Woodways

Updated 20 November 2021

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. 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 Care Act 2014.

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 team was made up of one inspector and a specialist advisor. The specialist advisor was a nurse with experience of working with people with a learning disability and people with mental health conditions.

Service and service type

Woodways is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. 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 Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided. The manager was in the process of applying to register with the CQC.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the different local authority commissioners and from Healthwatch, Barnsley. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection

We spoke with two people who lived at Woodways and two relatives about their experience of the care provided. We met with the nominated individual (the nominated individual is responsible for supervising the management of the service on behalf of the provider), manager and deputy manager. We spoke with five members of staff.

We looked around the building to check environmental safety and cleanliness. We looked at written records, which included three people’s care records and three staff files. A variety of records relating to the management of the service were also reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. This included reviewing policies and procedures.

Updated 20 November 2021

About the service

Woodways is a care home providing accommodation and personal care to younger adults who have a learning disability or autistic spectrum disorder and may also experience mental health difficulties. The service can support up to six people in six separate apartments on the first floor of the building. At the time of this inspection there were six people living at Woodways.

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

Processes and quality assurance systems needed to be developed. We found people’s care records needed to be reviewed and better organised; infection prevention and control, care records and medicines audits needed to be implemented; and regular supervisions needed to be sustained.

There were systems in place to recognise and respond to any allegations of abuse. Staff had received training in positive behavioural support. Safe recruitment procedures made sure staff were of suitable character and background. There were enough staff deployed to meet people’s care and support needs in a timely way. Medicines were stored safely and securely. There were effective systems in place to ensure people received their medicines as prescribed.

Staff were provided with an induction and relevant training to make sure they had the right skills and knowledge for their role. Staff told us they felt supported by managers and colleagues. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to access health and social care services as required. Positive and supportive relationships had been developed between people living at Woodways and the staff. People’s independence was promoted and their dignity was maintained. People were supported to maintain meaningful relationships and to access the community.

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.

The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right support

• People’s individual needs were met by the size and design of the service.

Right care

• The care and support provided was person-centred and promoted people’s dignity, privacy and human rights

Right culture:

• The ethos, values, attitudes and behaviours of managers and care staff ensured people using services led confident, inclusive and empowered lives.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This service was registered with us on 20 April 2021 and this is the first inspection.

Why we inspected

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.

The inspection was prompted in part due to concerns received about inappropriate use of restraint, medicines management, staffing levels and deployment of staff. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from these concerns. However, we have found evidence that the provider needs to make improvements with regards to governance systems and processes. Please see the well-led section of this report for further details.

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 have identified a breach in relation to good governance. 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.