Archived: Woodland View

Woodland View is a six bedroomed purpose-built bungalow providing personal care for adults with learning disabilities. The home does not provide nursing care. At the time of our inspection six people were using the service.

The home did not have a registered manager. A new manager had been appointed to manage the service. They were in the process of registering with the Care Quality Commission to become the registered manager. 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.

Family members were happy with their relative’s care. One family member said, “I think [my relative] is very well cared for.” They went on to say, “I am very pleased with where he is. I always say I have been very lucky.” They told us their relative was treated with respect by kind and caring staff who knew their needs well. One family member said, “They know [my relative] very well.”

Staff we spoke with demonstrated a good understanding of safeguarding and whistle blowing, including how to report concerns. One staff member said, “If I had any concerns I wouldn’t hesitate [to raise them].”

We found a small number of gaps in signatures on medicines administration records. Although these had been identified during the regular medicines audit there was no record of the action taken in response to the gaps. Trained and competent staff administered people’s medicines and medicines were stored safely and securely. Staff had detailed guidance to help them administer ‘when required’ medicines safely.

The registered provider ensured there were enough appropriately recruited and skilled staff on duty to meet people’s needs. One staff member said, “Safe numbers [of staff] are five, we try to have six on shift. There is enough and enough experienced staff.”

Plans were in place to make sure people continued to receive care in an emergency situation. Each person had personal emergency evacuation plan (PEEP). Regular health and safety checks were carried out to keep the building safe for people to live in. For example, checks of fire safety, fire-fighting equipment, electrical safety, gas safety, water systems and specialist equipment. The current servicing certificates for specialist beds were not available to view.

The service was very clean and well decorated. People’s rooms had been decorated and furnished to their individual taste, including personal belongings such as pictures and photos. The building was purpose-built for people using wheelchairs to move around safely and adapted for the use of specialist moving and assisting equipment. Staff supported people to transfer safely from their wheelchair into a comfortable chair.

Staff confirmed they were well supported. One staff member commented, “Great, [manager] has been good. It is nice to come to work and feel at ease. I am extremely well supported."

The registered provider followed the requirements of the Mental Capacity Act 2005 (MCA), including the Deprivation of Liberty Safeguards (DoLS). DoLS authorisations were in place for all six people using the service because they needed 24 hour supervision and support . We saw examples of MCA assessments and best interest decisions in people’s care records. Staff supported people with their communication needs to help them make as many of their own decisions as possible.

Staff knew how to support people sensitively with behaviours that challenged. Strategies staff used included keeping calm, talking calmly, modelling relaxed body language, having quiet time and a cup of tea.

People were supported to meet their nutritional needs. Some people had specialist input from health professionals to ensure their nutritional needs were met safely. We observed over the lunch time that staff followed people’s care plans exactly. People received the support they needed to eat their meal in a calm and relaxed atmosphere. One staff member said, “We have no concerns [about nutrition], we have plans in place.”

People had access to the health care they needed, including regular input from a range of health professionals, such as GPs, community nursing and physiotherapists. Each person had a hospital passport to help share important information about them should they be admitted to hospital. Care plans and risk assessment were in place to guide staff about how to support people’s specific health conditions.

Staff had access to detailed information about the people they cared for. This included the person’s life history, their medical diagnosis, their interests, preferences and their hopes and dreams for the future.

People’s needs had been assessed and personalised care plans had been developed. These contained details about people’s care preferences, such as their favourite toiletries and meals. Care plans included specific prompts for staff to follow to promote people’s choice and step by step written and pictorial guidance to promote safe and consistent care. Care plans were reviewed regularly.

People, along with family members, were involved in regular reviews of their care. These considered the person’s health over the preceding three months, family contact and a review of activities the person had taken part in. The review also included a discussion about people’s goals, hopes and ambitions for the future.

People had the opportunity to be involved in a range of activities, such as swimming, football, discos, holidays, theatre and shopping. One staff member said, “It is a vibrant service.” Another staff member said, “We always try to do something with them.”

We received positive feedback about the manager. One staff member said, “The staff feel comfortable approaching [manager]. She is a really nice lady.” The home had a good atmosphere. One staff member described the atmosphere as “good, calm at times.”

Family members were consulted about the quality of their relative’s care. All three family members providing feedback during the most recent consultation gave the service an ‘excellent’ rating.

The registered provider had a quality assurance programme in place. This included monthly monitoring checks by the manager and service coordinator, as well as other audits. Action plans had been developed where there were areas for improvement. The most recent action plan was to complete all staff appraisals and medicines competencies by the end of April.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with the relatives of people at the service, staff supporting them, and from looking at records.

Is the service caring?

A relative told us, 'They treat my (relative) really well. I come at different times and everything is always the same.' Another relative told us 'The girls here are really good, they have a gentle manner.'

Staff were provided with the training and support they needed to ensure people received caring and consistent support. Healthcare professionals who were familiar with the service were confident the service was caring for people well. One professional told us, 'The staff are very skilled; they're a good staff team.'

Care was individualised and centred around each person's needs. People's care and support was provided by staff who knew and understood their needs and preferences. Staff responded promptly and consistently to these. Staff communicated effectively with people using the service, no matter how complex their needs.

Is the service responsive?

We found that people were treated with dignity and respect. We observed that staff provided personalised care and they respected people's choices and wishes.

People had complex needs, but staff clearly understood their individual communication styles and provided consistent care. People and their families were encouraged to be involved in decisions about their care and treatment. A relative we spoke with told us, 'My relative is really happy at the home' Relatives participated in regular reviews of their relative's care and felt that the service responded to any concerns or issues. One relative commented, 'They keep us informed. If we have had concerns, I would talk to the manager.'

Is the service safe?

Relatives told us they were confident their relatives were safe. One said, 'My relative is probably as safe as you could get.'

We saw that risks to people's safety had been identified and assessed to ensure that appropriate care and support was provided to keep people safe. A relative told us, 'It's like home from home, she is part of the family.'

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Relevant staff had been trained to understand when an application should be made and how to submit one. We found that DoLS applications had been submitted and approved by the local authority for each person using the service, however no statutory notifications had been submitted by the service to the CQC to tell us about this.

The evidence we found showed people who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People were cared for in consistent, appropriate ways, which helped ensure they were safe.

Is the service effective?

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. We found that people who used the service were receiving the care and support they needed. The staff we spoke with could describe how they met the assessed needs of the people they were providing with care. Relatives and health and social care professionals told us people received good and appropriate care.

Relatives acting on behalf of people using the service were given appropriate information and support regarding their relative's care and treatment and understood the care and treatment choices available to them. The provider carried out checks to ensure people were treated well, such as relatives being asked for their feedback about the services provided.

Support for staff was provided through effective training, supervision and appraisal. Staff told us they were able to provide the personalised support people needed, because they had been trained to develop the specialist skills required. A member of staff told us, 'The training is very worthwhile'. 'It's done regularly and repeated which keeps it fresh in your mind.' The provider had implemented thorough audit processes to ensure the service was safe and to identify ways to improve.

Is the service well led?

The registered manager had been in post since October 2011 and staff were confident that if they were to raise any concerns, these would be taken seriously.

Quality assurance systems were effective and included working with staff and other stakeholders. Family members said they were happy with the care and they did not raise any concerns with us. They commented: 'I have no concerns'; and, 'Staff are very caring'.

The manager held regular team meetings with staff. People and their relatives were asked for their opinions on how the service was run. Regular checks of the premises took place to ensure it was safe and suitable for the people who lived there.

We were able to observe the experiences of people who used the service. For instance, we spent time with people as they had their breakfasts and lunches and observed how staff supported and encouraged them. We saw staff encouraged people to make their own choices and decisions. We saw staff were fully aware of each person's requirements, for example, some people needed additional support when they could not manage independently.

On the day of our visit some of the people who used the service went out to various visits and swimming. We saw staff had supported people as they got ready to go out. We saw that staff supported people to make choices about how they spent their day and the activities offered.

We saw that staff treated people with dignity and respect. We saw that people had freedom of movement around their home and could spend time in their bedrooms whenever they wanted. We saw that each person had their own bedroom which was personalised. We saw the provider had made suitable adaptations to meet the people's physical needs. We saw that there were quiet and places for therapy, such as a sensory room where people who used the service could relax. The home also had an extensive sensory garden which staff told us had been used a lot by people at Woodland View.

We observed that staff respected people's privacy and some people who used the service had their own private bathroom. All the rooms were spacious and big, which accommodated all the specialist equipment some people who used the service required. We saw that the people who used the service related well with the staff. We saw that the staff communicated well and appropriately with people in a way that was easily understood. We saw that staff were attentive and interacted well with people using a range of communication methods. Staff told us that people had a full programme of weekly activities and enjoyed going out into the community. We learned more about how care and treatment was provided when we talked with staff, observed their practices and looked at the records of the four people who used the service.

We found that before people received any care or treatment they were asked for their consent and the provider had acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

We found that people who used the service were protected and safe. We found that there was an effective infection control system in place and that the home had a clean and suitable environment.

We found that there were good systems in place for the involvement of other health or social care professionals.

We found that people who used the service had their care and welfare needs met.

We found that people's views were important and listened to. We found that there was an effective complaints system in place.