Woodcroft

Updated 5 August 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place.

This inspection took place on 6 July 2022 and was unannounced.

Updated 5 August 2022

About the service

Woodcroft is a residential care home providing personal care and accommodation to six people with learning disabilities at the time of the inspection. Five of these people lived at Woodcroft and a sixth person who had regular short stays at the service. The service can support up to six people in one building.

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

People were not always safe at Woodcroft. Safeguarding concerns were not always shared with the local authority. We witnessed unsafe moving and handling taking place and risks to people were not always effectively managed. Some infection prevention and control guidance provided by Public Health England were not always followed.

Staff did not always receive the training they required to enable them to support people safely. There were people who were having their liberty restricted at Woodcroft who had not had the appropriate mental capacity assessments, best interest decisions or Deprivation of Liberty Safeguards (DoLS) applied for.

We saw some positive caring interactions between staff and people living at the service, however people were not always treated with respect or dignity. At times people were very limited in the choices they could make for themselves and access to activities for some people was limited.

People had individual communication plans in place and staff had a good understanding of how to communicate with them effectively. However, support plans were missing some important information. One person’s records showed that they had a diagnosis of dementia, however how this may alter their support needs was not mentioned in their care and support plans.

The provider’s quality monitoring processes were not effective at identifying and addressing shortfalls. Health and safety audits took place however there was not an effective system to ensure actions were completed as a result. Audits did not take place to ensure people were receiving their medicines safely. There had been one notifiable incident involving a serious injury to a service user which had not been reported to CQC when necessary.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people

Right support:

• People's support needs were not always correctly recorded to ensure they received the most appropriate care. This included information around risks to people and how to maintain their skin integrity.

Right care:

• Care practices did not always uphold or respect people's dignity. We saw examples of punitive responses recorded to address people and observed a lack of respect for people's home.

Right culture:

• The culture in the service was impacting negatively on people's experiences and care support. There was a lack of effective leadership and governance at the service. Systems in place were not being reviewed appropriately to promote positive changes for people.

The provider has acknowledged that improvements needed to be made to people’s care and have agreed to work in conjunction with the local authority and other professionals to improve people’s experience of living at the service.

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 this service was good (published on 9 November 2018).

Why we inspected

The inspection was prompted in part due to concerns received regarding infection control, safeguarding and staffing. A decision was made for us to inspect and examine those risks.

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.

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment, consent for support, good governance, and notification of incidents.

Please see the action we have told the provider to take at the end of this report.

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.