We inspected Woodham Lodge on 13 September 2017. We informed the provider of our visit the day before our inspection. We did this because the service is a small care home and people who use the service are often out and we needed to be sure somebody was in at the time of our inspection. When we last inspected the service in July 2015 we found that the provider was meeting the legal requirements in the areas that we looked at and rated the service as Good. At this inspection we found the service remained Good.

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. The registered manager was not present for the inspection.

Woodham Lodge is registered to provide care and support for a maximum number of six people who have learning disabilities and / or physical disabilities. At the time of the inspection there were six people who used the service.

People were protected by the services approach to safeguarding and whistle blowing. There were systems and processes in place to protect people from the risk of harm. Staff were aware of safeguarding procedures, could describe what they would do if they thought somebody was being mistreated and said that management acted appropriately to any concerns brought to their attention.

Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety was maintained. Risks to people’s safety had been assessed by staff and records of these assessments had been reviewed. This meant staff had the guidance they needed to help people to remain safe

There were sufficient staff on duty during the day to meet the needs of people who used the service. Night staffing levels had changed to one waking night staff member and one sleeping night staff member who alternated each week between Woodham Lodge and one of the providers other services which was on the same plot of land. The sleeping staff member was shared across both services and woken if people needed support. We have asked the provider for additional information about the current staffing arrangements on night duty and will follow this up outside of the inspection process.

We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

Appropriate systems were in place for the management of medicines so that people received their medicines safely.

Staff had received induction training and shadowed other more experienced staff when they were first recruited. Staff had the knowledge and skills to support people who used the service. The majority of staff training was up to date and where there were gaps this training had been organised.

Staff had an understanding of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards and acted in the best interest of people they supported, however at the time of the inspection, processes had not been followed to formally record this. Information was supplied to us after the inspection to confirm that staff at the service had completed this process.

We saw that people were provided with a choice of healthy food and drinks, which helped to ensure that their nutritional needs were met. People were supported to maintain good health and had access to healthcare professionals and services. People were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments.

There were positive interactions between people and staff. We saw that staff treated people with dignity and respect. Staff were ki

The inspection took place on 20 July 2015. The inspection was unannounced.

The home provides care for up to six people with complex physical and learning disability needs. On the day of our inspection there were six people using the service. All six people had lived at Woodham Grange since the home opened in 1993.

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.

We spoke with care staff who told us they felt much supported and that the registered manager was always available and approachable. Throughout the day we saw that people and staff were very comfortable and relaxed with the registered manager and staff on duty. The atmosphere was calm and relaxed and we saw staff interacted with people in a very friendly, affectionate and respectful manner.

Care records contained risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary. We saw records were kept where people were assisted to attend appointments with various health and social care professionals to ensure they received care, treatment and support for their specific conditions.

We found people’s care plans were written in a way to describe their care, treatment and support needs. These were regularly evaluated, reviewed and updated. The care plan format was easy for service users or their representatives to understand by using pictures and symbols. We saw evidence to demonstrate that people or their representatives were involved in their care planning.

The staff that we spoke with understood the procedures they needed to follow to ensure that people were kept safe. They were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.

Our observations during the inspection showed us that people were supported by sufficient numbers of staff. We saw staff were very responsive to people’s needs and wishes.

When we looked at the staff training records they showed us staff were supported to maintain and develop their skills through training and development activities. The staff we spoke with confirmed they attended both face to face and e-learning training to maintain their skills. They told us they had regular supervisions with a senior member of staff, where they had the opportunity to discuss their care practice and identify further training needs. We also viewed records that showed us there were robust recruitment processes in place.

The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

During the inspection we saw staff were attentive and very caring when supporting people. Written comments from relatives were very consistent stating they were extremely happy with the care, treatment and support the home provided. Other professionals we spoke to were very positive about the care provided at Woodham Lodge.

We observed people were encouraged to participate in activities that were meaningful to them. For example, we saw staff spending time engaging people with people on a one to one basis, and others went on an outing in the mini bus. We saw holidays had been planned for people using the service.

We saw people were encouraged to eat and drink sufficient amounts to meet their needs. We observed people being offered a selection of choices. For those people that required assistance to eat their meal, this was carried out in a dignified and discreet manner.

We found the building met the needs of the people who used the service. For example, the environment was suitable for people who used a walking aid and wheelchair users. We were told that work on the refurbishment of the home will commence in August 2015.

We saw a complaints procedure was displayed in the main reception of the home. This provided information on the action to take if someone wished to make a complaint.

We found an effective quality assurance system operated. The service had been regularly reviewed through a range of internal and external audits. Prompt action had been taken to improve the service or put right any shortfalls they had found. We found people who used the service, their representatives and other healthcare professionals were regularly asked for their views.

During our inspection we asked the provider, staff and people who used the service specific questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions, as mentioned above.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, and the staff supporting them and from looking at records.

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

Is the service safe?

People who used the service had very complex physical and learning disability support needs. Not all were able to communicate verbally. However, we observed people to be comfortable in the presence of the staff team. We saw that staff used various and effective communication techniques to communicate with people. We saw and observed lots of positive interactions with staff and people who used the service.

We saw the provider had a rigorous training programme in place for staff. The staff training and observations helped to ensure people living in the home were appropriately supported and protected from harm.

People who lived in the home had regular assessments carried out and an annual review with their care managers. This ensured peoples care and support needs were current, effective, safe and protected their rights.

The senior support worker told us the provider used a dependency tool to work out how many staff were required on duty each day. This meant people who used the service received the correct level of care and support. When we spoke with the three support workers, they told us there was always enough staff on duty each day to meet people's needs.

Is the service effective?

We saw people who used the service and other professionals were involved with the planning of their care and the level of assistance they wanted wherever possible.

People’s care plans were individual and person centred, detailing individuals likes and dislikes, preferences and religious beliefs.

People who lived at the home were given access to specialist health care professionals including, dentists, opticians, and chiropodists to help ensure their wider health needs were being met.

Is the service caring?

People who received help with personal care were treated kindly and with respect. People smiled a lot were happy with the care staff and we saw their preferences being taken into account. For example, what they wanted to do during the day, and where they wanted to go on holiday. Two people had just returned from a weeks holiday in Bridlington and two people were out shopping with staff to purchase new clothes.

Is the service responsive?

People who used the service, their family, friends and other professional who worked with them were regularly asked for their views on the way the service was run. Responses to surveys were analysed and used to enable the manager to make changes to the service where needed.

Is the service well lead?

The staff working at the home told us they felt supported in their roles and were happy with the level of training they received. Staff were confident that any concerns or complaints they may have would be dealt with quickly, appropriately and in confidence.

Woodham Lodge provided care for up to six people with learning disabilities.

At the time of our inspection, the manager was on holiday.

We spoke to everyone living at the home during the visit, although most found it difficult to express their experiences of living there. One person said, “It’s ok". The same person then smiled.

We found the home had a very friendly atmosphere. It was very clean and tidy and the people living there looked happy and content.

We spoke to two relatives at the inspection visit and one relative said, “We are welcomed and kept informed”. Another relative said, “From a care prospective I would highly recommend”. The same relative said, “The décor could do with a lick of paint, but that is being seen to”.

We found appropriate arrangements in place to manage people’s medicines.

We were unable to check staff records as the manager was on holiday and held the key to the locked cupboard in which they were held. However we were able to check electronic training records including a training matrix which confirmed regular training occurred.

We saw a complaints book in the reception area along with the complaints policy.

We asked one person what they would do if they did not like something or did not want to do something. They indicated that they would tell the staff. One relative we spoke to confirmed that they knew how to complain and said. “I have never had to complain as they listen and change things that might not be working”.

The manager told us they always ensured they carefully assessed the care and support needs of people. All people their relatives, representatives’ and health care professionals, where necessary were involved in this process. We saw detailed care plans of how staff would then help people to meet their needs. This meant staff had the information they needed to support each person and keep them safe.

The arrangements for supporting people to make decisions about their daily lives and preferences were recorded in their care plans. Each person was supported to take appropriate risks to promote as much independence as possible.

All people who used the service had lived together since the home opened 21 years ago. The relationships between staff and the people who lived there were good and personal support was provided in a way that promoted and protected their privacy and dignity.

The standard of the accommodation, décor and furniture and fittings were very good and provided a clean and comfortable place to live.

There was a stable and competent staff team who had the training, skills and experience to meet the specific needs of the people who lived there.

The health and safety of the people who lived in the home was taken seriously, and the proper checks and tests of safety equipment were in place.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. We spoke with staff, observed people and care practices, and looked at care records.

We saw people had their own style of communication, for example body language, facial expressions, gestures and signs which staff understood and responded to.

We saw people were given time to express their needs and were involved in making day to day decisions. People were supported in a way which was mindful of their right to respect, dignity and privacy. People appeared relaxed, content and at ease in their surroundings.