

Staff felt they had received enough training and support to do their role and found the leadership of the management team to be effective. The recruitment process was robust, including all required checks to help ensure staff employed were fit to work in a care setting.

Rating at last inspection

The last rating for this service was Requires Improvement (published 14 January 2020).

Why we inspected

This was a planned inspection based on our ongoing monitoring of the service. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained the same. This is based on the findings at this 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 coronavirus and other infection outbreaks effectively.

Please see the safe section of this full report. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Woodlands View Care Home on our website at www.cqc.org.uk.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We found the following examples of good practice.

¿ People had care plans and risk assessments in place for COVID-19 so that staff could support them appropriately and safely.

¿ People were supported to keep in touch with friends and family virtually.

¿ The provider had developed policies, procedures and risks assessments for managing the service in relation to COVID-19.

¿ Staff who were in the higher risk groups had risk assessments completed.

¿ When people tested positive for COVID-19 they had to isolate in their rooms, for a set period of time. Staff were clear on what it meant to isolate and what symptoms of COVID-19 to look out for. A risk assessment was completed if a bedroom door needed to be left open.

¿ Staff had received training on donning and doffing personal protective equipment (PPE), infection control and COVID-19. They had their competency assessed. They told us they had enough information to do their jobs safely.

¿ All staff we spoke with were clear on what processes were in place and why they were needed. Staff were given bags to take their uniform home in so they could wash it safely and help prevent transmission.

¿ Staff told us that the registered manager had been very supportive and gave clear leadership during difficult times.

Further information is in the detailed findings below.

About the service

Woodlands View Care Home is a purpose-built residential care home providing personal care up to 120 people. At the time of the inspection there were 74 people being supported. The home has four separate units which can each house 30 people.

People’s experience of using this service and what we found

People were happy with the care and support they received. Staff were kind, friendly and attentive to people’s needs. People gave mixed views about if there were enough staff to meet their needs. Staff also felt more staff were needed to give people more attention. Staff were trained and felt supported.

People felt safe and staff were aware of how to promote people’s safety. Regular checks were in place to ensure staff worked in accordance with training and health and safety guidance adhered to.

There were governance systems in place and these were used effectively in most cases. However, we found concerns relating to staffing on one unit, call bell monitoring and the process in which the move of people between units was managed. These had not been identified through the quality systems. Following the inspection, the provider’s quality team reviewed this and shared their findings with us.

The environment was decorated festively for the season and people told us they liked it. There was plenty of communal space for people to enjoy. People who were participating enjoyed the activities that were provided, however people on one unit and those who were cared for in the rooms lacked stimulation and social interaction.

People were not always supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. This was because a recent move between units had occurred and a robust process was not followed. Staff knew people well and worked in a way that promoted people’s preferences and wishes.

People were involved in planning their care and they, along with their relatives. People had end of life care plans which were going to be further developed. Complaints were responded to appropriately. Feedback was sought through meetings and surveys.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The last rating for this service was Requires Improvement (published 27 August 2019) and there were multiple breaches of regulation. We imposed conditions on their registration to help drive improvement. 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 improvements had been made and the provider was no longer in breach of regulations. At this inspection, while there have been some improvements, the rating has remained the same.

You can read the report from our last inspection on our website at www.cqc.org.uk

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Woodlands View is a residential care home that was providing personal and nursing care to 106 people aged 65 and over at the time of the inspection.

People’s experience of using this service:

People and their relatives told us that permanent staff were good and they felt safe with them. People and their relatives told us that the use of agency staff was an issue. The home had a shortage of permanent staff and was very reliant on agency staff.

Permanent staff mostly knew people well and this included individual risks. Agency staff did not always have awareness of people’s individual risks and were not always supervised by permanent staff.

People did not always receive appropriate pressure care management and were not always supported safely when assisted to eat and drink. Safe moving and handling was observed in most cases however were observed two instances where staff were about to use unsafe practice and corrected themselves when acknowledged they were observed. Where there were unexplained bruises or skin tears, a proper recorded investigation had not taken place in all cases.

Bedrails were not always used with bumpers and individual risk assessments and care plans in relation to risks were not always clear. Risk information passed to the manager was not always collated effectively which meant that the manager and provider’s oversight of risk in the home was not always accurate. This had a potential to impact on staffing levels as the information shared with the department who planning staffing levels did not give an accurate level of dependency.

The manager and area director had been in post for a month prior to the inspection and were still developing and implementing plans to improve the running of the service.

Rating at last inspection: At the last inspection the service was rated as ‘Requires Improvement’.

Why we inspected: This inspection was brought forward due to information of risk and concern.

Enforcement: Action we told provider to take at the back of the report.

Follow up: We will continue to monitor the progress of the service and plan the next inspection. We can inspect sooner if we receive further concerns.

Woodlands View Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Woodlands View Care Home provides accommodation for up to 120 older people, this included people with nursing care needs and some people living with dementia. At the time of the inspection there were 102 people living there.

The service did not have a registered manager. An experienced manager had been managing the home for six months with the brief to improve and stabilise the service while the provider recruited a permanent manager. They did apply to register, however as a new permanent manager was employed they withdrew their application. The new manager explained that he was planning to apply to the Commission for registration. A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.

The provider’s quality assurance systems were not always used effectively and did not provide the management team with a complete overview of the quality and safety of the service. Systems had not identified shortfalls in relation to personalised care and ensuring people were treated with dignity and respect. People’s care was not always fully carried out and not all needs were responded to. Care provided was not always person centred and people’s care plans were not developed in a way that promoted this.

Staff supporting people knew how to recognise and report risk to people’s wellbeing. However, not all staff were able to tell us how they would report concerns outside of the organisation.

People and staff were positive about the recently appointed manager and how the service was currently managed. Staff had received training updates in relation to fire procedures and oxygen management. Further development was needed for some staff with regard to evacuation techniques. Management reviewed accidents and incidents to reduce any reoccurrence.

People were supported by staff who were recruited safely. Feedback about staffing was not always positive. Staff had received an induction, ongoing training and felt supported. Staff did not always work in accordance with their training and some updates were still needed.

Medicines were mainly managed safely and people received them promptly. However, there were some discrepancies that needed to be addressed. Infection control practice was adhered to by most staff but we did observe some not following their training in relation to this.

People enjoyed a variety of food which looked and tasted appetising but choices and preferences needed to be responded to by staff. There was appropriate access to health and social care professionals. Staff had an understanding of the Mental Capacity Act 2005 and adhered to its principles.

People told us that staff were kind and caring. However, communication, mainly on one unit, needed improvement. Privacy and dignity was not always promoted. Confidentially was promoted and visitors were made welcome.

The activities plan would benefit from further development in particular to prevent social isolation for people in their rooms but people who were able to participate in communal areas were happy with what was offered.

People were supported at the end of their life with compassion and care and complaints were responded to and people’s views were sought.

On 3 February 2018 there was a major incident at the home. An investigation into the incident remains on going and the Commission continues to work with other agencies in regards to this.

Woodlands View Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates up to 120 people in four adapted buildings. At the time of the inspection there were 87 people living there. One unit remained closed following an incident on 3 February 2018.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run. However, people and relatives we spoke with did not know the registered manager.

There were systems in place to monitor the quality of the home. However, they had not identified the areas of concern or those that required improvement that we found on inspection or fully addressed the shortfalls from the previous inspection.

Staff knowledge and procedures in relation to fire safety and oxygen management needed to be addressed. Medicines records were not always accurate and the process for reordering of stock was not robust. People had their risk assessed in most cases; however, staff did not always follow the assessments. Staff knew how to recognise and report any risks to people’s safety internally. However, staff were not always clear how to report to external agencies.

There were additional numbers of staff on duty and this would reduce when the fourth unit reopened. There was a recruitment process in place. However, they needed to ensure employment gaps were consistently explored and references were always verified. Staff were due updates to their training and had not received any updates since the incident in February. However, staff supervision had recently commenced.

Most people were supported in accordance with the principles of the Mental Capacity Act 2005; however, this was not consistent. Staff asked people for their consent before supporting them.

People told us that they enjoyed the food and their health needs were met.

People were addressed by staff with respect and kindness. However, people’s dignity was not always promoted. People needed to be consistently involved in the planning of their care and consideration was needed to support people with their relationships. Confidentiality, in regards to records, was not always promoted.

People received care which they told us met their needs but gave mixed views about the activities provided. Care plans were in the process of being changed to the provider’s new format and those changed included appropriate information to help staff meet people’s needs. There was a complaint’s process and we found that the response to complaints had been improved. Staff were more positive about the running of the home and the provider was providing regular support.

In response to our findings at this inspection we issued an urgent notice instructing the provider that they needed to take immediate action to address the concerns. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Woodlands View Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates up to 120 people in four adapted buildings. At the time of the inspection there were 112 people living there.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.

The provider changed in December 2017. HC One limited, purchased some Bupa Limited Homes including Woodlands View Care Home.

Medicines were not always managed safely. Some people received care in a person centred way but we observed some people who did not. People, and their relatives where appropriate, were not always involved in planning their care. People gave mixed views about the activities provided.

There was a complaint’s process which people and their relatives knew how to use. However, people were not confident that they would receive feedback from the registered manager.

There were not always sufficient staff available to meet people’s needs in a timely way. Most people were supported in a safe way, however, some assessments and processes did not always promote this.

Staff knew how to recognise and report any risks to people’s safety and staff were recruited safely. However, staff were overdue updates to their training.

Most people were supported in accordance with the principles of the Mental Capacity Act 2005, however, this was not consistent. People gave mixed views about the food and relatives raised concerns about staff response to changes in people’s health at times.

People were addressed by staff with respect and kindness. We found that confidentiality was promoted. Further development was needed to help ensure people’s dignity was always promoted.

There were systems in place to monitor the quality of the home. However, they had not identified the areas that required improvement that we found on inspection. People, relatives and staff were not all positive about the running of the home.

Following our inspection we were made aware of an incident on 03 February 2018 involving a fire on one of the units at the home. One person sadly died during this incident. We are working with other agencies looking into the circumstances surrounding this.

This inspection was carried out on 20 June 2017 and was unannounced. This was the first inspection under their new registration. Prior to registering with the CQC there were breaches of regulation. At this inspection we found that although they had made some improvements, they were not meeting all the standards.

Woodlands View Care Home provides accommodation for up to 120 older people, including people living with dementia. The home also provides nursing care. At the time of the inspection there were 116 people living there.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.

People’s individual risks were assessed, however, this was not consistent and some needs were not risk assessed. Staff knew how to recognise and respond to abuse, however, there were some issues observed and documented that had not been reported.

There were sufficient staff to meet people’s needs however during the evening needed to be reviewed and recruitment processes were robust. Staff had received training but some of this needed to be developed and updated. Staff felt supported but one to one supervisions were infrequent. People’s medicines were mainly managed safely but there were issues that needed to be addressed.

The service was made up of four units. We found that standards differed significantly across the units. For example, interaction between staff and people they supported was positive on some units, and not so positive on other units.

People did not always have their dignity and privacy promoted. We found that confidentiality was not always promoted.

People told us that staff were kind and we saw staff speak kindly with people. However, people and their relatives were not always involved in planning or reviewing their care.

The service did not always adhere to the principles of the Mental Capacity Act or conditions imposed by DoLS authorisations.

People who were at risk of not eating and drinking enough had their intake monitored, however we found that this may not be identified as a need by staff on one unit. People had access to health and social care professionals as needed.

People’s personal care needs were met but there was a lack of person centred care in some instances. People’s care plans were in place but some areas of needs did not have a plan and people’s views on activities were mixed.

There were quality assurance systems in place and we found that in some areas these had been effective. However, we noted that many issues identified by audits or regional manager visits remained an issue so the process had not been effective. Formal complaints were responded to. There were systems in place that had identified some issues within the home. However, these were not yet resolved.

People, relatives and staff were positive about the management team. Staff felt the home had improved since the last inspection.