Woodheyes

Woodheyes is a residential care home providing personal care to older people with dementia and sensory needs at the time of inspection. Care was delivered over two floors in one adapted building, with passenger lift access. The service can support up to 38 people. At the time of our inspection there were 27 people living at the service.

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

Some quality assurance systems and processes in the service needed improvement. Not all audits were robust enough to identify shortfalls.

People’s needs and risks were not always fully assessed. We could not be assured people were supported to have maximum choice and control of their lives. Mental capacity assessments were not robust or detailed. This meant staff may not be able to support people in the least restrictive way possible and in their best interests; the policies and systems in the service needed improvement.

The number of staff on duty at times, and the lack of supervision were the only concerns staff highlighted for improvement.

People, relatives and staff were complimentary about the provider and manager, who had recently taken up their position. Staff noted improvements made at the service following our previous inspection, most notably infection prevention and control, where government guidance was now routinely followed.

People were supported to access healthcare services when required. People had access to their medication when they needed it, and medicines were managed safely. Minor concerns of medicine administration were noted.

People felt safe and protected from harm and abuse by staff who had been trained in safeguarding procedures. Staff were recruited safely.

People and relatives told us staff were caring and compassionate and were treated with respect. The service was welcoming, and there was a positive atmosphere. Complaints were investigated and people and relatives felt able to raise their concerns.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 21 January 2021). The service has been in Special Measures since 21 January 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced focused inspection of this service on 29 October 2020. Breaches of legal requirements were found, and the service was placed in special measures. We imposed conditions on the providers registration. A director completed an action plan after the last inspection to show what they would do and by when to bring about the improvements needed.

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at were used to calculate the overall rating at this inspection. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at 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 the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Woodheyes on our website at www.cqc.org.uk

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Woodheyes is a residential care home providing personal care to older people with dementia and sensory needs at the time of inspection. The service can support up to 38 people. At the time of our inspection there were 33 people living at the service.

Care was delivered over two floors in one building, with lift access.

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

At the time of our inspection there was an outbreak of COVID-19 at the service. We found multiple failings in the provider’s infection prevention systems and processes which increased the risk of the transmission of COVID-19, and placed people at significant risk of harm.

There were not enough staff to monitor people who posed risks to others from acquiring COVID-19, and opportunities to provide staff with the appropriate training in relation to COVID-19 were missed. The service did not support people who required oxygen therapy in a safe way. Staff did not have all the skills and knowledge needed to provide safe care.

Whilst the service was visibly clean there were not enough housekeeping staff to ensure the enhanced cleaning required during an outbreak of COVID-19.

People’s care plans and risk assessments had not been reviewed following the outbreak of COVID-19. The service was not safe to support people who required specific therapies to maintain their health specifically from the complications arising from contracting COVID-19.

People were not protected from avoidable harm, and their privacy, dignity, needs and preferences were not always met.

There had been inconsistent management of the service both prior to and following the COVID-19 outbreak. This was further compounded by the registered manager and deputy manager contracting COVID-19. Quality assurance systems and processes had lapsed which prevented the concerns we found during the inspection being identified.

People’s medicines were managed safely.

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 10 July 2020).

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about an outbreak of COVID-19 at the service. A decision was made for us to inspect and examine those risks.

We inspected and found there was a concern with infection prevention systems and processes, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.

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 coronavirus and other infection outbreaks effectively.

The overall rating for the service has changed from Good to Inadequate. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe, caring and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Woodheyes on our website at www.cqc.org.uk.

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 infection control, safe care and treatment, safeguarding and the services governance arrangements at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.

Woodheyes provides care and accommodation for up to 38 older people some of whom are living with dementia. It is situated in Leicester Forest East, Leicestershire. Accommodation is on the ground and first floors with a lift for access. At the time of our inspection there were 37 people using the service.

People’s experience of using this service

People told us the staff at the home were exceptionally caring. They gave us many examples of how staff valued them and put them first in everything they did. We saw staff continually interacted with people, checked on their well-being, and ensured they were comfortable and had everything they needed. The culture in the home was one of compassion and empathy. Staff listened to people and provided them with care and support in the way they wanted.

People said they felt safe at the home and trusted the staff. The staff knew how to minimise risk to people and assist them in ways that were safe. The home was well-staffed, and people said staff had time to meet their care needs and spend quality time with them.

People had their medicines safely when they needed them. Staff ensured people had access to healthcare services. 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.

All the people we spoke with said they liked the meals served. A person told us, “The food is very good. Meals are excellent. I never leave anything.” Lunchtime was relaxed and sociable with attentive, friendly staff assisting people. The home was bright, clean and well-decorated throughout with level access to all areas including the gardens.

Staff supported people to making decisions and determine their own lifestyles. A person said, “I can go to bed when I want. I can have a selection of food. The clothes I wear are my choice.” 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 received personalised care and staff were responsive to their needs. The home's activities co-ordinator provided a wide range of one-to-one and group activities for people. We saw care workers facilitating an armchair exercise class with people who enjoyed this gentle workout.

People said the home was well-managed and they would recommend it to others. They told us the registered manager and staff were approachable and listened to them. There were effective systems in place to monitor the home and ensure staff provided good-quality care. The home had close links with community health and social care professionals to and people were encouraged to use local facilities including a coffee shop, garden centre and pub.

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

Rating at last inspection

At the last inspection we rated this service Good (report published on 17/11/2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Woodheyes is a residential care home and provides care for up to 38 people. Thirty six people were using the service when we visited and many were living with dementia.

At the time of our inspection there was a registered manager in place. It is a requirement that the service has a 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. The registered manager was not available during our visit so we spoke with the proprietor and deputy manager.

People and their relatives were not always satisfied with the activities available to them. We found that people were not always offered opportunities to take part in their hobbies and interests. The registered manager told us that they would take action to review the activities available to people.

People and their relatives felt safe with the support offered to them. Staff understood their responsibilities to protect people from abuse and avoidable harm and to remain safe. The registered manager had processes in place to manage accidents and incidents appropriately. The recording of some incidents was not always accurate and the provider told us they would make improvements. Risks to people’s health and well-being were assessed and reviewed. For example, where a person was at risk of falling, staff followed guidance the registered manager had made available to them.

The provider had a recruitment process in place for prospective staff that was followed. This included checks on the suitability of staff to work with people in the caring profession. People, relatives and staff were satisfied with the number of staff available to offer care and support and we found that staffing levels were suitable.

People received their prescribed medicines in a safe way by trained staff. The provider had made guidance available to staff on how to handle people’s medicines safely and we saw staff following these instructions. The administration of people’s medicines was recorded and checked by senior staff members to make sure people had received them.

People received care and support from staff with the necessary skills and knowledge. Staff had received training in areas such as keeping people safe. New staff received an induction when they started to work for the provider that included checking their knowledge. The registered manager observed staff when they delivered care so that they could receive feedback and guidance on their work.

People were supported in line with the Mental Capacity Act (MCA) 2005. People were asked for their consent to their care where they could. Where there were concerns about people’s ability to make decisions, the registered manager had assessed people’s mental capacity. Where necessary, the provider then made decisions with others such as family members that were in people’s best interests. Staff understood their responsibilities under the MCA. The registered manager had made applications to the appropriate body where they had sought to deprive a person of their liberties.

People were satisfied with the food and drink offered to them. The provider had sought specialist advice where there were concerns about people’s eating and drinking. People had access to healthcare services such as to their GP and dentist. We saw that staff shared information with each other about people’s health so that they could provide effective support.

People received support from staff who were kind and compassionate. Staff protected their dignity and privacy and showed respect for people. People’s care records were stored safely and discussions about people’s care needs occurred discreetly. People’s relatives could visit without undue restriction.

People were supported to be as independent as they wanted to be to retain their skills. People, where they could, were involved in decisions about their care. Where people required additional support regarding decisions about their care, this was available to them.

People and their representatives had opportunities to contribute to the planning of their care. People had care plans that detailed their individual support requirements and were reviewed. This meant that staff had up to date guidance when offering care to people. Staff knew about the people they cared for including people’s preferences for how they wanted their care to be carried out. We saw staff providing care based on people’s preferences.

People’s and their relatives knew how to make a complaint. The provider had a complaints policy in place that outlined what they would do should they receive a complaint. When a complaint was received, the provider explained what action they would take.

Staff felt supported by the registered manager and knew their responsibilities. This included how to report the inappropriate or unsafe practice of their colleagues should they have needed to.

People, their relatives and staff had opportunities to give feedback to the provider. Some relatives felt that the provider listened but did not always take action to make improvements. We found that the provider was open to feedback and took action where they received suggestions for improvements from people. Where we were told by people and their relatives, and where we saw that improvements could be made to the activities offered to people, the provider told us they would take action.

The registered manager was aware of their responsibilities and had arranged for quality checks of the service to take place to make sure that it was of a high standard. For example, checks on the practice of staff and equipment took place.

Information about the people who used Woodheyes was kept in their individual care files and stored securely. Staff were aware of their responsibilities to maintain accurate records. Other records relating to the staff and the management of the service were accurate, kept secure and could be easily accessed when required.

People had a range of assessments in place, which were used to develop care plans to inform staff about how to support people and meet their daily care needs. Records showed people's health and care needs were met by the staff and health professionals. People were satisfied with the medication arrangement. People were provided with a choice of meals prepared to suit their dietary requirements. One person said: 'The food is wonderful. There's always a choice and I quite like having a small sherry with my meal.'

People lived in an environment that was clean and well maintained. All equipment used by people and staff were kept clean and staff ensured the hygiene protocols were followed at all times.

People were supported by staff recruited who were suitable and qualified to work with vulnerable people. One person said: 'The girls are very good they know what help you need and are kind.'

We found evidence of gaps in records and improvements are needed. The records completed to monitor people at risk of poor nutrition and hydration was not effective. The new care planning format did not always have the information with regards to people's social interests and hobbies.