Woodgrange provides nursing and residential care in three separate units. The units provide care for people who require residential care, people who require nursing care and a separate unit 'Memory Lane' that provides care for people living with dementia. They are registered to provide care for up to 64 people. At the time of our inspection there were 62 people living at the home.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

There was a registered manager 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.

On the day of our inspection staff interacted well with people. People and their relatives told us that they felt safe and well cared for. Staff knew how to keep people safe. The provider had systems and processes in place to keep people safe. Medicines were administered and managed safely.

We found that people’s health care needs were assessed and care planned and delivered to meet those needs. People had access to healthcare professionals such as the district nurse and GP and also specialist professionals. People had their nutritional needs assessed and were supported with their meals to keep them healthy. Where people had specialist dietary needs appropriate arrangements were put in place to support them to manage these.

There were sufficient staff to meet people’s needs and staff responded in a timely and appropriate manner to people. Staff were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs. The provider had a training plan in place and staff had received supervision.

Staff felt able to raise concerns and issues with management. Relatives and people who lived at the service were aware of the process for raising concerns and were confident that they would be listened to. Regular audits were carried out and action plans put in place to address any issues which were identified.

Accidents and incidents were recorded and investigated. The provider had informed us of notifications. Notifications are events which have happened in the service that the provider is required to tell us about.

Further information is in the detailed findings below.

This inspection took place on 5 August 2015 and was unannounced. Woodgrange provides care for older people who have mental and physical health needs including people living with dementia. It provides accommodation for up to 62 people who require personal and nursing care. At the time of our inspection there were 61 people living at the home. The location is divided into three units, a unit for people who require residential care, a nursing unit and a specialist unit providing dementia care.

At the time of our inspection there was a registered manager 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

On the day of our inspection we found that staff in all the units interacted well with people and people were cared for safely. People and their relatives told us that they felt safe and well cared for. Staff were able to tell us about how to keep people safe. The provider had systems and processes in place to keep people safe.

The provider acted in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. If the location is a care home the Care Quality Commission is required by law to monitor the operation of the DoLS, and to report on what we find.

We found that people’s health care needs were assessed and care planned and delivered

to meet those needs. People had access to other healthcare professionals such as a dietician and GP and were supported to eat enough to keep them healthy. People had access to drinks and snacks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.

There were usually sufficient staff to meet people’s needs and staff responded in a timely and appropriate manner to people. However the dementia care unit did not have sufficient staff some times during the day. Staff were kind and sensitive to people when they were providing support and people had their privacy and dignity considered.

Staff had a good understanding of people’s needs and were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs. The provider had a training plan in place and staff had received regular supervision, however they had not received appraisals.

We saw that staff obtained people’s consent before providing care to them. People had access to activities and community facilities.

Staff felt able to raise concerns and issues with management. Relatives were clear about the process for raising concerns and were confident that they would be listened to. The complaints process was on display however it was only available in written form so not everyone could access it.

Regular audits were carried out and action plans put in place to address any issues which were identified. Audits were in place for areas such as falls and infection control.

Accidents and incidents were recorded. The provider had informed us of incidents as required by law. Notifications are events which have happened in the service that the provider is required to tell us about.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.

This was an unannounced inspection. During the inspection, we spoke with four people living at the home, four relatives, four nurses, one care staff, the registered manager and the chef. We also spoke with a visiting professional by telephone following our visit.

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.

Woodgrange provides accommodation and nursing care for up to 64 people who have nursing or dementia care needs. There were 59 people living at the home when we visited. Two of the people were not living there permanently. The home provides accommodation in two units. One of the units (Memory Lane) specialises in providing care for people with dementia.

People told us positive things about the service they received. People and their relatives said that they were very happy with the service. In addition, our own observations and the records we looked at supported this view.

People told us that they felt safe and well cared for. When we spoke with staff they were able to tell us about how to keep people safe. However we observed occasions when there were insufficient staff available to meet people’s needs. For example when we carried out observations in The Memory Lane unit we found that during the second half hour of our observation there was insufficient staff available to meet people’s needs.

The provider acted in accordance with the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS). The provisions of the MCA are used to protect people who might not be able to make informed decisions on their own about the care or treatment they received. At the time of our inspection there was one person who was subject to DoLS.

We found that people’s health care needs were assessed, and care planned and delivered

to meet those needs. People had access to other healthcare professionals such as a dietician and a chiropodist.

People were supported to eat enough to keep them healthy. People had access to a range of snacks and drinks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.

We looked at records of fluid intake and found there were gaps in the completion of the record which could put people at risk of not having sufficient fluids because accurate monitoring was not in place.

People told us that they felt their privacy and dignity were respected and made positive comments about staff. During our inspection we observed one occasion when we considered a person’s dignity was not taken into account as staff were providing care to one person and talking about another. We saw that care took into account people’s preferences.

Staff were provided with both internal and external training. In particular, staff told us that they had participated in dementia care training. The registered manager told us that all staff received an element of this training so that they were able to understand the needs of people with dementia. Staff told us they had received an induction when they started work with the provider.

We saw that staff obtained people’s consent before providing care and were aware of how to respond if people refused care. People and relatives were aware of their care plans

Staff told us that they would usually raise concerns with the nursing staff rather than the registered manager as they knew them better. We found people and relatives were not consistently sure about the process for raising concerns.

We looked at four care plans for people who used the service. These were personalised and provided detailed guidance about how people’s needs should be met.

We noted members of staff spoke appropriately to people in a friendly manner. One person said, “They look after us very well.” Another person told us, “I feel very safe here, the staff are very kind.”

The chef told us how they would meet with each person on admission to the home to find out about their eating preferences. We also saw minutes from monthly nutrition meetings between the chef and the team leaders from each unit.

Following lunch, the people commented on quality of the meal. One person said, “That lunch was very good.”

We looked around the home and observed a high overall standard of cleanliness. We saw people’s rooms were clean and communal areas were clean and tidy. The home was free from mal odour.

In each of the communal lounges we saw at least three members of care staff interacting and communicating with people. One person who lived at the home told us,” The staff are first class; they are always around when you need them. They are always talking to you too.”

We asked people at the home if they were able to make complaints and how these were managed. One person gave us the names of the people they would approach with complaints. Another person said they had no need to complain because they were happy with the care they received.

One relative told us, “Woodgrange is very homely, there are objects everywhere which stimulate XXX’s mind; they seem to have a put a lot of thought into everything.”

We found that people were cared for in a clean, well presented home. People’s care was based about their individual needs. The staff provided care in a pleasant and professional manner. One person living at the home said, “I can’t say anything negative about the staff, they’re all marvellous.”

We saw staff had time to interact with people. The home has a full-time activities coordinator who organised a wide range of activities. On the day we visited we saw a group word game in the morning and a conker competition in the afternoon.

We saw the trained chef provided a choice of hot and cold foods at each mealtime and snacks throughout the day.