Woodside Residential Care Home

Updated 22 February 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 inspection was conducted by 2 inspectors. It was supported remotely by an Expert by Experience who spoke with relatives of people who use the service. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Woodside Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Woodside Residential Care 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection a registered manager had not been in post since October 2022. In the interim, the Director of Care and Operations for the provider was overseeing the day to day running of the service together with her assistant.

Notice of inspection

This inspection was unannounced.

What we did before inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. However, we were able to review information we had received about the service such as information shared with us from health professionals who visit the service and people who use the service, including their friends, families. We used this information to plan our inspection.

During the inspection

We spoke to 5 people who used the service,7 staff including the Director of Care and Operations, 6 relatives and a professional and observed staff interacting with people. We looked at a range of documents, including; 6 peoples care plans, additional care planning documents for persons with specific dietary needs or support, medicine records, staff recruitment files and training records. We reviewed staff meeting minutes and governance documents.

Updated 22 February 2023

About the service

Woodside Residential Care Home is providing regulated activity of accommodation and personal care to up to 40 people in one adapted building. The service is registered to provide support to people living with dementia, learning disabilities, older people, younger adults and autistic people. At the time of our inspection there were 31 people using the service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support: The model of care did not meet the Right Support, Right Care, Right Culture guidance. People did not benefit from an interactive and stimulating environment such as listening to music or the use of therapy lighting both specified within their care plans. People were also not supported with daily exercise and assisted to leave their room as required within their care plan.

Where appropriate, legal safeguards had been put in place and the least restrictive measures were used. We found people did have a choice about their living environment and were able to personalise their rooms.

Right Care: Peoples’ care plans were incomplete and entries were contradictory. Some clinical needs had not been identified and risks assessed. For example, people with diabetes did not have care plans in place to maintain foot care despite having poor skin integrity and sores on their feet. There were discrepancies over how foods should be pureed to mitigate the risks of choking. We found that all the food groups had been blended together into a liquid, as opposed to separately to the required consistency. Care plans lacked details of what pressure level people’s mattress should be inflated to and had not been set correctly so that it had the most comfort and support to mitigate the risk of scores. Staff did not have access to communication aides specified within people’s care plan to assist with their communication. However, we observed staff showing kindness to people and being polite and respectful whilst supporting them. Staff were able to tell us about the needs and individual preferences of people.

Right Culture: There was ineffective oversight of the service. Quality assurance processes were established and identified risks, but these were not followed up and mitigated in a consistent and timely manner. People were not always supported by staff who had been trained and assessed as competent. Staff had not completed mandatory training including in learning disabilities and autism. Whilst, people received consistent care from staff they did not always understand and support them with their basic care and specific health needs. Staff told us, “We have had a lot of agency (staff), but we tend to use the same agency, they know as much as we do about people.” Following our inspection staff told us, “Training (for staff) is ongoing” and changes had been made to how care was provided to people. A staff member told us, “We now have signs in the kitchen (to remind staff of how to puree food), we use moulds for the food, meat is separate from vegetables.” We observed staff to be kind, patient and attentive to people. Staff told us they liked their job and cared about the people. Relatives told us they felt their relatives were safe and well cared for in a home described as, “Bright, welcoming, clean and comfortable with good food.”

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The last rating for this service was requires improvement (the report was published on 14 June 2022). Consequently, we followed up on previous breaches of legal requirements from their last inspection.

At our last inspection we recommended that improvements were required to ensure people were safe, specifically; People were appropriately assessed, care plans contained details of individuals needs and how best to support them, people were responded to in a timely and appropriate manner when seeking assistance, incidents were recorded, investigated and actions taken to improve care and medicines were managed safely.

Improvements were also required to ensure the service was well managed, specifically; Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirements and continuous learning and improving care.

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

The inspection was prompted in part due to concerns received about the safety of people and their dignity and care. A decision was made for us to inspect and examine those risks. As a result, we undertook an unannounced focused inspection to review the key questions of safe and well-led only.

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.

Enforcement and Recommendations

We have identified breaches in relation to the safe care and treatment of people, insufficient safeguarding systems and processes operating, the safe appointment of staff and overall governance systems at this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.