We inspected Woodside on 22 February 2016. The inspection visit was unannounced.

Woodside provides accommodation for people in a residential setting and is registered to provide care for up to 40 people. There were 35 people living at the home when we inspected the service. People were cared for over three floors of the home.

A requirement of the provider’s registration is that they have a 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 and associated Regulations about how the service is run. There was a registered manager in post at the time of our inspection. We refer to the registered manager as the manager in the body of this report.

At our previous inspection on 26 August 2015 we found the provider was not meeting all of the required standards. We identified one breach in the legal requirements and regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found care and treatment was not always provided with the consent of the relevant person. We asked the provider to make improvements in this area. The provider had sent to us an action plan by the required date which stated all of the required improvements would be undertaken by the end of November 2015. During this inspection we checked improvements had been made. We found sufficient action had been taken in response to the previous breach of the regulations.

The manager and staff understood their responsibilities under the Mental Capacity Act (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure people were looked after in a way that did not inappropriately restrict their freedom. The manager had made applications to the local authority where people’s freedom was restricted in accordance with DoLS and the MCA.

Staff received training in safeguarding adults and were able to explain the correct procedure to follow if they had concerns. All necessary checks had been completed before new staff started work at the home to make sure, as far as possible, they were safe to work with the people who lived there.

Each person had a care and support plan with detailed information and guidance personal to them. Care plans included information on maintaining the person's health, their daily routines and preferences. We found people were supported with their health needs and had access to a range of healthcare professionals where a need had been identified. There were systems in place to ensure that medicines were stored and administered safely.

The manager and staff identified risks to people who used the service and took action to manage identified risks and keep people safe. People were encouraged to eat a balanced diet that took account of their preferences and where necessary, their nutritional needs were monitored.

There were enough staff employed at the service to care for people safely and effectively. New staff completed an induction programme when they started work to ensure they had the skills they needed to support people effectively. Staff received training and had regular meetings with their manager in which their performance and development was discussed.

Care staff treated people with respect and dignity, and supported people to maintain their privacy and independence. People made choices about who visited them at the home. This helped people maintain personal relationships with people that were important to them.

People were supported in a range of activities, both inside and outside the home. Staff were caring and encouraged people to be involved in decisions about their life and their support needs. People were able to make decisions about their environment and choose how their bedroom was decorated which made it personal to them.

People who us

We carried out this inspection on 26 August 2015. The inspection was unannounced.

Woodside is registered for a maximum of 40 people offering accommodation for people who require nursing or personal care. At the time of our inspection there were 38 people living at the home. Two people were in hospital. Several people using the service were living with dementia and had high level care needs which required the support of two care workers.

A requirement of the service’s registration is that they have a 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A registered manager was in post and had been since April 2015. This person was on annual leave at the time of our inspection.

People who were considered to lack capacity were not always supported in line with the Mental Capacity Act 2005 (MCA). Staff obtained consent from people before supporting them, however care records did not always show people had provided consent to their care.

There were processes to minimise risks to people’s safety, however care records did not always reflect people’s current care needs, so we could not be assured that all risks were being managed. Following assessment, arrangements had not always been made so that equipment was available for people’s use in order to maintain their safety, however the provider told us staff had put in safety measures to reduce the risks.

People told us they felt safe living at the home and could raise any concerns they had with staff. Staff were trained in safeguarding people and understood how to protect people from abuse.

People received their medicines in a timely way from staff trained to administer them. Overall there were enough staff to support people, however people did not always receive support at the times they preferred.

Checks were carried out prior to staff starting work to ensure their suitability to work with people who lived in the home. Staff received training which gave them the skills and understanding to support people with their health and social care needs.

People told us staff were kind and respectful and had the right skills to provide the care and support they required. Staff treated people with dignity and respect. People told us they enjoyed the food at the home and had a choice of meals and drinks, which they could have at times to suit them.

People were referred to other health professionals when required, however this was not always done in a timely way. Care records contained relevant information to help staff provide people with personalised care. People were involved in their care and were asked for their views and opinions about the support they received. People told us they enjoyed the activities on offer at the home.

People told us they could raise any concerns with the registered manager, and these would be listened to and acted upon. People, relatives and staff told us the management team were approachable and responsive. The management team kept people informed of the proposed changes within the service. There were processes to understand the experiences of people who lived within the home. This was through regular communication with people and staff and a programme of other checks and audits. However, audits to monitor the quality and safety of the care provided had not identified information on care records was not always up to date, and assessments were not always completed to assess people’s abilities to make decisions.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

On the day of our inspection there were 39 people living at Woodside. We spoke with eight members of staff, five people who used the service and three relatives. We looked at policies and processes, six care records and staff records and rotas to gain an insight into the care provided.

We saw that people and their families were involved in decisions about the care provided and details of their needs and interests were included in their care records.

Care plans and risk assessments were updated regularly to ensure people received the care they needed. There were a variety of activities designed to meet people's needs and maintain their independence. People told us they liked living at Woodside. One person told us, “I wouldn’t want to live anywhere else.”

We reviewed the way that medicines were managed and found that adequate safeguards were in place to administer people's medication.

There were adequate numbers of staff on duty and staff received appropriate support and training to enable them to care for the people who lived there. Staff told us they really liked working at Woodside and that the provider was very supportive. One person told us, “Staff can’t do enough.”

Records were stored securely and were fit for purpose. We saw that processes were in place to allow staff to access information required to deliver care. We saw that people’s information was protected and that staff were supported to maintain confidentiality.

When we visited Woodside we met with most of the people using the service and spoke with three people in more depth about their experience of care at Woodside. We met and spoke with three relatives, the registered manager and service manager. We spoke briefly with members of staff delivering care at the time and spoke in depth with three staff members about how they delivered care to people that used the service.

People who used the service told us they were happy with the way staff provided their care. They told us, “The staff are very good. I wouldn’t go anywhere else” and “The food is good and family and friends can visit when they want too.”

We asked relatives about the care provided to their family member and they each told us that the care delivered to people was good. They told us, “Everything is fine. It is warm here and clean” and “Mom has settled in well, we have no problems.”

We saw people's bedrooms were clean, warm and well furnished. People had brought some personal items with them into the care home and this made their rooms "homely."

Staff told us they had regular training, which meant they could support the specific needs of people who used the service.

People who used the service, and their relatives, told us they had no concerns and were confident that should they report a concern it would be dealt with promptly.

During this review we visited five of the provider's care homes. We visited The Limes on 14 June 2011, we visited Westlands on 15 June 2011, we visted Fourways on 16 June 2011, we visited Woodside on 21 June 2011 and we visited The Sycamores on 22 June 2011.

We spoke with 17 people using these services and eight relatives who were visiting at the time. People told us they liked living at the care home and felt well cared for. One person told us 'we like it because staff 'speak nicely' and said staff were ‘friendly’ towards them. People told us they were happy with the care they received and encouraged by staff to maintain as much independence as possible. We saw people making their own drinks when they wanted to and helping with the washing up after lunch. People told us they liked doing this. Each person we spoke with told us they felt safe and would be able to talk to staff if they felt concerned about their care. Some people were not able to talk to us about their care because of their dementia, however when we asked them if they were comfortable they smiled and nodded.

We asked people about the food being served to them and they told us they enjoyed their meals and there was always a choice.

Relatives told us they had no concerns about how their family member was being cared for. They told us that care given was 'respectful' and 'nothing was to much trouble'.

Relatives we spoke with at each care home told us that staff had ‘time for everybody’ and the managers were very approachable. Relatives liked the way that they could be involved with the care of their family member and join in with activities if they wanted to. Relatives made particular comments about how well the staff kept them informed about their family member's care needs.

Relatives told us the food looked good and people always had sufficient to eat and drink. They told us that snacks and drinks were always ‘available' and they could make a cup of tea for their family member whenever they visited.