We carried out an unannounced inspection of the service on 13 and 14 January 2015. Woodleigh Christian Care Home provides accommodation for people who require nursing or personal care, diagnostic and screening procedures and the treatment of disease, disorder or injury for up to a maximum of 44 people. On the day of our inspection 33 people were using the service and there was 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.
People knew how to report concerns if they thought they or others were the victim of abuse. People were protected by staff who were able to identify the signs of abuse. People’s safety was protected as access to the home was secure and prevented unauthorised access to the home.
People were supported by staff to maintain their safety without unnecessarily restricting their freedom. The registered manager had processes in place that protected people’s safety through the timely investigation of accidents, incidents and other concerns raised by staff or people.
There were enough staff to meet people’s needs. Robust recruitment procedures were in place. People were protected against the risks associated with the unsafe management of medicines.
People received care from staff who felt supported by the management. Staff undertook a detailed induction and received regular assessment of their work. Staff understood people’s needs.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The DoLS are part of the MCA. They aim to make sure that people are looked after in a way that does not restrict their freedom. The safeguards should ensure that a person is only deprived of their liberty in a safe and correct way, and that this is only done when it is in the best interests of the person and there is no other way to look after them. The registered manager was aware of these safeguards. People told us they had the freedom to leave the home when they wanted to and did not feel unlawfully restricted.
People were encouraged and supported by staff to eat and drink as much as they could. People told us they were happy with the access they had to their GP other health care professionals. Appropriate plans were not put in place to monitor the fluid intake for a person who had been diagnosed with a Urinary Tract Infection (UTI). A UTI is an infection in any part of the urinary system such as the kidneys, ureters, bladder and urethra. We were informed after the inspection that monitoring of this person’s fluid intake was now in place.
People spoke positively about the staff, however we observed some poor staff practise. We saw a person left for too long in the middle of the lounge in their wheelchair whilst waiting to be moved which caused them distress. We observed the staff handover and the language used to describe some people was not appropriate. Phrases such as being; “Being shirty” were used and were disrespectful.
This was a breach of Regulation 17 HSCA 2008 (Regulated Activities) Regulations 2010, which corresponds with Regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014.
You can see what action we told the provider to take at the back of the full version of the report.
People responded positively to the staff. People were supported by staff who understood their life history and the things that were important to them. Staff told us people were given a choice of whether they wanted a male or female member of staff to support them with their personal care. The majority of people told us this choice was offered although two did say they did not always happen. All people told us their dignity was maintained by the staff.
People were provided with information about how they could obtain independent advice about their care from Independent Mental Capacity Act Advocate (IMCA) to make major decisions. IMCAs support and represent people who do not have family or friends to advocate for them at times when important decisions are being made about their health or social care. People received support from staff were able to describe the steps they took to preserve people’s privacy and dignity when providing personal care. People told us they felt able to do things that were important to them and staff supported them in following their hobbies and interests.
People’s care records were written in a person centred way. People’s records were stored on an electronic care record system. However we found that the use of this system did on occasions lead to gaps in the recording of the daily care and support provided for people.
People were supported in an environment that had been adjusted to ensure people living with physical or mental health conditions were able to lead as independent and fulfilling a life as possible. People knew how to make a complaint and the registered manager told us they encouraged people to raise concerns with them.
The registered manager carried out regularly audits to assess the quality of the service people received and whether it met people’s current level of need. However when we raised the concerns identified within this report they were not always aware of them. This could place people’s health and safety at risk.
This was a breach of Regulation 10 HSCA 2008 (Regulated Activities) Regulations 2010, which corresponds with Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014.
You can see what action we told the provider to take at the back of the full version of the report.
The registered manager told us they had an ‘open door’ policy if people wished to discuss any concerns. People were encouraged to access other organisation within local community. The registered manager was aware of, and could explain how they met their CQC registration requirements. However upon review we did find some examples of statutory notifications that were not sent in a timely manner.
People were supported by staff who felt valued and listened to. Staff understood their roles and told us they enjoyed working at the home. The provider used innovative ways to provide support for people and their relatives. External professionals visited the home to offer people and relatives advice about the challenges of living with or supporting some who is living dementia.