The inspection took place on the 20 June 2017 and was unannounced.Woodlands Nursing Home provides personal care, accommodation and nursing care for up to 28 people. On the day of our inspection there were 23 older people at the service, some of whom were living with dementia and varied health conditions. The service is spread over three floors with a passenger lift, communal lounge and dining room.
The home had a registered manager. 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.
The service was very caring. Without exception, people and their relatives told us the staff were extremely caring, compassionate, attentive and dedicated in their approach. They commended the exceptional quality of the care they received. Comments from people and relatives included “When I came here to visit staff were just wonderful. So calm and reassuring it was just what I needed. It was just a good feeling I got from them and then everyone else has followed on from there” and “Not only have they cared for my relative so wonderfully they have given me so much support”.
Staff developed positive caring and compassionate relationships with people, exceeding their expectations. The ethos of the home was that of an extended family. Staff knew each person as an individual and what mattered to them, they treated people with the utmost dignity and respect. One member of staff said “We are a family, that's why I love working here and putting smiles on people's faces”.
People receiving end of life care were treated with exceptional care and compassion. The service had strong links with a local hospice and a local Palliative Care Coordinator, who provided training recommendations and support for staff to provide high quality care for people nearing the end of their lives. A health professional told us “I have great faith in the clinical opinions of the nursing staff they provide excellent care and following advance care plans and contingency plans. They are rightly proud of the fact that almost every resident who dies does so in the home rather than in hospital”.
People, relatives and health professionals consistently told us how the service was exceptionally personalised to meet people's individual needs. Staff spoke with pride and passion about the way people were cared for. Management and staff continuously looked for ways to improve people’s care so they received positive experiences and led fulfilling lives at the service. One person told us “The staff are amazing, just amazing. They cannot do enough for you and help me so much. The nurse is a godsend and meets my needs for sure”.
The service found innovative and creative ways to enable people to live life to the full and continued to do things they enjoyed. The service was currently a pilot site for a United States based charity ‘Music & Memory’. Music & Memory brings personalised music into the lives of older people and people living with dementia through digital music technology. One person told us “I love listening to the old tunes, it really is lovely. I remember them well”. The provider was innovative and set about identifying a suitable adult dog from a local dog breeder that could spend a substantial amount of time with the people as the resident PAT (pets as therapy) dog.
Staff held skills and trained to a high standard to care for people. There was a strong emphasis on training and continued development for staff. Staff spoke passionately about people whose lives had improved since they came to live at the service. For example, one person who came to the service to receive end of life care had their life improve over time, with the staff committed to giving exceptional care to the person working closely with a range of health professionals. The person became well enough to return home.
Care planning was focussed upon a person's whole life. People and relatives were asked to complete a comprehensive 'life book /social profile' upon admission to the home. This was a wide ranging document that included people’s history, preferences, skills and a family tree. This enabled staff to ensure that a holistic approach to care was taken.
The provider strived for excellence and improving the lives of people who lived at the home through involvement with external organisations and the local community. This included local schools, churches and clubs. A tutor from a local college told us “It is apparent that the students gain benefits from spending time within the home with older people and the sharing of experiences and knowledge, its win win all round”.
The provider had robust and embedded quality monitoring arrangements through which they continually reviewed, evaluated and improved people's care. These showed the service was consistently high performing and surpassed expectations. People received a consistently high standard of care because staff and management put people first and at the heart of the service, using innovation and continuously looking for new ways to improve their care and quality of life. People, relatives and professionals spoke highly around the exceptional quality of care provided at Woodlands Nursing Home. One person told us “Oh my, what can I say about the manager. She is absolutely delightful. Always comes to see me and asks if I am ok and has a lovely chat with me”. A relative told us “Always get a super warm welcome and the offer of a drink, it’s like a family it really is”. Another relative told us that if they needed a home in the future, this would be the one. They said “I want to put my name down, it’s very good”.
The culture of the service was open and inclusive and encouraged staff to see beyond each person's support needs. The provider had clear values which the registered manager promoted to staff. The provider and registered manager showed an outstanding drive and passion to ensure the service was under a continuous improvement plan and working to be an outstanding service, ensuring people were at the heart of the service.
Staff undertook an induction programme at the start of their employment at the service and staff that were new to care were supported to undertake the Care Certificate. Staff told us they felt well supported and that they had received regular supervision and an annual appraisal. A staff member we spoke with said, "Our supervision is very good. The registered manager does my supervision and it is very worthwhile. If I am struggling with anything I can talk to them about it”.
People received the support they needed to manage their nutritional intake. There was clear individual guidance about how to support people safely and effectively with eating and drinking. The service employed a resident chef who was knowledgeable on people’s needs. One person told us “I’ve never eaten such glorious food in a long time”.
People and relatives told us they felt the service was a safe environment, where people felt free from harm and had no concerns in raising issues with any staff or managers. One person told us “I feel totally safe and secure here. It is the best place I could be”. People received their medicines safely and had access to relevant health care professionals and received appropriate assessments and interventions in order to maintain good health.