Woodlands Farmhouse

Updated 8 March 2023

Inspection team

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Woodlands Farmhouse is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.

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

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection, this included notifications made by the service with the Care Quality Commission. We sought feedback from the local authority who work with 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 annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

Inspection activity started on 19 January 2023 and ended on 16 February 2023. We visited the service location on 24 January and 7 February 2023.

We spoke with 5 people who used the service about their experience of the care provided. We spoke with 6 members of staff including the registered manager, the home manager, the deputy manager and care staff.

We reviewed a range of records. This included 3 people's care plans and care records. We looked at MCA assessments, best interests decisions and Deprivation of Liberty Safeguards applications. We looked at a variety of records relating to the management of the service.

After the inspection visit

We continued to seek clarification from the manager and provider to validate evidence found. We also reviewed updated care plans, records related to staff training, infection control and quality monitoring.

Updated 8 March 2023

About the service

Woodlands Farmhouse is a residential care home providing personal care to up to 13 people. The service provides support to older people. At the time of our inspection there were 9 people using the service.

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

Various changes in the management of the home over the last 14 months had caused disruption to the service people received. The checks designed to ensure a high quality service had not been used or used consistently to ensure the quality of the service continued during periods of change.

Record keeping had become poor, with some records either not found or possibly not kept. Some other management systems had also been changed but not followed through or completed by managers who had then left.

People, and the service overall, would benefit from a period of management stability and a reintroduction of effective systems and structures to ensure people received high quality care and that any issues or improvements needed were identified and acted upon.

People said they liked the meals but had no real choice. Mealtime experience and menus were therefore going to be reviewed by the provider.

People said they made choices about their day to day lives. There was mixed understanding and application of the MCA by staff so people’s legal rights were not always upheld.

People were cared for by staff who required refresher training in some areas. Staff supervision also needed to be improved and sustained.

Medicine management had been improved; people’s medicines were managed safely. Regular auditing of medicines was now in place.

People needed to be better protected from the risk of infection. General cleaning of the home needed to be improved and new carpets were needed and were on order. The infection control policy needed to be reviewed to reflect current staff practice.

Staff were recruited safely. There were enough staff to keep people safe but staffing levels and times, particularly in respect of the night shift needed review to ensure people had the care they needed and had genuine choice in their care.

People said they felt safe and would talk with staff if they had any concerns. Staff knew how to report concerns and were confident people were protected from abuse or mistreatment.

Accident and incidents were recorded and reviewed. People’s care plans and risk assessments were being updated and reviewed on the on line care planning system.

People said they were happy at the home and knew they could speak to staff about any issues they had. There was a stable, caring staff team. People told us they were happy with their own rooms and the environment had been improved for them over time.

People were supported with their health care and staff said they had a good relationship with health care professionals. The service worked in partnership with other agencies to ensure they provided good care and followed good practice.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was good (published 23 February 2018).

Why we inspected

The inspection was prompted in part due to concerns received about medicine administration, care planning and risk assessing, record keeping and management systems and structures. A decision was made for us to inspect and examine those risks.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed to requires improvement following 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 COVID-19 and other infection outbreaks effectively.

Enforcement and recommendations

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.

We have found 1 breach in relation to governance at this inspection. Please see the action we have told the provider to take at the end of the full version of this report. We have also made 3 recommendations relating to staffing, people’s mealtime experience and application of the MCA.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.