This comprehensive inspection took place on 4 and 7 February 2019 and was unannounced on the first day.

Woodeaves Residential Care Home (Woodeaves) 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.

The home is located in a residential area on the outskirts of Nantwich and covers three floors connected by a passenger lift, a stair lift and stairs. Communal facilities include two lounges and one dining room which are located on the ground floor. Woodeaves could accommodate up to 22 people. At the time of the inspection there were 20 people living at the home. This was because two of the rooms could be occupied on a shared basis but were currently occupied as single accommodation.

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 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.

People continued to receive a safe service. Processes were in place to minimise the risk of harm. Accidents and incidents were recorded and there was management oversight to identify emerging trends. Detailed risk assessments were completed and regularly reviewed. Safe recruitment practices were employed by the home. Medicines were managed and administered safely. People told us staff came quickly when they needed them and that there were sufficient staff to meet their needs.

Staff were aware of the need to report concerns in order to protect people from abuse. However, there had been a delay in reporting an allegation to management. This was brought to the attention of the deputy manager on the first day of inspection and the correct process was then followed.

People received a service that was not consistently effective. This was because mental capacity assessments were carried out routinely for all people living at Woodeaves, rather than in line with the principles of the Mental Capacity Act 2005. This practice had been introduced as a requirement from a monitoring visit by the local authority and, although not appropriate, had not been questioned by the registered manager.

A person’s care plan had not been updated and was not reflective of their current needs which left them at risk of receiving care that was not effective. We observed there were long periods without staff interaction although they exhibited symptoms of anxiety. When we made the deputy manager aware of our concerns action was taken immediately to address whilst further liaison with a specialist team took place.

Staff received regular supervision and appraisal, their competency was regularly checked and they had access to a wide range of training.

The provider had introduced an electronic care management system since the last inspection. The registered manager informed us that there was still an element of “embedding in” for the most effective use. We saw that staff did not always carry the hand-held devices used for recording interventions at the point of delivery.

People continued to receive a service that was caring. People told us that staff were kind and gentle and we observed some caring and patient practice. The service had achieved a score of 9.8 out of ten from 33 reviews on a website which allows people who use, have u

The inspection tool place on 20 June 2016 and was unannounced.

The home was last inspected on 14 January 2014 and was meeting the required standard.

Woodeaves is a large detached Victorian house and is registered to provide accommodation for 22 people who require nursing or personal care. The home is located in a residential area on the outskirts of Nantwich. The home has twenty bedrooms. Communal facilities include two lounges and a dining room which are located on the ground floor. There is a small secluded garden area to the rear of the home. The home has a passenger lift to access the first and second floor and the majority of the bedrooms, four ground floor bedrooms are available.

The home had 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 2008 and associated Regulations about how the service is run.

People’s needs were assessed and care plans identified people’s needs whilst fostering and maintaining independence where possible.

Some people who used the service did not have the ability to make decisions about some aspects of their care and support. Staff had an understanding of the systems in place to protect people who lacked capacity to make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

Staff had good relationships with people who lived at the home and were attentive to their needs. Staff respected people’s privacy and dignity at all times and interacted with people in a caring, respectful and professional manner.

Staff were knowledgeable about the risks of abuse and the reporting processes.

We found that the storage, administration and disposal of medications was safe.

The organisation had thorough recruitment practices so that suitable staff were employed.

Staff received suitable induction and training to meet the needs of people living at the home. Staff were well supported by the manager. This meant people were being cared for by suitably qualified, supported and trained staff.

There were systems and processes in place to monitor the quality of the service and address shortfalls.

During our visit we spoke to four staff members who worked at Woodeaves this included the manager, the deputy manager, a senior carer and another care worker. We also spoke to four of the people who lived at Woodeaves and two relatives of the people who lived there.

Comments from the people who lived at Woodeaves included:

“I’ve been here for three years in February and had no problems at all”.

“In the main yes, I’m happy. The staff are pleasant, food is good, it’s clean, quite pleasant atmosphere”.

There were 19 people who currently lived at the home. We observed interaction between the people who lived at Woodeaves and the staff on duty and it was clear that their needs were well known to staff. It appeared that people living there were happy and content and they were given the support they needed.

One of the relatives we spoke with told us they had chosen if for their relative because “we found it friendly and homely”.

We asked staff what it was like working at Woodeaves and one of the care workers we spoke with told us “I love working here …I love the people”.

We looked at staff personal files and found that people who lived at the home were protected because appropriate checks were undertaken before staff were recruited and the people we spoke with who lived at Woodeaves told us they felt safe there and felt staff knew what they were doing.

We spoke to three people who live in the home and they told us that they "were very happy" and the staff were "very nice" and "very good". One person told us that they had had their Christmas party the other day and they told us that there was "lots of food" and that they had "eaten too much". We spoke to a family member who told us that they were very pleased with the home and that it had a "homely feel to it".

We spoke to people having their lunch and they told us that the food was "always very good" and "always plenty of it". We asked one person what they had had for lunch and they told us in detail and that it was "very nice".

We spoke to a family member and they told us that they were "very pleased with the home". We viewed records to ensure that people's care and support was being delivered in accordance with personal care plans and that equipment which was beng used to support people and promote their independence was used safely and properly maintained.

People we spoke with were happy with the support and care they received in Woodeaves. They told us that staff listen to any worries or concerns they may have and they were confident these would be listened to and acted upon. We were also told they were able to follow their daily routines as they wish.

People who use the service told us they receive the level of support they require to live as independently as possible. They like living in Woodeaves and like the staff who support them. They also told us staff help ensure they were kept safe and that their health and social care needs were being met. One person told us living in Woodeaves ensured they were able to continue living in their home town of Nantwich.

Overall people who use the service told us were satisfied with service they receive.

We were told by Cheshire East Social Services that they had carried out a quality monitoring visit of Woodeaves and had been accompanied by staff from the infection prevention and control team. The visit was part of their quality monitoring role. They had also received concerns about staffing levels and infection control within the service from a district nurse. They told us that following the visit, which had identified a number of areas of concern, the management of Woodeaves had addressed the majority of issues and that positive action had been taken.