We carried out this inspection on 31 January 2018. The inspection was unannounced. This meant no-one at the service knew we were planning to visit.

Wood Hill House 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. Wood Hill House is registered to provide accommodation for persons who require nursing or personal care and treatment of disease, disorder and injury. The service is a detached property within its own grounds and can accommodate a maximum of 83 people. There are a total of five floors, including a ground and lower ground floor. The service was organised into six units; Longley 1, Longley 2, Devonshire, Endcliffe, Weston and Richmond. At the time of the inspection there were 67 people living at the home.

At our last inspection we rated the service 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.

There was a manager at the service who was registered with the CQC. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 spoken with were very positive about their experience of living at Wood Hill House. They told us they were happy, felt safe and were respected.

We identified improvements were needed to the design, adaptation and decoration of the service to make it more stimulating for people living with dementia.

The service provided a programme of activities to suit people’s preferences. People spoken with gave mixed feedback about the quality of activities provided.

Sufficient numbers of staff were provided to meet people’s needs. We saw staff responded in a timely way when people required assistance. We spent time observing lunch on each unit and saw that there was a relaxed and calm atmosphere on all units. Devonshire unit differed slightly; we observed less social interaction taking place and staff appeared more rushed when serving food.

We found systems were in place to make sure people received their medicines safely so their health needs were met. Medicine protocols were in place to guide staff when to administer medicines prescribed on an ‘as and when’ basis to meet people’s health needs.

Staff recruitment procedures were in place. The registered provider ensured pre-employment checks were carried out prior to new staff commencing employment to make sure they were safe to employ.

Staff were provided with relevant training, which gave them the skills they needed to undertake their role. Staff knew people well and positive, caring relationships had been developed. People were encouraged to express their views and they were involved in decisions about their care. People’s privacy and dignity was respected and promoted. Staff understood how to support people in a sensitive way.

People’s care records contained detailed information and reflected the care and support being given.

There were systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the registered provider’s policies and systems supported this practice.

We carried out this inspection on 20 April 2015 and it was unannounced.

Our last full inspection of the service took place on 18 November 2013 and we found the service was not compliant with some of the regulations we inspected at that time. We carried out a follow up inspection on 4 March 2014 to see action the service had taken to become compliant and found, on this visit, the service was fully compliant.

Wood Hill House was registered in September 2013. It is an 83 bedded service providing short stay rehabilitation and intermediate care and nursing to adults aged 18+. Services are provided in partnership with the local NHS trust. The service is located in the Grimesthorpe area of Sheffield, a short distance from the city centre. At the time of inspection, there were 35 people using the service, with one unit closed due to reduced demand.

It is a condition of registration with the Care Quality Commission that the service has a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. The registered manager was present on the day of our inspection.

People and their relatives told us they felt the service was safe, effective, caring, responsive and well led.

People were protected from abuse and the service followed adequate and effective safeguarding procedures. Care records were personalised and contained relevant information for staff to provide personalised care and support to people who used the service.

The service followed good practice in relation to the decision making processes and in line with the Mental Capacity code of practice, with the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards being followed.

Medicines at the home were managed well and the medication competency assessments were carried out on an annual basis for all staff who administered medicines.

Formal staff supervision had not been carried out on a regular basis. We spoke with the registered manager about this, who told us they were aware this was an issue and were seeking to address it. Staff appraisals had not been completed on an annual basis but staff still felt supported by management. The registered manager told us they would ensure this was done in future.

Quality monitoring systems at the service had not been carried out on a regular basis. We spoke with the registered manager about this, who told us they would ensure these were carried out with the appropriate frequency in future.

Most staff were up to date with their training requirements and any refresher training requirements had been identified and were being addressed.

During our inspection, we found the service was fully compliant with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People we spoke with told us that they felt that they were well looked after. One person told us that the staff took “good care of us”, and another told us that they got plenty of help when they needed it.

We observed care taking place within the home and saw that people were routinely treated with dignity and respect. Staff showed consideration for people’s preferences and wishes when they spoke with them, and regularly checked on people’s wellbeing.

People we spoke with were positive about their experience of receiving care and support at Wood Hill House. One person said: “Staff take me out for a walk, which I like.” Another person told us that they enjoyed the food. They said there was always a choice and the quality was good. However, we found that the provider did not always meet people’s care needs.

We found that people’s privacy was not always respected, and the arrangements for involving people in their own care were inadequate.

We checked the property and found that it was well maintained and decorated. Communal rooms were laid out so that people could get around easily. The dining areas were suitably spaced so that people could eat their meals in a quiet environment

We checked staff files and saw that arrangements were in place to commence providing supervision and appraisal for staff. At the time of the inspection the home had not been open very long and therefore the supervision programme had not begun for the staff we checked.

People were made aware of the complaints system. This was provided in a format that met their needs. The provider had a complaints policy in place which was available throughout the service.