This was an unannounced inspection that took place on 24 May 2018.

Woodlands is located within a purpose built complex of flats set in its own grounds on the outskirts of Penrith

This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service. At the time of our visit 13 people were receiving care and support.

The home had a suitably qualified and experienced 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.

We previously inspected this service in February 2017 and found the following breaches of the Health and Social Care Act; Regulation 17 Good Governance and Regulation 18 Staffing . In December 2016 we rated the service as 'Requires Improvement'. Following the last inspection we met with the provider and asked them to complete an action plan to show what they would do, and by when, to improve the service.

The staff team were aware of their responsibilities under the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Risk assessments and support plans provided guidance for staff. People who used the service were involved in writing support plans and were able to influence the content. The registered manager had ensured the plans reflected the person-centred care that was being delivered.

The staff team understood how to protect vulnerable adults from harm and abuse. Staff had received suitable training and talked to us about how they would identify any issues and how they would report them appropriately. Risk assessments and risk management plans outlined how people were to be kept safe. Arrangements were in place to ensure that new members of staff had been suitably checked before commencing employment. Any accidents or incidents had been reported to the Care Quality Commission as necessary and suitable action taken to lessen the risk of further issues.

The registered manager ensured that there were sufficient staff to meet people's needs. Our findings corroborated this. Staff were suitably inducted, trained and developed to give the best care possible. We met experienced and kind team members who understood people's needs.

Medicines were appropriately managed in the service with people having reviews of their medicines on a regular basis. People saw their GP and health specialists whenever necessary. They accessed hospital appointments as a matter of routine.

We saw that an assessment of needs was in place and that the staff team analysed the outcomes of care for effectiveness. Most people cooked for themselves or went out into the community for a meal. Those who chose to eat the food provided by the service were very complementary of it.

Suitable equipment was in place to support people including an adapted bath.

We observed kind, patient and suitable support being provided. Staff knew people well and made sure that confidentiality, privacy and dignity were maintained.

The registered manager had successfully improved the service since our last inspection and intended to develop it further. Staff were able to discuss good practice and issues around equality and diversity and people's rights.

Complaints and concerns were suitably investigated and dealt with. Good records manageme

The inspection took place on 22 February 2017 and was unannounced.

At our last inspection of this service three breaches of the legal requirements were found. These related to safe care and treatment; staffing and governance. Requirement notices were issued to the provider. The registered manager developed an action plan to help keep improvements on track. We found during the inspection that the targets set in the action plan had mostly been achieved.

Woodlands is an independent housing with care scheme. The scheme consists of 57 private apartments for older people. The service is registered to provide personal care to people living at the scheme. Each apartment has its own bathroom, living room, one or two bedrooms and a kitchen. People are encouraged to remain as independent as possible. The services offered include help with personal care, meals, medication and general domestic duties if required. There are extra charges for these services. The scheme also has communal lounge areas, a dining room and communal gardens, which people can use if they wish.

At the time of our inspection there were 16 people receiving the personal care service.

The registered manager was in attendance during our inspection. 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 this inspection we found that the provider had made improvements to meet the requirements of the regulations about safe care and treatment, staffing and governance, although further improvements were needed, particularly around staffing.

We found that people’s care plans and risk assessments had been reviewed and updated to help ensure they received safe care and support that met their needs and expectations.

We spoke to people who used this service. They told us that they were “pleased” with the care and support they received. They told us that they were “confident” that staff knew what they were doing. People told us that they were aware of the complaints process and that they knew who to speak to if they were not happy with any aspect of their service. The people we spoke to were positive about their care and of the staff who supported them.

We found that the service supported people, if they wished, to access health and social care professionals when necessary. Independence was respected and people who used the service told us that they were treated with dignity and kindness.

We reviewed a sample of the staff records. The service ensured that appropriate checks had been carried out to help make sure only suitable people had been recruited to work with vulnerable adults. We found that staff had been provided with appropriate training to help make sure they kept their skills and knowledge up to date. We also saw that staff received supervision and had their care practices monitored by senior staff. This helped to make sure that staff worked safely and in line with the policies and procedures of the service.

People who used the service and staff working at the service told us that the manager or the senior were available to speak to if necessary. The registered manager told us that they welcomed feedback from people, whether positive or negative. Feedback had been used to help improve the service.

We looked at how people were supported with their medicines. Although medicines had not always been managed appropriately, we found that the registered manager had taken steps to make improvements.

People who used the service were able to express their views on the service during meetings, when they had their support plans reviewed and via an annual survey carried out by the provider.

Although the staffing levels in the early part of the day had been improved, concerns remained with

The inspection took place on 7 and 11 April 2016 and was unannounced.

Woodlands is an independent housing with care scheme. The scheme consists of 57 private apartments for older people. The service is registered to provide personal care to people living at the scheme.

Each apartment has its own bathroom, living room, one or two bedrooms and a kitchen.

People are encouraged to remain as independent as possible. The services offered include help with personal care, meals, medication and general domestic duties if required. There are extra charges for these services. At the time of our inspection there were 11 people receiving personal care service.

The scheme also has communal lounge areas, a dining room and communal gardens, which people can use if they wish.

There is a registered manager at this service.

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 people we spoke to during our visit to this service all told us that they were “satisfied” with the service received and that they felt “safe”.

People who used this service described the staff to us. They said; “The girls (staff) are very nice indeed. They treat me well.” And “The staff are smashing, and are really nice. They know me very well.” One person told us; “I think the manager is very particular who is employed. You couldn’t wish for nicer staff.”

People told us that the staff “know what they are doing.” There were some differences of opinion regarding staff continuity. For example, one person said that they had the same “one or two staff” visiting them; whilst another described the difficulties they had experienced explaining their routines to new staff. At the time of our inspection the service was undertaking a staff recruitment drive.

People who used the service also commented: “They (staff) are very friendly and kind. I have the best of both worlds here as I am quite independent but there is always someone here if I need help.” and “The staff always arrive when I expect them. They are very nice indeed and don’t rush me.”

We found that there were insufficient numbers of staff on duty and this impacted on the standard and safety of support provided to people who used this service

People who used this service were not properly protected from the risks of receiving unsafe or inappropriate care. This was because care plans and risk assessments had not been reviewed and updated as people's needs changed.

Medicines were not managed appropriately and safely. Medication errors had been identified and where people needed help and support with their skin care, risk assessments, care plans and medicine administration records had been poorly maintained.

There were policies and procedures in place to help keep people safe from the risks of abuse. Staff had been trained in this subject and were able to describe the actions they would take should they suspect someone was being abused.

We found that staff were appropriately trained and supported in their work. This meant that they had the skills and knowledge to carry out their roles effectively and efficiently.

The service had policies and procedures in place with regards to the Mental Capacity Act and the deprivation of liberties safeguards. Staff at the home had received training to help them understand the legal processes.

People who used this service were treated kindly and with respect and dignity by the staff supporting them.

We found that people were able to comment on the quality and standard of the service they received and were able to meet with the registered manager on a regular basis.

Personal information about people who used this service had been kept securely and staff had received training about keep