Background to this inspection
Updated
3 December 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: The inspection team consisted of two inspectors 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 service.
Service and service type: The service is a ‘care home’. People in care homes receive accommodation and nursing or personal care. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
The service did not have a manager registered with the CQC. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection: This inspection was unannounced.
What we did: Prior to the inspection, we checked all the information we had received about the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
We contacted the local authority commissioning and safeguarding teams and the local Healthwatch. Healthwatch are a consumer champion in health and care. They ensure the voice of the consumer is heard by those who commission, deliver and regulate health and care services.
Throughout the inspection we spent time in the communal areas of the home observing how staff interacted with people and supported them.
During the inspection we spoke with six people who used the service. We spoke with 10 members of staff including the manager and regional manager.
We reviewed the care records for 11 people. We looked at four staff personnel files, in addition to a range of records in relation to the safety and management of the service. After the inspection we reviewed further information which we had requested from the management team.
Updated
3 December 2019
About the service: Woodlands Care Home provides residential care for up to 42 older people. At the time of the inspection there were 20 people living at the service, some of whom were living with a dementia.
People's experience of using this service: The location has a history of none compliance with regulations and has been inspected six times since July 2015. At no inspection during this period has the provider achieved an overall rating of good.
At the last inspection we found three breaches of regulations. There was a failure to provide safe care and treatment, a failure to ensure staff had the required training and a failure to assess, monitor improve and mitigate the quality and safety of the services provided.
The service was not well led. The provider failed to have sufficient oversight of the home and ongoing breaches of regulations were identified. In total, nine breaches of regulations were identified during the inspection.
The action plan devised by the provider in response to the findings at our last inspection had not driven improvement.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Consent to care and treatment was not always sought in line with the principles of The Mental Capacity Act 2005 (MCA).
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice.
Appropriate action was not always taken to safeguard people from abuse. Incidents of a safeguarding nature were not always reported to CQC.
Training the provider deemed mandatory had not been delivered to staff.
Timely action had not been taken to address concerns regarding the environment. This placed people at risk of avoidable harm.
Support was not personalised and specific to the individuals needs and people were not always treated with dignity. Staff had not completed training in dignity and respect and had not recognised situations which were undignified for people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected: The inspection was brought forward as we received information of risk and concern.
Rating at the last inspection: The service was rated as requires improvement (the report was published in August 2018).
Enforcement: Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have concluded.
Follow up: Following the inspection we referred our concerns to the local authority responsible for safeguarding. In addition, we requested an action plan from the provider, and evidence of improvements made in the service. This was requested to help us decide what regulatory action we should take to ensure the safety of the service improves.
The overall rating for this registered provider is 'Inadequate' and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If not, enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.
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.