This inspection site visit took place on 18 and 23 July 2018 and was unannounced.

A Woodlands House is a residential care home which provides care and support for up to 14 older people living with dementia. At the time of our inspection there were 14 people living at the home. Accommodation was arranged over three floors with stairs and a passenger lift to the first floor, people with better mobility stayed in rooms on the second floor and had been assessed as being able to use the stairs. The ground floor had a dining area and two communal lounges. 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.

The service 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 registered manager is also one of the providers of 29 years; they were in day to day charge and worked alongside a deputy manager and care staff team to provide care for people.

The service was last inspected on 28 and 29 January 2016 and was rated Good across all questions. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staff were aware of their responsibilities in relation to keeping people safe and knew who to contact externally should they feel their concerns had not been dealt with appropriately.

Systems were in place to identify risks and protect people from harm. Risk assessments were in place and reviewed monthly. Where someone was identified as being at risk, actions were identified on how to reduce the risk and referrals were made to health professionals as required.

Policies and procedures were in place to ensure the safe ordering, administration, storage and disposal of medicines. Medicines were managed, stored, given to people as prescribed and disposed of safely.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and people were encouraged to make decisions about their care and treatment. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. The members of the management team and care staff we spoke with had a full and up to date understanding of DoLS. These safeguards protect the rights of adults by ensuring that if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. Appropriate DoLS applications had been made, and staff were acting in accordance with DoLS authorisations.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

There were sufficient staff to meet people's needs and keep them safe. The registered manager told us that they did not use agency staff as they liked to ensure that staff had a good understanding of people’s needs and the care they needed. Safe staff recruitment procedures ensured only those staff suitable to work in a care setting were employed.

Staff had undertaken appropriate training to ensure that they had to skills and competencies to meet people’s needs. Staff attended regular supervision meetings with the regis

We spoke with four of the fourteen people who lived at the service. One person told us, “It’s very good here. There is nothing to complain about. I enjoy the activities provided. I like the man who comes with the animals and the singing session is good. We also throw a ball occasionally and that’s alright as well.”

However, due to their disabilities many of the people accommodated were not able to tell us about their experiences. To help us to understand the experiences people have we used our Short Observational Framework for Inspection (SOFI) tool. This tool allows us to spend time watching what was going on in a service and helps us to record how people spent their time, the type of support they get and whether they have positive experiences.

We spent 30 minutes watching care and support provided to four people in the dining room. We observed people being served and helped with the main meal of the day. The care staff on duty knew what support and the encouragement they needed to maintain their independence.

We also gathered evidence of people's experiences of the service by looking at a selection of records and talking with members of staff. We found that people's care needs were being managed safely by the service and that staff had a good understanding of their roles and responsibilities.

Due to their disabilities many of the people accommodated were not able to tell us about their experiences. To help us to understand the experiences people have we used our Short Observational Framework for Inspection (SOFI) tool. This tool allows us to spend time watching what was going on in a service and helps us to record how people spent their time, the type of support they get and whether they have positive experiences.

We spent 45 minutes watching care and support provided to five people in a lounge area. We observed people being served and helped with hot drinks. We also observed people participating in an activity which involved people throwing and kicking a soft ball to each other. We found that people had positive experiences. The care staff on duty knew what support they needed and they respected their wishes if people wanted to be left on their own.

Care staff we spoke with told us they had received training that enabled them to deliver care that met people’s needs. They also told us they felt well supported by the provider in their work.

We spoke with 3 people who use the service during our visit. We were unable to talk to other people who live at the home due to their age related memory loss however we did speak to family members and staff. People who use the service told us that they were treated well by the staff and said that staff were kind. They said that they were happy living at A Woodlands House and said that they had no concerns. They also told us that they knew how to make a complaint if they needed to and were confident that the manager would respond appropriately to any concerns that may be raised.

Relatives of people told us that they were happy with the care provided and said that people’s privacy and dignity was respected. The majority confirmed to us that they were consulted about the care and support their relatives receive but one person told us “We have not been invited to formal reviews or seen care plans although I know we can arrange this at any time”. All said that they were able to visit whenever they wished and that they were always made welcome by the manager and staff. They told us that they had no concerns about the staff at the home and said staff were kind and caring.

We spoke with staff during the visit to the home and they told us that the training provided was good and that if they had any training needs they could discuss this with the manager who would arrange appropriate training for them. They also told us that the staffing levels were sufficient and confirmed that additional staff are deployed when required. Staff said that they all worked well together as a team.

A Woodlands House is a residential care home which provides care and support for up to 14 older people living with dementia. At the time of our inspection there were 13 people living at the home.

The service 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 registered manager is also one of the providers; they were in day to day charge and worked alongside staff in order to provide care for people. The provider is the person who has the legal responsibility for meeting the requirements of the law. Providers are often the owner of the service and are the ‘registered person’ with the CQC. 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.

Staff were aware of their responsibilities in relation to keeping people safe .Staff felt that reported signs of suspected abuse would be taken seriously and knew who to contact externally should they feel their concerns had not been dealt with appropriately.

Systems were in place to identify risks and protect people from harm. Risk assessments were in place and reviewed monthly. Where someone was identified as being at risk actions were identified on how to reduce the risk and referrals were made to health professionals as required.

Policies and procedures were in place to ensure the safe ordering, administration, storage and disposal of medicines. Medicines were managed, stored, given to people as prescribed and disposed of safely.

Safe recruitment practices were followed. Disclosure and Barring Service checks (DBS) had been requested and were present in all checked records. There were sufficient numbers of staff on duty to keep people safe and meet their needs. The registered manager told us that they did not use agency staff as they liked to ensure that staff had a good understanding of people’s needs and the care they needed.

People’s rights were upheld as the principles of the Mental Capacity Act and the Deprivation of Liberty Safeguards had been adhered to. The registered manager had made DoLS applications for all the people living at the home to ensure people’s rights were protected.

Staff spoke with us about the range of training they received which included safeguarding, food hygiene and dementia training. Relatives felt that staff were suitably trained and felt confident that they knew how to support people with dementia.

People were supported to maintain good health and had access to health professionals. Dietary needs and nutritional requirements had been assessed and recorded. Weight charts were seen and had been completed appropriately on a monthly basis.

Staff knew people well and they were treated in a dignified and respectful way. A relative told us “they are remarkably patient, I’ve never heard a raised voice. They have some well-developed interpersonal skills”.

The care that people received was responsive to their needs. People’s care plans contained information about their life history and staff spoke with us about the importance of knowing people’s backgrounds. Staff told us “we let them settle in gently the first few days and we sit and chat about likes and dislikes”, “we sit and have a cup of tea and make them feel at ease”.

Quality assurance systems were in place to regularly review the quality of the service that was provided. Feedback from people, relatives and professionals were sought to monitor quality.

Relatives told us the home was well led and that there was regular contact with the registered manager.

Staff and relatives spoke positively of the registered manager and deputy manager. A relative told us “the main thing is they’re approachable if I wanted to chat I know I can”.