The inspection visit took place on 07 and 08 June 2018. The first day of the inspection was unannounced. This meant people living at Woodhill House Home for Older People, their relatives, the registered manager and staff working there didn’t know we were visiting.Woodhill House Home for Older People is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Woodhill House Home for Older People provides accommodation and residential care for up to 46 people. It is a two-story building located in a quiet residential area of Morecambe. At the time of our inspection visit there were 43 people who lived at the home. People who live at Woodhill House Home for Older People are older people who may be living with dementia. It is a local authority residential home and is currently divided into four areas or suites. One of the suites is residential, providing care for people who have no mental health needs. The other three suites support people that require personal care and mental health support.
The service had a registered manager in place. 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.
At our last inspection in February 2016 the service was rated as good. At this inspection visit carried out in June 2018, we found the registered provider did not consistently ensure all staff working unsupervised at the home had received training on safeguarding people who may be vulnerable from abuse. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) 2014 – Safe care and treatment.
Care plans and information compiled to share with health professionals did not always contain clear, up to date and accurate information on people’s medical, emotional and physical needs and choices.
Although auditing systems were in place, systems and processes were not consistently implemented to ensure compliance with the Regulations. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014 – Good governance.
We looked at recruitment procedures to ensure people were supported by suitably qualified and experienced staff. Records we viewed did not consistently have a full employment history included. We have made a recommendation about this.
We looked at a sample of records related to the administration and storage of medicines and observed a staff member administering medicines. Stock totals on site did not consistently match documented totals. It was difficult to assess how much medicine one person had received when they self-administered it with an inhaler. We have made a recommendation about this.
Relatives told us staff treated their family members as individuals and delivered personalised care that was centred on them as an individual. We saw evidence that people were supported to access healthcare professionals when required.
Staff delivered end of life care that promoted people’s preferred priorities of care.
The registered provider had dementia friendly signage around the home to ensure people were living in an environment that promoted their safety, independence and positive wellbeing.
We saw staff were responsive to each person’s changing needs. They worked together to ensure people who became agitated were offered support to meet their needs and soothe their agitation.
We saw evidence that indicated people had the opportunity to participate in regular activities to promote their physical and emotional wellbeing.
There were systems to record safeguarding concerns, accidents and incidents and corrective action took place as required. The service carefully monitored and analysed such events to learn from them and improve the service.
We found there were sufficient numbers of staff during our inspection visit and effectively deployed throughout the home.
Staff we spoke with confirmed they did not start in post until the management team completed relevant checks.
Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection. We found supplies were available for staff to use when required, such as hand gels.
We observed lunch time and noted people had their meal at a table, where they sat or in their bedroom. We noted people took the option of having additional portions of the food.
We observed only positive interactions between staff and people who lived at Woodhill House for Older People. We saw staff took time and chatted with people as they performed moving and handling procedures in communal areas.
There was a complaints procedure which was made available to people and visible within the home. People we spoke with, and visiting relatives, told us they were happy and had no complaints.
The management team used a variety of methods to engage with people their relatives and staff. People told us the management team were approachable and the registered manager took regular walks around the home to assess the environment.
You can see what action we have taken at the back of the full report.