Woodland Park

Updated 25 November 2022

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.

Inspection team

The inspection was conducted by one inspector, a specialist adviser with experience in nursing care 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.

Service and service type

Woodland Park 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. Woodland Park is a care home with 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 there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 31 August 2022 and ended on 16 September 2022. We visited the location on 31 August 2022 and 14 September 2022.

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.

During the inspection

We spoke with seven members of staff including the registered manager and deputy manager. We spoke with six people, observed staff interactions with people in communal areas and spoke with 10 peoples relatives. We reviewed 10 peoples care records, and nine peoples nursing and medication records. We reviewed three staff files and records relating to maintenance, fire safety, complaints and quality assurance. We also reviewed policies relating to medicines, infection prevention and control and safeguarding.

Updated 25 November 2022

About the service

Woodland Park is a residential care home providing personal and nursing care to up to 31 people. At the time of our inspection there were 22 people using the service. The home is set close to Babbacombe Downs, the sea and local shops and services.

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

Quality assurance systems did not always effectively identify areas for improvement. Medicines audits were not effective because they did not identify where improvements were needed and who was responsible for ensuring action was taken. The provider had not identified there was not always a first aid trained member of staff on duty at night. Maintenance issues with the call bell system meant the registered manager was not able to establish how long staff were taking to answer call bells. Records relating to the care provided did not contain sufficient detail to establish what care people had received throughout the day. Some maintenance tasks had not been completed for several weeks, including weekly fire tests.

The risk of people falling or developing pressure damage were not always fully assessed or monitored, which increased the potential of people being at risk of harm. Systems did not always work effectively to ensure safeguarding concerns were appropriately recorded, reported and investigated. However, we found no evidence of harm to individuals. Staff, health professionals and people’s family members told us they felt clinical needs were well met. People’s families were reassured their relatives were safe at Woodland Park. One said, “I feel she is safe there; they look after her pretty well.” Another said, “I feel she is safe; I know all the girls, it reassures you.” People received their medicines safely, however, records were not always completed in line with best practice or the provider’s medication policy. This meant, for example, it was not clear when timed medication had been administered.

We recommended the provider review procedures to ensure medicines are administered and recorded in line with their medication policy.

We received mixed feedback regarding staffing levels. Some people and their families told us there were not enough staff, and that it could sometimes take a long time for call bells to be answered. Other people’s family members said there were enough staff, and they had no concerns. Staff told us people received safe care, and staffing levels were generally sufficient at the planned levels. Staff were recruited safely, and appropriate employment checks were made prior to staff starting work.

We recommended the provider ensure their dependency tool considered peoples individual needs to ensure safe staffing levels.

Assessments of people’s needs did not always include their personal preferences, emotional, social, cultural religious or spiritual needs. Four people who were admitted to the home in July and August 2022 had no personalised care plans in place and a fourth person had a short-term care plan in place which lacked personalised detail. Staff told us that whilst care plans did not always contain personalised information, they did know people well, endeavour to find out their individual preferences and shared this informally as a staff team. Staff had sufficient skills and experience to meet people’s needs.

People were supported to work with other health professionals and access health appointments. One relative told us how staff were working with their loved one and health professionals to alter their medication regime so the person could be better supported in the community. They told us, “They are changing it so they can open up her options, to go home with district nursing support or to a residential home.”

The culture of the service was positive, and people were supported to achieve the best outcomes for them. For example, one person had made significant improvement whist at the service and was moving on to live in the community with support. Staff felt well supported by the registered manager. One staff member told us, “[registered manager] is lovely, the biggest support, she brings so much joy and her energy’s great.” People and their families were asked for feedback about the service. Staff worked openly with other health professionals and made appropriate alerts when things went wrong. People’s families told us the registered manager was responsive when they raised concerns. One said, “When I have raised things, they have gone and sorted it out.” A second family member said, “They always tell me what’s happened, they have been amazing.”

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.

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

Rating at last inspection

The last rating for this service was good (7 May 2019).

At our last inspection we recommended the service ensure the medicines administration policy was updated in line with professional guidance, to include covert medicines administration, transcribing of changes to prescriptions and 'as required' medicines procedures. At this inspection we found the medicines administration policy had been updated.

Why we inspected

We received concerns in relation to the quality and safety of care people received, staffing levels, staff skills and experience and poor maintenance of equipment. As a result, we undertook a focused inspection to review the key questions of safe, effective 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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, safeguarding, person-centred care 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 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.