We carried out this unannounced inspection on 21 and 22 August 2018. Woodlands Quaker Care Home is a care home without nursing. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The inspection was prompted in part by a notification of an incident which raised concern about staffs understanding of Cardiopulmonary Resuscitation (CPR) and when this should be used. This inspection examined those risks.

Woodlands Quaker is a residential home that provides personal care and accommodation for up to 44 older people. The service accommodates up to 35 people in the 'Main House' and up to 9 people in a self-contained unit called 'The Spinney'. The Spinney accommodates people with higher levels of dependency, most of whom are living with dementia. At the time of the inspection there were 44 people living at the service.

A registered manager was in post. 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.

Staff understood their responsibility to report any concerns and were aware of the action to take if they suspected abuse had occurred. People were supported to manage their risks by staff who were aware of the need to protect people from avoidable harm. There were sufficient numbers of staff available to meet people’s care and support needs. The provider recruited staff safely. People received their medicines as prescribed. The environment was well maintained and clean. Systems were in place to monitor infection control.

Staff had the knowledge and skills required to provide effective care. People’s care needs had been assessed and they were involved in the development of their care records. People were asked for their consent before care was provided and their decisions were respected. People’s capacity to make decisions had been assessed and staff understood the principles of the Mental Capacity Act. Staff ensured people had enough food and drink and received support from relevant healthcare professionals when required.

People received support from kind and caring staff. People were encouraged to make their own choices and decisions. People were supported to maintain their independence and staff supported people in a way that respected their privacy and dignity.

People were involved in the planning and review of their care and care records were reflective of their needs. Information about changes to people’s care needs was shared with staff to ensure people continued to receive the support required. People had access to a wide range of activities and hobbies which met their individual interests. People knew who to contact if they were unhappy about any aspect of their care. The provider had systems in place to manage complaints effectively.

People felt the service was well-led and said they were happy with the care they received. People and staff felt confident to share their ideas and the registered manager used these to make improvements. There were effective quality audit systems in place to monitor the quality of service people received.

This inspection took place on 9 and 10 February 2016 and was unannounced. At the last inspection completed 9 April 2014 the service was meeting all legal requirements inspected.

Woodlands Quaker is a residential home that provides personal care and accommodation for up to 44 older people. The service accommodates up to 35 people in the ‘Main House’ and up to 9 people in a self contained unit called ‘The Spinney’. The Spinney accommodates people with higher levels of dependency, most of whom are living with dementia. At the time of the inspection there were 44 people living at the service and a registered manager was in post. 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 told us that they felt safe living at the service and we found they were protected by staff who could recognise any potential signs of abuse. Risks to people were reduced through the use of risk assessments and effective reporting of accidents and incidents. People received their medicines as prescribed. Staff were recruited safely and background checks were completed for all staff members and volunteers. People were supported by sufficient numbers of staff to keep them safe.

People were supported by a staff team who had received the training and support they needed to carry out their roles effectively. People were supported to understand and consent to the care they received. Where they lacked the capacity to provide consent or make decisions about their care, the principles of the Mental Capacity Act 2005 were followed. People enjoyed the food and drink they received and their nutritional needs were met. People’s day to day health needs were met and they were supported to access healthcare professionals where needed.

People were supported by a kind and caring staff team who knew them and supported their individual preferences. People were encouraged to make choices about their day to day care. We saw that people’s privacy and dignity were protected by staff and their independence was promoted. People were supported to maintain relationships that were important to them.

People and their relatives were involved in the development and review of their care plans. They received the care and support they needed. People had access to leisure opportunities and plans were in place to further develop the range of activities that people could access. People told us that they were able to raise complaints if they needed to. We saw that complaints were responded to appropriately.

People and staff were involved in the development of the service. The registered manager proactively sought people’s views in order to identify areas for improvement. The service was well-led by management and managers made themselves visible and available to people. Quality assurance systems were in place in order to identify and action areas for improvement within the service.

The inspection team consisted of one inspector. We gathered evidence to help us to answer out five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them and from looking at records.

Is the service caring?

The people we spoke with were positive about the way they were cared and supported. One person told us: "Care is excellent and staff have the patience of Jobe". People were cared for by kind and attentive staff. We observed people asking staff to do things for them. Staff responded to the requests promptly and efficiently.

Is the service responsive?

During our inspection an accident occured. We observed that staff took immediate and appropriate action to assist the person. When people who lived in the home made suggestions for changes these were actioned as far as practically possible. The service worked well with external professionals to make sure people received good standards of care.

Is the service safe?

People were treated with dignity and respect by staff. People told us they felt safe and we observed a relaxed atmosphere. Safeguarding procedures were robust and staff had received training including annual refresher courses. Staff we spoke with demonstrated a good knowledge of safeguarding and how to respond when concerns arose. There were risk management plans in place for people and health and safety. We noted that there were enough staff allocated to care for people and ensure their safety.

Is the service effective?

People's health and care needs had been assessed and care plans were in place. There was evidence of people and or their relatives being involved with the development and regular reviews of care plans. Staff encouraged and supported people in leading interesting and enriched lifestyles.

Is the service well led?

The service had a quality assurance system in place that involved people who lived in the home, visitors and all staff. Records showed us that improvements had been made when they were identified through monitoring processes. Staff told us they were clear about their roles and responsibilities.

During this inspection, we spoke with 10 people, two relatives, four staff members, one visiting healthcare professional and the home manager.

People’s care was planned and delivered appropriately. Records showed that people received care and treatment from other healthcare professionals. One person said, “I cannot speak highly enough of this place.”

Arrangements were in place to ensure that people received their medicines as prescribed. People we spoke with told us they received their medicines in a timely manner.

We found that selection and recruitment processes were robust to ensure that only suitable staff were employed to work with people. One person said, “The staff are very caring and patient.”

People and their relatives knew how to complain. People’s comments and complaints were taken seriously and responded to appropriately. One person said, “Any niggles I have are sorted out straight away.”

Records were fit for purpose and accurate. People’s confidentiality was maintained in the way that records were stored.

We carried out this review to check on the care and welfare of people. There were 43 people living at the home on the day of the inspection, including eight people in the dementia unit. We spoke with seven people, one relative, three staff, and the home manager.

We saw that people were well presented and wore clothes that reflected their own preferences, style, and gender. We found that people were involved in making care and treatment choices, which staff respected. One person said, "It is up to me, I choose."

We found that people’s care records were detailed and staff delivered care that met people’s needs and preferences. We saw that people had a wide range of activities they could take part in. On person told us, “There is always plenty to do here.” This meant that people's needs were met.

We found that arrangements were in place to ensure that people were safeguarded from abuse.

We found that staff were supported through supervision, appraisals, and training to carry out their role appropriately. One person said, “The staff are well trained so everyone gets what they need.”

We found that systems to monitor the quality of services were effective at identifying shortfalls in the home and action was taken to make improvements. One person said, “This is a wonderful place to live.”

People using the service told us that they were very satisfied with the care that was provided. They said the staff were patient and helpful and that they enjoyed the food.

Some comments included –

“The staff look after me very well. I couldn’t be in a better place”.

“I am alright I have no complaints I am satisfied with my lot”.

Some people were unable to make comment but they appeared comfortable and content in their surroundings.