The inspection visit took place on 07 and 08 June 2018. The first day of the inspection was unannounced. This meant people living at Woodhill House Home for Older People, their relatives, the registered manager and staff working there didn’t know we were visiting.

Woodhill House Home for Older People is a ‘care home’. 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.

Woodhill House Home for Older People provides accommodation and residential care for up to 46 people. It is a two-story building located in a quiet residential area of Morecambe. At the time of our inspection visit there were 43 people who lived at the home. People who live at Woodhill House Home for Older People are older people who may be living with dementia. It is a local authority residential home and is currently divided into four areas or suites. One of the suites is residential, providing care for people who have no mental health needs. The other three suites support people that require personal care and mental health support.

The service had 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.

At our last inspection in February 2016 the service was rated as good. At this inspection visit carried out in June 2018, we found the registered provider did not consistently ensure all staff working unsupervised at the home had received training on safeguarding people who may be vulnerable from abuse. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) 2014 – Safe care and treatment.

Care plans and information compiled to share with health professionals did not always contain clear, up to date and accurate information on people’s medical, emotional and physical needs and choices.

Although auditing systems were in place, systems and processes were not consistently implemented to ensure compliance with the Regulations. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014 – Good governance.

We looked at recruitment procedures to ensure people were supported by suitably qualified and experienced staff. Records we viewed did not consistently have a full employment history included. We have made a recommendation about this.

We looked at a sample of records related to the administration and storage of medicines and observed a staff member administering medicines. Stock totals on site did not consistently match documented totals. It was difficult to assess how much medicine one person had received when they self-administered it with an inhaler. We have made a recommendation about this.

Relatives told us staff treated their family members as individuals and delivered personalised care that was centred on them as an individual. We saw evidence that people were supported to access healthcare professionals when required.

Staff delivered end of life care that promoted people’s preferred priorities of care.

The registered provider had dementia friendly signage around the home to ensure people were living in an environment that promoted their safety, independence and positive wellbeing.

We saw staff were responsive to each person’s changing needs. They worked together to ensure people who became agitated were offered support to meet their needs and soothe their agitation.

We saw evidence that indicated people had the opportunity to participate in regular activities to promote their physical and emotional wellbeing.

There were systems to record safeguarding concerns, accidents and incidents

The inspection visit at Woodhill House Home for Older People was undertaken on the 29 February 2016 and was unannounced.

Woodhill House Home for Older People is a two story building located in a quiet residential area of Morecambe. At the time of our inspection visit there were 42 people who lived at the home. People who live at Woodhill House Home for Older People are older people who may be living with dementia. It is a local authority residential home and is currently divided into three areas or suites. One of the suites is residential, providing care for people who have no mental health needs. The other two suites support people that require personal care and mental health support.

The service had 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.

At the last inspection on 24 October 2013, we found the provider was meeting the requirements of the regulations that were inspected.

During this inspection, staff had received abuse training and understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of vulnerable adults. Staff we spoke with told us they were aware of the safeguarding procedure.

The provider had recruitment and selection procedures in place to minimise the risk of inappropriate employees working with vulnerable people. Checks had been completed prior to any staff commencing work at the service. This was confirmed from discussions with staff.

We found staffing levels were suitable with an appropriate skill mix to meet the needs of people who used the service.

Staff responsible for assisting people with their medicines were trained to ensure they were competent and had the skills required. Medicines were safely kept and appropriate arrangements for storing medicines were in place.

Staff received training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

People and their representatives told us they were involved in their care and had discussed and consented to their care. We found staff had an understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

Comments we received demonstrated people were satisfied with their care . The registered manager and staff were clear about their roles and responsibilities. They were committed to providing a good standard of care and support to people who lived at the home.

A complaints procedure was available and people we spoke with said they knew how to complain. Staff spoken with felt the registered manager was accessible, supportive and approachable and would listen and act on concerns raised.

The registered manager had sought feedback from people who lived at the home and staff. They had formally consulted with people they supported and their relatives for input on how the service could continually improve. The registered manager had regularly completed a range of audits to maintain people’s safety and welfare.

During our inspection we looked at care, staff training records and staff supervision arrangements. We checked maintenance records and undertook a tour of the building. We also spoke with a number of people living at the home and staff throughout the inspection. We observed the quality of care and support provided by staff during the inspection. We did this to confirm people were having their care needs met. We also wanted to identify that staff had been well trained and appropriate support arrangements were in place for them.

We found people were being supported by staff who had been trained and appropriate support arrangements were in place for them. The home had been well maintained and was clean and hygienic when we visited. Good care practices were observed and people were having their nutritional needs met.

We observed the staff team providing sensitive and flexible personal care support. The staff were kind and patient and showed a good understanding of the needs of the person in their care.

The people we spoke with said they were happy and enjoyed living at the home. One person said, “I am receiving the best care possible. I have never had cause to complain about anything from the day I moved in. The girls look after me really well”.

During our inspection we contacted the Lancashire contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.

We invited an expert by experience to join us on the inspection. These are people who have had experience of using services either personally or as a carer and contribute their perspective to the inspection process.

We spent time meeting and talking with people who lived at Woodhill House, their family and friends, and with other professionals and members of the staff team. We noted that the relationship between the care staff and the people who lived at Woodhill House was very warm and friendly.

People told us,” We keep a close eye on our weekly visits and are very happy”.

“I come in regularly and have nothing but praise for the place”.

“There have been lots of changes to cope with and the staff has been very supportive, as a family we are delighted”.

“I feel safe and well looked after”.

“It is absolutely fantastic, the staff are caring and everyone is very well cared for”.