This inspection was carried out on 7 January 2019 and was unannounced.

Woodside Residential care home is a ‘care home’. People in care homes receive accommodation and 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. Woodside Residential home is registered to provide accommodation and personal care for up to 30 older people. The service care for people living with Dementia. At the time of our inspection there were 27 people living in the service. Accommodation is arranged over three floors.

At our last inspection we rated the service as Good. 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.

At this inspection we found the service remained Good.

Woodside residential care home was undergoing an extension to the current building. This would add additional bedrooms to the service as well as additional communal space.. The new lounge would include large doors out to a secure garden area that people could use at any time. At present the service does not have any outside space. There would be a new kitchen and dining room. A library was planned and a volunteer had been found to read books and newspapers to people living at the service.

The builder understood they needed to make sure the work created the least disruption for the people living at the service; only the project manager entered the service, all other builders remained outside and all external work would be completed before doing anything inside. They anticipated the build to be completed by the end of 2019.

People experienced a service that was safe. Staff had received training about protecting people from abuse, and they knew what action to take if they suspected abuse. Risks to people’s safety had been assessed and people were supported to take positive risks. The premises were maintained and checked to help to keep people safe.

Staff were supported to fulfil their role in meeting people’s needs. The complaints policy was accessible to people using the service.

People were given their medicines safely and when they needed them. Policies and procedures were in place so that people received their medicines when needed. People were supported to remain as healthy as possible and they had been given access to healthcare professionals when needed.

People had access to the food and drink that they enjoyed. People were supported to choose what they wanted to eat and drink, their nutrition and hydration needs had been assessed and recorded.

People were treated with kindness and respect. Their needs had been assessed and support had been provided to meet these needs.

People were central to the support they received. Care and support was planned with people and their relatives and reviewed to ensure people continued to have the support that they needed. People were encouraged to be as independent as possible.

People took part in activities of their choice and could choose what they wanted to do each day. There were enough staff to support people to participate in the activities they chose.

Processes were in place to monitor quality and people were asked for feedback about the service provided.

Services are required to prominently display their CQC performance rating. The provider had displayed the rating in the entrance hall. The CQC rating was also displayed on their website.

Further information is in the detailed findings below.

Care service description

Woodside Residential Care Home can provide accommodation and personal care for 32 people living with dementia. Accommodation is arranged over three floors and comprises of five double rooms for couples or those wishing to share, and twenty two single rooms. At the time of the inspection there were 26 people living at the service.

Rating at last inspection

At the last inspection, the service was rated Good and Requires Improvement in the ‘Safe’ domain.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 8 June 2016. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach of Regulation 12 of the Health and Social Care Act Regulated Activities Regulations 2014, Safe care and treatment. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Woodside Residential Home on our website at www.cqc.org.uk

At this inspection we found the service remained Good overall and is now rated Good in the Safe domain.

Why the service is rated Good

People told us they felt safe using the service and staff were helpful and kind. A visitor told us they would recommend the service.

The service had improved since the last inspection. Care records included risk assessments of people’s mobility, and their potential risk of falls, together with detailed guidance to move people safely and consistently. People’s risk assessments regarding the use of bed rails had been reviewed and measures were in place to reduce the risks of people falling out of bed.

People were positively supported with their behaviour. There was guidance in place about what action the staff needed to take to make sure the person and everyone else was safe. Health care professionals told us that the staff followed their recommendations to support people with their behaviour and systems were in place to ensure people’s needs were reviewed and updated. Communication within the staff team had improved to ensure that people’s health care needs were being monitored and met.

Staff knew how to recognise and respond to abuse. They had received training on how to keep people safe.

Regular checks were made on the premises and equipment to ensure it was safe. Each person had a personal emergency evacuation plan (PEEP) in the event of an emergency, A PEEP sets out the specific physical and communication requirements that each person has to ensure that they can be safely evacuated from the service in the event of a fire. Staff were involved in regular fire drills.

Accident and incident records and monthly fall audits were reviewed. Any concerns were investigated and action taken such as referrals to the falls clinic for further assessment.

There were sufficient numbers of staff on duty at all times to ensure that people’s needs were met.

New staff had been recruited safely and checks were carried out on staff to make sure they were suitable and safe to work with people.

People received their medicines safely and there were robust systems in place to ensure that medicines were stored correctly and safely.

This inspection took place on 8 June 2016 and was unannounced.

Woodside Residential Care Home can provide accommodation and personal care for 32 people living with dementia. Accommodation is arranged over three floors and comprises of five double rooms for couples or those wishing to share, and twenty two single rooms. At the time of the inspection there were 26 people living at the service.

There was a registered manager working at the 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 and associated Regulations about how the service is run.

People were protected against the risks of potential abuse. All staff had attended training about safeguarding people from harm and abuse, and staff knew about different types of abuse and how to raise concerns. People were supported with their finances to ensure they had access to cash when they wanted to.

Risks to people were identified and assessed. Care records included risk assessments of people’s mobility, and their potential risk of falls; however they did not always have step by step guidance to move people safely and consistently.

There were systems in place to identify and manage any risks to people’s health and wellbeing. Accident and incident records and monthly fall audits was reviewed. Any concerns were investigated and action taken such as referrals to the falls clinic for further assessment.

The staff carried out regular health and safety checks of the environment and equipment. This helped to ensure that people lived in a safe environment and that equipment was safe to use. People had a personal emergency evacuation plan (PEEP) in the event of an emergency, and staff were involved in fire drills.

People received their medicines safely and there were robust systems in place to ensure that medicines were stored correctly and safely.

There were sufficient numbers of staff on duty at all times. Staff had support from the registered manager to make sure they could care safely and effectively for people. The registered manager and head of care were involved with supporting people on a day to day basis. Staff had received regular one to one meetings and an annual appraisal with a senior member of staff.

People received care from staff who had been trained to meet their individual needs. Staff completed induction training when they first started to work at the service, which included shadowing established staff before they worked on their own.

The policies and procedures to recruit staff ensured that staff employed to support people were suitable to do so. All the checks that needed to be carried out on staff to make sure they were suitable and safe to work with people had been completed.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). At the time of the inspection some people had DoLs authorisations in place and the registered manager had applied for further authorisations for other people who were at risk of having their liberty restricted. There were mental capacity assessments in place to assess if people needed to be considered for any restrictions to their freedom.

Before people decided to live at the service their support needs were assessed by the registered manager to ensure their needs would be met. People and their relatives were involved in the assessment. Care plans contained details of people’s preferences and choices, however, in some cases further detail was required to show how people’s personalised care was being provided. This was an area for improvement. The plans had been reviewed to make sure staff were aware of people’s current care needs. People’s health care needs were monitored and met, with health care professionals being involved i

One inspector carried out this inspection. We spoke with four people using the service, three visitors, the manager and six members of staff. We looked at range of records including five care plans, monitoring records, risk assessments, medicine records, staffing rotas, meeting minutes and auditing records. There were 28 people using the service at the time of our inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

The service was safe.

People told us they felt safe and we observed staff who understood how to protect people's rights and safeguarded the people they supported.

People's care needs and the qualifications, skills and experience of the staff were taken into account when making decisions about staffing numbers required to the meet the needs of people who used the service.

Is the service effective?

The service was effective.

People received the care outlined in their care plan in the way it was agreed. Staff understood people’s care plans and knew what people’s needs were.

People's health and care needs were assessed and they were involved in their plans of care. Specialist needs including nutrition and dementia care needs had been identified in care plans where required.

Is the service caring?

The service was caring.

People that we spoke to said they were happy living in the home. Relatives said they thought staff were kind and caring.

Staff were patient when supporting people and treated them with respect. People’s preferences and interests had been recorded, and care and support was provided in accordance with people’s wishes.

Is the service responsive?

Records showed the service responded to changes in people’s health needs and made referrals to other professionals when needed.

We found that the managers was approachable and encouraged people to voice any concerns or ideas for change.

Is the service well led?

The service was well led.

There was a clear management structure in place.

Staff told us they were clear about their roles and responsibilities and that they felt supported by the management team.

Systems were in place to ask people who used the service, relatives and staff for their views about the service. People’s views were taken into account to improve the service.

Audits of the service provided had been completed to assess the quality of the care.

You can see our judgements on the front page of this report.

We received information from whistle blowers who raised concerns that the care being provided to the people using the service was not fully meeting their needs. We found that when people’s care needs changed we could not be sure that people were getting the care and support that they needed to promote their health and well-being. Care plans did not always reflect the individual and personalised care being provided.

The provider had taken steps to make sure people were protected from abuse.

We found the home to be clean and tidy and free from unpleasant odours. There was a system in place for infection control to protect people from the risk of infection.

The systems in place to manage the administration of medication did not ensure that people received their medicines at the times they needed them and in a safe way.

Although there were checks on the quality of service being provided we could not be assured that these were effective to make sure people were protected from inappropriate or unsafe care.

We used a number of different methods to help us understand the experiences of people using the service. Many of the people using the service were not always able to tell us about their experiences. We observed how people interacted with staff and the management of the service. We saw the atmosphere in the service was calm and relaxed.

People using the services, relatives and visitors told us that they were satisfied with the care being provided. Relatives said: “We took my relative out and when we arrived back at Woodside she said “it's lovely to be home! That confirmed to me that she is happy here". “The staff are excellent, kind, friendly and cheerful” “I have nothing but praise for the care given at Woodside”. A visitor said: “I visit many different homes in the area. I can honestly say this is the best – first class care".

The staff told us that consent for care and support was obtained from people using the service or their representatives during discussion about the care and support the person needed.

Staff recruitment records showed that new staff had been thoroughly checked to make sure they were suitable to work with vulnerable people.

People and relatives told us they did not have any complaints but would not hesitate to speak to the manger or staff if they had any concerns.

During our visit we saw that people were being treated with dignity and respect and people’s independence was encouraged. People were spoken to in a respectful way.

People we spoke to and visiting friends and relatives told us that they were very happy with the care provided. One visitor said “we are happy with the care” and the staff “are always happy”.

We saw that people experienced safe and effective care based on detailed care plans that encouraged independence. There were risk assessments that met individual needs and provided good guidance to staff to minimise potential risks. We saw that good nutritional care was provided in a way that met people’s needs and preferences.

People using the service were protected from abuse as they were supported by a staff team who had appropriate knowledge and training on safeguarding adults. People we spoke to told us if they had any concerns they would report them to the manager or senior person on duty.

Staff we spoke to and records we reviewed, demonstrated that there were the appropriate number of staff on duty at the right times, to meet people’s needs. Staff were appropriately inducted and supported. They received ongoing training and supervision which provided them with the skills and knowledge to meet the changing needs of the people they were supporting.

The provider had systems in place to monitor and assess the quality of the service. Information was used to review and improve the way care was delivered.

Some of the people who use services had special communication needs. They used a combination of short phrases, individual words, gestures and signs to express themselves. We did a number of things to consult with these people. These included observing a small number of them for a period of time so that we could assess how they were feeling and how helpful they were finding the assistance they received.

People said or showed us that the staff treated them with respect and supported them to raise any concerns they had. They said or showed us that they received the health and personal care they needed and that they were comfortable in their home. One person said, 'I get on okay with the staff and they're nice to me'. A carer (relative) said, 'the staff really do look after the residents in the best possible way'.