Woodleigh Rest Home Limited

Updated 7 April 2023

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 Health and Social Care Act 2008.

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 first day of the was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The second day of the inspection was carried out by one inspector. A third inspector made telephone calls to staff.

Service and service type

Woodleigh Rest Home is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement dependent on their registration with us. Woodleigh Rest Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was not a registered manager in post. There was a manager in post but they resigned during the inspection.

Notice of inspection

This inspection was unannounced on both days.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with 8 people and 3 relatives about their experience of the care provided. We looked around the building and observed care and support in communal areas. We spoke with 8 staff including the nominated individual, manager, deputy manager and care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 6 people’s care records and multiple medication records. We looked at 3 staff files in relation to recruitment, training and supervision. We also looked at a variety of records relating to the management of the home including polices and audits.

Updated 7 April 2023

About the service

Woodleigh Rest Home is a residential care home providing personal care to up to 33 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 19 people using the service.

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

People were not safe. Medicines were not managed safely. Routine checks were not in place and we were not assured people received their medicines as prescribed. Risks to people’s health and safety and wellbeing had not been effectively assessed and reviewed. This included risk relating to moving and handling, skin integrity and the environment. People’s nutritional needs were not always met.

The manager was unable to demonstrate effective leadership. This had not been effectively addressed by the provider and they were unable to demonstrate robust governance arrangements and evidence of lessons being learned. Specific issues we raised at the last inspection had not been addressed.

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.

Staffing levels had been increased and staff had received support, training and supervision to carry out their role. Recruitment was managed safely. Most people and relatives told us they felt safe and there were enough staff to meet people’s needs. Staff were kind, respectful and caring.

The service had made some improvements since the last inspection. However, they were not consistent and some initial improvements had not been sustained. The provider was responsive to the inspection findings and provided assurances they would make the required changes to improve the quality and safety of care.

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 25 July 2022) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

We carried out an unannounced inspection of the service on 14,16 and 27 June 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. The report only covers our findings in relation to the Key questions Safe, Effective 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 COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from Inadequate to Requires Improvement based on the findings of this inspection

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

Enforcement

We have identified breaches in relation to the management of risk and medicines, nutrition and hydration and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures:

The overall rating for this service is ‘Requires improvement’. However, we are placing the service in 'special measures.' We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services 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, 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.