Archived: Woodlands Care Home

Updated 28 January 2017

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 5 and 7 December 2016 and was unannounced. The first day of the inspection was carried out by four adult social care inspectors, an inspection manager 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. The second day of the inspection was conducted by two adult social care inspectors.

Before the inspection we reviewed the information we held about the home, including reviewing statutory notifications and information received from the local authority and clinical commissioning group.

The registered provider had been asked to complete a Provider Information Return (PIR). This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help plan and inform our inspection.

We used a number of different methods to help us understand the experiences of people who lived in the home, including observations and speaking with people. We spoke with eight people who lived at the home, four relatives of people who lived at the home, a visiting professional, a regional manager, the registered manager, a unit manager, a one to one member of staff, four nurses, eight care staff, an activities coordinator and a chef.

We looked at 14 people’s care records, five staff files and training data, as well as records relating to the management of the service, such as maintenance and audit records. We looked around the building and saw people’s bedrooms, bathrooms and other communal areas.

Updated 28 January 2017

The inspection of Woodlands Care Home took place on 5 and 7 December 2016 and was unannounced on both days. The previous inspection, which had taken place during September 2015 had found the home required improvements and there was a breach of regulation in relation to providing safe care and treatment.

This inspection found a continued breach of Regulation 12 Safe care and treatment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and additional breaches, including Regulations 18 Staffing, 10 Dignity and respect and 17 Good governance were found.

There were 55 people living at Woodlands across four units during our inspection; 13 on Thornhill, 11 on Mirfield, 8 on Hopton and 23 on Calder. Each unit was self-contained with a communal lounge, dining area, bathroom and toilet facilities. Bedrooms were single rooms with en suite facilities. There was a central kitchen and laundry located on the ground floor and a hairdressing salon.

Admissions to Thornhill had been suspended by the local authority due to safeguarding concerns on this unit in relation to staffing, the role of one to one staff and the management of medicines. The registered manager was working with the local authority and clinical commissioning group to address these concerns.

The home had a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission 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 2008 and associated Regulations about how the service is run.

There was a safeguarding and whistleblowing policy in place and the registered manager and staff were able to outline the actions they would take if they had any concerns anyone was at risk of abuse or harm.

Risks to people were assessed. However, these sometimes lacked personal information and were not always up to date and therefore did not always reflect current risks.

People were not always provided with safe care and treatment. Some people were not assisted to move regularly and some people did not receive adequate assistance to meet their continence needs.

Regular checks were made to ensure the safety of the building and equipment.

Despite a dependency tool being used to help determine staff numbers, there were not always sufficient numbers of staff to meet people’s needs. Safe recruitment of staff was evident.

Medicines were stored safely but were not always administered in a safe way. This included covert medicines being crushed without advice being sought regarding the safety of this and sufficient quantities of prescribed medicines not being available.

Staff received induction and regular training. However, some staff had not received regular one to one supervision.

People were not always supported to have maximum choice and control of their lives and staff did not always support people in the least restrictive way possible. Some nursing and care staff were unaware of which people could legally be deprived of their liberty to receive care and treatment.

People’s hydration needs were met and drinks were offered throughout the inspection. However, mealtimes on Calder were not well organised and we observed a person sat for a long period of time, awaiting their meal. Some people did not receive appropriate support to have their nutritional needs met.

People received additional support from health care professionals, in order to have their care and treatment needs met where this was appropriate.

Although some staff treated people with kindness and compassion, showing respect for their privacy and dignity, other staff did not. Some staff used derogatory terms and spoke over people to each other. Some staff failed to recognise when people’s dignity was being compromised.

Care plans were updated regularly but people or their relatives were not always involved in this.

Activities took place and attempts had been made to make these person centred.

We saw people were offered choices throughout the day. However, during our inspection, everyone living in the home was served Halal meat and the registered manager confirmed people were not consulted or given a choice regarding this.

Some care records were inaccurate and incomplete and, in some cases, records were falsified. Audits were not robust and did not identify some areas for improvement. Regular staff meetings took place and staff felt informed. Staff felt the registered manager was effective.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

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.

This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

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 any concerns found during inspections is added to reports after any representations and appeals have been concluded.