Archived: Woodland Road

12 Woodland Road is a residential care home registered to accommodate four people who have a learning disability. It is managed and operated by MacIntyre Care. The service operates from a dormer bungalow located in a residential area of Ellesmere Port close to local shops and transport links. At the time of our visit, three people were living there.

At our last inspection in November 2015 we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection or ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People could not verbally tell us about the quality of the support they received. People appeared relaxed and comfortable with staff at all times and the support staff provided was centred entirely on the needs of individuals. The registered provider had introduced communication plans which outlined in detail what each type of non-verbal communication expressed by people meant and how it must be responded to.

Staff had had received training in how to protect vulnerable adults and were clear about how they could report any allegations of abuse. They were also clear about the agencies they could speak to if they had concerns about poor practice within the service.

The premises were well maintained, clean and hygienic. Equipment such as hoists, portable electrical appliances and fire extinguishers were regularly serviced to ensure that they were safe. Risk assessments were in place identifying any potential hazards within the environment that could pose a risk to people and how this risk could be prevented. Personal evacuation plans were also in place to ensure the safe evacuation of people in the event of a crisis.

Assessments were in place highlighting the risks people faced from health issues such as weight loss and malnutrition as well as risks which reflected their vulnerability. These were closely monitored and reviewed regularly.

Sufficient staff were on duty at all times of the day. Staff were always available to attend to people’s needs. Staff rotas were available to confirm that there were sufficient staff on duty at all times. Staff recruitment was robust with checks in place to ensure that new members of staff were suitable people to support vulnerable adults.

Medication management was robust and promoted the well-being and safety of people who used the service. Checks were in place to ensure that medication was given when needed and systems in place to ensure that supplies never ran out. Staff who administered medication received appropriate training and had their competency checked.

Staff received training appropriate to their role. Staff received supervision to ensure that they were aware of their progress and to discuss any needs they had. Group supervision in the form of staff meetings also took place.

The registered provider had taken the requirements of the Mental Capacity Act into account. This included assessments on the degree of capacity people had, how limited capacity would impact on their daily lives and how decisions could be made in their best interest. Staff had received training in the Mental Capacity Act and understood the principles associated with it.

The nutritional needs of people were met. Meals were prepared in a clean and hygienic kitchen. Food stocks were sufficient and staff were aware of the nutritional needs of people and the considerations in supporting them to eat and drink.

Staff provided a caring, inclusive and person centred approach in the way they delivered support to people. They took the privacy and dignity of people into account through practical arrangements such as knocking on doors and in the manner they interacted with people.

People were provided with activities both inside the service and in the wider community. These were provided on a one to one basis and were in line with perceived preferences.

Care plans were very person centred, presented in an easy read format and reviewed regularly in the face of changing needs.

A system for people to make complaints was available.

Although not applicable at the time of our visit, the registered provider had arrangements in place for dealing with situations where people were reaching the end of their lives.

The registered manager adopted an open and transparent approach to running the service and was very knowledgeable about the needs of those who used the service.

Staff told us that they considered the registered manager to be approachable and was running a well led service. This view was echoed by other professionals and relatives who had made compliments.

The registered provider had a number of audits in place to ensure that a commentary on the quality of care could be made and fed back comments from questionnaires to people.

Notifications required by law of any adverse events within service were always sent to us and the rating from our last visit was put on prominent display.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We saw that staff treated people who used the service with respect. We noted that the needs of people were addressed at all times. One person was unwell during our visit and we noted that staff ensured that the person was comfortable and was provided with everything that they needed at the time. Although people who lived at Woodland Road had limited verbal communication, we saw that they appeared relaxed and comfortable with the staff team.

Is the service effective?

There was an advocacy service available if people needed it, this meant that when required people could access additional support.

People's health and care needs were assessed on a regular basis, and while people had limited verbal communication, people involved in their care where involved in the reviewing of their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required

People's needs were taken into account with care plans outlined in pictorial form and other information presented in the same way. Work within the premises had included the refurbishment of a sensory room designed to further enable people to feel comfortable and relaxed.

Is the service caring?

Our observations noted that staff were attentive to the needs of the people and that their work focussed exclusively on the needs of people. People were not able to tell us about their experiences of the support they received yet we were able to tell from non-verbal communication that they felt at ease and happy with the staff team. We saw comments from one family member who stated; 'The staff are a great group of people and they are relaxed and dedicated to getting it right for my sister. We are fortunate that she lives in such a caring place'

Is the service responsive?

The service had a Quality Assurance processes in place which sought the views of people involved in the support of people living at Woodland Road. When issues had been identified for improvement, they were dealt with promptly. Where changes to the overall care of people had occurred, we saw evidence that families had been informed of these. Staff considered that they were listened to by the provider. We saw evidence in health records demonstrated that as soon as new health conditions arose, the staff team ensured that people received prompt referral to medical agencies. We also saw evidence through care plans that as needs changed; plans were amended and reviewed on a regular basis.

Is the service well-led?

The service had a manager who was registered with us to carry out their roles. We noted that the service always told us when there were significant incidents. The service remained part of a larger organisation which had systems in place to ensure that people received a person centred level of support. We saw evidence in care plans that the service worked with other agencies to ensure positive outcomes for people.

You can see our judgements on the front page of this report.

We looked at four care plans and one risk assessment. We found that work had been completed to ensure that the care and welfare of people had been promoted. We also looked at medication guidelines in relation to PRN medication which relates to medication given to people when needed. Again we found that medication procedures had been improved to promote people's health and wellbeing. We held discussions with staff who confirmed that work had been completed to achieve compliance and they felt that more continuity of care had been achieved.

We were introduced to one person living at Woodland Road. This person had limited verbal communication yet they appeared relaxed and interacted with staff in a positive and friendly manner. Staff were able to spend time with this person supporting them on a one to one basis and we observed that this person responded well to this.

As a result, the service is now compliant with all outcome areas.

We looked at how the service assessed the needs of people prior to them moving into the service. Records showed the needs of people already using the service had not been taken into consideration in a meaningful way prior to an offer of a placement being made. Records also showed the negative impact of certain behaviours on people had not been documented in their support plans and risk assessments. This meant people may not have received appropriate support.

Information provided after the inspection visit showed that staff received training around the protection of vulnerable adults. Records showed medication was not always administered appropriately.

There was a system in place to encourage the staff team to support people who used the service to raise issues or complaints on their behalf. Relatives spoken with told us they felt involved in the support and care provided to their family members and felt they were listened to.