The inspection took place on 14 November 2016 and was unannounced. The service provides accommodation and personal care for up to 29 people some of whom are living with dementia. On the day of our inspection 27 people were using the service. At our last inspection in April 2014, the service was meeting the standards of our inspection methodology.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 were protected from the risk of abuse as staff had attended training to provide them with knowledge and an understanding of their roles and responsibilities with guidance in how to respond if they suspected abuse was happening. Staff were aware of the different types of abuse and what measures they should put in place to help people maintain their independence while supporting them to be safe.

People were supported by a sufficient number of experienced and caring staff. We saw over the meal times that staff were extremely busy and managerial staff were involved with serving and supporting people with their dietary requirements. The manager told us they were keeping the staffing ratio under close review to gauge if additional staffing were required. The provider had ensured appropriate recruitment checks had been carried out on staff before they commenced work to determine they were suitable to work with the people living at the service.

The provider had systems in place to manage medicines and people were supported to take their prescribed medicines safely. People were encouraged to self-medicate where it was safe for them to do so. Just prior to our visit the pharmacist supplying the service medication had carried out a full inspection which was overall satisfactory with a few recommendations.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. MCA, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals. Some people at the service were subject to the Deprivation of Liberty Safeguards (DoLS). Staff had been trained and had a good understanding of the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. The MCA records could have been more closely related to other parts of the care plan which would certainly assist any bank, agency or unfamiliar staff to know and understand the relative’s needs. We understand that this will be addressed through care reviews.

People’s health needs were managed appropriately with input from relevant health care professionals. People were treated with kindness and respect by staff who knew them well. People were supported to maintain a nutritionally balanced diet and sufficient fluid intake to maintain good health. Staff ensured that people’s health needs were effectively monitored. The staff were aware of individual health needs and responded to people’s concerns and behaviours in an appropriate and compassionate manner.

Positive and caring relationships had been developed between the people and staff. People were supported to make day to day decisions and were treated with dignity and respect at all times. People were given choices in their daily routines and their privacy and dignity was respected. People were supported and enabled to be as independent as possible in all aspects

We spoke with five people who used the service and four members of staff. We considered our inspection findings to answer questions we always ask: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found:

Is the service safe?

When we arrived at the service the deputy manager asked to see our identification and asked us to sign in the visitor's book. One person told us, “I feel safe living here because there are always staff on duty including at night.”

There have been no applications made under the Mental Capacity Act (MCA) 2005 in relation to a Deprivation of Liberty Safeguards (DoLS).We saw that there was a policy and procedure in place and that training for staff was planned.

Is the service effective?

People's care records showed that care and treatment was planned and delivered and each person’s care records were reviewed monthly.

Is the service caring?

One person told us, “The food is lovely and beautifully cooked.” People who used the service had been invited to complete a satisfaction questionnaire in September 2013 all were either satisfied or well satisfied with the service.

Is the service responsive?

People using the service were provided with the opportunity to participate in activities which interested them. An activity co-ordinator worked in the service for five sessions per week. One person told us, “I enjoy the activities.” They also informed us they knew how to make a complaint if they were unhappy.

Is the service well-led?

The service worked with other services to ensure people received the planned care.

We spoke with four people who used the service, relatives and five members of staff as part of this inspection. People who used the service told us that the staff were polite and friendly, the food was good and they felt safe especially at night.

One person stated, "I like to be left alone when I want which the staff respect, but the staff do help me when required." another person told us, "The staff help me to go to Stowmarket and nothing is too much trouble."

We found the service was compliant in five areas. The environment was well maintained and odour free. The service has a garden which was available for the people to enjoy as was the garden tea-room. The equipment within the service was well maintained and regularly checked and the staff had received supervision, appraisals and on-going training support.

The service was non-compliant in one outcome and we have told the service to work upon this particular aspect of care delivery, monitoring and recording

This was a follow up visit to assess to the compliance and ongoing maintenance of standards in relation to the care and welfare of people and monitoring the quality of the service. We had previously made two compliance actions in these areas. We had concerns that people’s health safety and welfare was not being maintained and the provider had not noticed this through their own monitoring of the service. At this inspection were pleased to note progress had been made.

Care plans had been reviewed and were now accessible to staff and people living at the service. They were up to date and gave clear instruction to people on how best to meet people's needs. Risk assessments had been completed, training had been sourced and attended and advice from professionals had been sought. This meant that people at Woodfield Court were receiving appropriate care and support.

We met a relative and a person who lived at the service. Both were very complimentary about the service. Both said they would recommend it to others. The person living at the service said “I can’t find fault at all. I like to be independent where I can and they help me. If I want something more I just ask. I know if I had a problem they would sort it out”.

We observed that people who use this service were treated with respect and dignity. Staff knocked on people’s bedroom doors before entering. Any question or query that people who use the service had was followed up and treated as important. We saw that solutions were found by staff to the individuals satisfaction. Examples during our visit included an unexpected postal delivery for one person and a concern about a car arriving to transport a person.

We saw that relatives and visiting professionals were made welcome and treated with warmth and respect. We saw that GPs and district nurses visited the service to support staff in ensuring people’s health and welfare was maintained.

We met and spoke with five people who use the service. People told us that care staff worked hard to support them and took their views and experience into account when providing care and support. One person told us, “This is just the job. It has everything I want. If I need for anything, I just ask and the staff sort it out.”

Two people were able to communicate and confirmed they had personal care plans and that they were involved in writing these.

People using the service told us that they felt safe. We were told that if they had any concerns they would speak to the managers of the service as they felt confident matters would be resolved, or that they would speak to their relatives. Two relatives we spoke with felt confident that the management of the home would deal well with any concerns they raised. Both relatives told us they were very satisfied with the care and support their relative received.

People who use the service told us that they were happy with the care they received at Woodfield Court. One person we spoke with commented “Its very peaceful living here”. Other people commented “Yes I suppose I am quite happy” and “I like living here its ok”.

We spent some time observing the care being provided at the home. Whilst staff did provide the required care and support there was limited positive interactions (the way in which people are engaged with) and on occasion, some negative interaction by them. We have expanded on these observations in Outcome 4 of this report.