Woodhill House Home for Older People

We found the following examples of good practice.

Staff were trained in infection prevention and control and using Personal Protective Equipment (PPE) safely. We saw staff used the appropriate levels of PPE. The registered manager monitored staff wearing PPE to check good practice was followed. The provider had ensured sufficient quantities of PPE were available throughout the pandemic.

The staff team kept the home clean and hygienic. Frequently touched surfaces were cleaned regularly throughout the day to reduce the risk of infection. The registered manager took advice from appropriate specialists about maintaining a clean, hygienic and comfortable environment for people.

The registered manager had followed government guidance about visiting. They had supported window visits and outside visiting during the height of the pandemic.

The provider had supplied a robust ‘visiting pod’ in the grounds of the home to allow people to visit their friends and relatives safely. The registered manager had introduced COVID-19 secure indoor visiting and arranged COVID-19 secure activities for people to support their wellbeing.

The provider had arranged for regular COVID-19 testing for staff and people who lived in the home. They had also arranged for people who lived in the home and staff to receive the COVID-19 vaccine.

Staff had been trained in the use of Lateral Flow Device, (LFD), COVID-19 tests. They carried out an LFD test before each shift and knew not to attend the home if their test showed they were positive for COVID-19. This reduced the risk of staff who had no symptoms bringing infection into the home.

The registered manager had ensured staffing arrangements reduced the risk of infection spreading in the home. Staff were allocated to consistently work in specific areas of the home to reduce the risk of transmission of infection.

We observed the staff followed social distancing guidance while moving around the home. The registered manager had ensured clear information about maintaining social distancing was in place to guide staff and visitors. The home had large communal rooms where people living in the same area could meet safely.

The registered manager followed good practice around safe admissions when people moved into the home. People were tested for COVID-19 before their admission and were supported to self-isolate for 14 days after they moved in.

Woodhill House Home for Older People is a residential care home providing personal care to 45 people aged 65 and over at the time of the inspection. The service can support up to 46 people in one purpose-built building.

The home is arranged into four living areas called ‘houses’. Three houses accommodate people who are living with dementia and one house provides accommodation for older people who have physical care needs.

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

People were safe and protected from harm and abuse. All staff who worked in the home had been trained in how to identify and report abuse. The registered manager had identified and managed risks to people’s safety. There were enough staff to support people. The provider carried out checks on new staff to make sure they were suitable to work in the home. The staff handled medicines safely and people received their medicines as their doctors had prescribed.

The staff were trained and skilled to provide people’s care. People enjoyed the meals provided. The staff supported people to maintain good health and to see their doctors as they needed. The staff respected the decisions people made and people’s rights were protected. 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.

The staff treated people in a kind and caring way. The staff knew people well and respected their individuality and diversity. The staff asked people for their views about their care and respected the choices people made. The staff protected people’s dignity, privacy and independence.

The staff planned and provided care to meet people’s needs and take account of their choices. People enjoyed a range of activities and could see their families and friends as they wished. People knew how they could raise concerns about the service. The registered manager had processes to ensure people would receive care at the end of life to meet their needs and respect their wishes, beliefs and cultural needs.

People told us this was a good home and said they would recommend it. There was an experienced registered manager employed. People knew the registered manager and were confident approaching her. The registered manager monitored the quality of the service. She asked people for their views and made changes in response to their feedback to improve the service.

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 requires improvement (published 30 July 2018) and there were breaches of regulations. 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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected: This was a planned inspection based on the previous rating.

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.

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.

Woodhill House Home for Older People is a two story building located in a quiet residential area of Morecambe. At the time of our inspection visit there were 42 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 three areas or suites. One of the suites is residential, providing care for people who have no mental health needs. The other two 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 the last inspection on 24 October 2013, we found the provider was meeting the requirements of the regulations that were inspected.

During this inspection, staff had received abuse training and understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of vulnerable adults. Staff we spoke with told us they were aware of the safeguarding procedure.

The provider had recruitment and selection procedures in place to minimise the risk of inappropriate employees working with vulnerable people. Checks had been completed prior to any staff commencing work at the service. This was confirmed from discussions with staff.

We found staffing levels were suitable with an appropriate skill mix to meet the needs of people who used the service.

Staff responsible for assisting people with their medicines were trained to ensure they were competent and had the skills required. Medicines were safely kept and appropriate arrangements for storing medicines were in place.

Staff received training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

People and their representatives told us they were involved in their care and had discussed and consented to their care. We found staff had an understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

Comments we received demonstrated people were satisfied with their care . The registered manager and staff were clear about their roles and responsibilities. They were committed to providing a good standard of care and support to people who lived at the home.

A complaints procedure was available and people we spoke with said they knew how to complain. Staff spoken with felt the registered manager was accessible, supportive and approachable and would listen and act on concerns raised.

The registered manager had sought feedback from people who lived at the home and staff. They had formally consulted with people they supported and their relatives for input on how the service could continually improve. The registered manager had regularly completed a range of audits to maintain people’s safety and welfare.

We found people were being supported by staff who had been trained and appropriate support arrangements were in place for them. The home had been well maintained and was clean and hygienic when we visited. Good care practices were observed and people were having their nutritional needs met.

We observed the staff team providing sensitive and flexible personal care support. The staff were kind and patient and showed a good understanding of the needs of the person in their care.

The people we spoke with said they were happy and enjoyed living at the home. One person said, “I am receiving the best care possible. I have never had cause to complain about anything from the day I moved in. The girls look after me really well”.

During our inspection we contacted the Lancashire contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.

We spent time meeting and talking with people who lived at Woodhill House, their family and friends, and with other professionals and members of the staff team. We noted that the relationship between the care staff and the people who lived at Woodhill House was very warm and friendly.

People told us,” We keep a close eye on our weekly visits and are very happy”.

“I come in regularly and have nothing but praise for the place”.

“There have been lots of changes to cope with and the staff has been very supportive, as a family we are delighted”.

“I feel safe and well looked after”.

“It is absolutely fantastic, the staff are caring and everyone is very well cared for”.