Woodford House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We assessed all the quality statements with the key question of effective and found improvements had been made. There were now processes in place to assess people’s needs and involve relatives and people in reviews of care plans. Staff worked with other health professionals to make sure people received the most appropriate care and support. Nursing staff were supported to maintain and update their clinical knowledge. People were supported to make decisions about their care and support. Staff followed national guidelines when people did not have capacity to make sure all decisions were in their best interests. People were supported to maintain a healthy lifestyle and attend appointments with professionals such as the dentist.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives told us their loved ones received care and support which was centred around their assessed needs and choices and they were involved throughout the process. One relative told us “We were involved in [their] recent care meetings, looked at all aspects” and another added “They review him every month and ask me if I have concerns”.

Staff told us they knew people well, particularly at the present time, with reduced numbers of people living at the service. This meant they were able to recognise small changes and adjust their care accordingly. One member of staff said, “We have the time at the moment to discuss changes in people and how we might improve or change their care”.

People’s needs were assessed before moving into the service. Assessments were basic, containing limited information. A current assessment of need had also been completed, however, sometimes the information was similar, even when people had moved into the service some time ago. One person moved into the service in 2020 and both the initial assessment and current assessment differed in very few places. Both assessments said the person had no falls in the last year but had a fractured hip following a fall within 2 years. The current assessment had not been updated to take into account the passage of time so the person had now had no falls within those 2 periods. However, we were assured staff knew people well and were aware of their current needs. Staff had undertaken recognised assessment tools to identify the level of care people needed to meet their needs and mitigate risks. These tools included assessing the risk of malnutrition, acquiring pressure sores and falls.

Relatives told us they were involved in the planning and reviewing of their loved ones’ care. One relative said “I had a few issues with the previous management around choice and cleanliness and conditions of the food and everything has improved”.

Registered nurses told us they received the support they needed from the provider to regularly update their continuing professional development. One staff member told us, “(the registered manager) is very supportive and makes sure we have what we need”. Another told us, “We have a clinical lead who supports all the services so we can also call on her to run things by”. The registered manager told us they were completing a mental health first aid course to enable them to better support people and staff.

Registered nurses are required to ensure they continue their professional development to keep up to date with best practice and to be able to renew their NMC registration. There were registered nurses working in the service, including the registered manager and deputy manager, and their continued development had been maintained. The registered manager made sure information was cascaded to staff. People’s nutrition and hydration needs were met. Staff used appropriate tools and followed the advice of healthcare professionals to make sure people were cared for well and risks were mitigated. A dietician told us they worked well with staff and could see the improvements in taking and following advice given.

People told us they were supported to access other services effectively, such as eye tests. One relative told us “We had some issues with the GP, they were supportive with that and helped me sort it”.

Staff told us they were given the information they needed about people when they moved into the service so they were able to provide their care.

We spoke with a healthcare professional who told us staff shared appropriate information with them, made referrals that were necessary, and followed advice given.

The provider used an electronic care planning system to document care records. The registered manager and staff were able to share access where appropriate, and were able to print a copy to share if people needed to move between services. For example being admitted to hospital or needing to move to another care home. This supported people to receive appropriate care If they were not able to express all their needs.

People were supported to manage their health and wellbeing and relatives told us they were involved. One relative said “I’ve seen improvements, [they’re] gaining weight”.

Staff told us they supported people to make healthy choices where they were able to. Some people found it more difficult to make day to day choices and staff described how they would support decision making in different scenarios, such as the meals they ate, or around their personal care.

People were supported to gain advice from healthcare professionals when they needed to. This was evidenced through the contact people had with for example, dieticians, tissue viability nurses, opticians, dentists and GP’s when necessary. One person had been supported to see a dietician to enable a weight loss programme. Advice had been given and staff supported the person to make healthier choices. Their care plan clearly set out the plan of choices to encourage.

People and relatives were positive about their care and told us their expectations were met. They had more opportunities to do things that mattered to them including individual and group activities. Relatives told us “They’ve definitely tried to do things, there are activities every day to keep them involved” and another added “[They’re] always asked if [they’d] like to get involved and [they] like to watch”.

Staff told us they knew people well and picked up when people’s needs were changing. When they fed this back to senior care or nursing staff, their feedback was taken on board and changes were made to reflect the changes.

Processes were in place to monitor people’s care and ensure positive outcomes. The registered manager knew people well and was aware of their needs and if changes needed to be made. During our assessment visit the registered manager was often chatting with people and checking if they needed to make any changes or had concerns. People clearly knew them well and were comfortable chatting.

Relatives told us that people were supported to have choice and control of their lives and staff supported their best interests. One relative told us their loved one “Has breakfast in bed or in [their] room if [they] choose” and “Goes to bed when [they] want”.

Staff were able to describe how they supported people to make decisions when they had difficulty making day to day choices and decisions. Staff described how they supported people to choose their clothes for the day, what meals to choose from the day’s menu and how they wanted to be supported with personal care. Staff told us people had the right to refuse, but they would return again a bit later to see if they had changed their mind, and keep trying.

The provider had made many improvements in relation to consent to care and treatment and was no longer in breach of regulation. Mental capacity assessments were well written and clearly set out why the assessor considered the person did not have capacity to make a specific decision. Best interest decision making showed the process undertaken to enable decisions to be made in a person’s own and best interest when they were deemed to lack capacity.