Woodland Residential Home Limited is a residential care home. It is registered with us to provide accommodation and care to a maximum of 38 older people, some of whom may be living with dementia. On the day of our inspection 30 people were living at the home. People’s bedrooms are all situated on the ground floor. People have access to communal areas within the home and access to the home's gardens.

The home was last inspected on 1 October 2015, where we gave the service an overall rating of good. At our last inspection, we rated the key question of well-led as requires improvement. This was because the provider had not ensured the quality monitoring systems in place were effective in identifying where improvement was needed. At this inspection, we have given the service an overall rating of good and kept the key question of well-led as requires improvement.

The provider had systems in place to monitor the quality of care provided. At our last inspection we found these were not effective in identifying when people’s care records had not been updated or reviewed. At this inspection we again found some people’s care records were not up to date or reviewed in line with the provider’s system. The provider had also failed to notify us when applications to lawfully deprive people of their liberty had been authorised.

People were happy with the care and support they received and gave positive comments about the staff and management at the home. Staff felt supported in their roles and were confident that if they had concerns these would be listened to.

People continued to feel safe living at the home. Staff had received training in and understood how to protect people from any harm and abuse. Staff knew how to and were confident in reporting any concerns they may have about a person’s safety. Plans were in place to help to reduce any risks to people’s safety and wellbeing, although these were not always reviewed in line with the provider's systems. Staff understood the support they needed to give to people to keep them safe. People were happy they were supported by sufficient numbers of staff to safely meet their needs. People received their medicines safely and when they needed them, as prescribed.

Staff received the training and support they needed to support people effectively. Staff sought people’s consent and people’s right to make their own decisions about their own care and treatment was supported by staff. People were supported to eat and drink enough and had a choice as to where to eat their meals. People’s nutritional needs and any risks associated with these were assessed and reviewed as required.

People were supported by staff who knew them well and had good relationships with them. People were involved in their own care and staff treated them with dignity and respect.

People received care that was individual to them and responsive to their needs. People knew how to raise concerns and complaints about their care and felt comfortable to do so if needed.

Further information is in the detailed findings below.

A single inspector carried out this inspection. We carried out the inspection to check that the provider had made the necessary improvements to address shortfalls identified at our last visit in April 2014 with the management of medicines. We focused on answering one key question, is the service safe?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. As part of this inspection we spoke with four people who used the service.

This is a summary of what we found-

Is the service safe?

Appropriate arrangements were in place to manage medicines. People spoken with were happy with the way their medication was managed by staff. One person told us, “I receive my medicines daily and they are on the ball with everything.” Another person told us, “I always receive my medicines”.

The service had suitable arrangements for the safe storage of medicines. Appropriate arrangements were in place in relation to the recording of medicines. We noticed improvements in the completion of the Medication Administration Records (MAR). On the whole, the MAR showed that people had been given their medicines as prescribed. This meant that people were protected against the risks associated with medication.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

• Is the service safe?

• Is the service caring?

• Is the service responsive?

• Is the service effective?

• Is the service well led?

This is a summary of what we found-

Is the service safe?

People were supported in a relaxed and unhurried way by a team of staff who were very experienced in caring for older people. There were enough qualified, skilled and experienced staff to safely meet people’s needs.

Risks to people had been identified, assessed and kept under review.

Appropriate arrangements were not in place to safely manage medicines. The medication administration records were not always accurate and it was not always possible to determine if people had been given their medicines as prescribed. This meant that people were not protected against the risks associated with medication. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to the management of medicines.

Is the service caring?

People spoken with were positive about the care and treatment they received. One person commented that staff were, “Pretty good” and another person told us that staff were, “Wonderful”.

Staff interactions were supportive and respectful. Staff assisted people sensitively, whilst at the same time promoting people’s independence as much as possible. Staff demonstrated a good understanding of people's needs and preferences.

Is the service responsive?

People told us they felt able to raise concerns. One person told us, “I always speak my mind, they are pretty good at listening”.

The service responded to people's changing needs. People had access to support and advice from the multidisciplinary team.

Is the service effective?

People's needs were assessed and care and treatment was planned and delivered in line with their individual needs. People told us that they felt the service met their needs. It was clear from our observations and from speaking with staff that they had a good understanding of the people's care and support needs.

People were protected from the risks of inadequate nutrition and dehydration. People were provided with a choice of suitable and nutritious food and drink, which was freshly prepared in the home. Special diets were catered for including diabetic, vegetarian and soft diets.

Is the service well led?

The registered manager left their employment at the service at the end of March 2014. A replacement manager had been recruited and was due to start employment in May 2014. The provider assured us that the replacement manager would submit an application form to register with the Care Quality Commission as the registered manager of the service as soon as possible.

Staff felt part of a good team and that they were well supported.

The quality of service provided by the home was regularly assessed and monitored. Staff confirmed that medication audits took place regularly, although due to the recent departure of the registered manager, this had been difficult to maintain. Satisfaction surveys had been sent out to people who used the service, their relatives/advocates and visiting professionals.

We talked to six people, four staff and the manager. We looked at four care records and other records related to the running of the home. We had a look around the home and talked to people in their bedrooms, with their permission.

People told us that they were very satisfied with the care and support they were offered. One person said that they couldn't get, "Better treatment anywhere". Staff were described as, "Very kind" and, "Always helpful".

People were very clear that their consent was sought by the service in relation to how care was provided. Staff were clear about the importance of involving and working with people to make sure people had positive experiences of care.

Care plans contained clear guidance for staff on people's needs and how these should be met. This was done in a way that reflected people's individuality and preferences. Records were reviewed and updated when people's circumstances changed.

The home was clean, tidy and well maintained. Regular safety and maintenance checks were being carried out to make sure that the premises were safe and suitable for people's needs. People were very pleased to be able to arrange their bedrooms in line with their personal preferences.

The service supplied people with information about how to raise any concerns and complaints.

We visited unannounced on the 30 July 2012. There were 35 people living in the home on the day of the visit. We spoke to three staff, the registered manager, a member of the management team, seven people who lived at the home and a visitor. We looked at three care records, three staff records and other records related to the running of the home.

People told us that they were very satisfied with the care and support they were offered at the home. One person told us that it was an “excellent home”. People spoke in a very positive way about the staff and management team and comments included that staff were “helpful”, “kind” and “marvellous”. People were satisfied with the food served at the home with one person describing it as “excellent”. One person described the home as “lively, with lots going on” which was why they had chosen to live there.

Care files clearly recorded that people were supported to access health and medical professionals and detailed records of any treatment that was necessary were recorded.

Measures were in place to keep people at the home safe by providing staff with information about how to do this and access to regular training. People told us that they felt safe at the home and had confidence in the staff that looked after them.

Systems were in place to make sure that only people who were suitable worked at the home so that people who lived there were kept safe.

The home evaluated the service provided to make sure that people were safe and well cared for but the findings were not always recorded.

Records were kept securely but were not all accurate, up to date and reflective of people’s circumstances which could compromise their care. The home was aware of this and measures were in place to address this issue.

This inspection took place on 30 September 2015 and 1 October 2015 and was unannounced. At our previous inspection no improvements were identified as needed.

Woodland Residential Care Home Limited is registered to provide accommodation with personal care to a maximum of 37 older people. There were 33 people living at the home on the day of our inspection.

A registered manager had not been in post since June 2014. It is a requirement of the provider’s registration with us that they have a registered manager in post. A manager was in place who had applied with us to register as the 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.

Systems were in place to monitor the quality of service provision but these did not always identify how improvements would or had been made when issues were found. Some people’s care records did not always reflect what staff told us about people’s care although this care was delivered safely.

Staff understood their role in providing safe care to people. They had received training to be able to recognise when people might be at risk and understood the procedures they needed to follow if they suspected people were at risk of danger, harm or abuse.

People were supported to take their medicine by staff who were trained to assist them. People received their care and support when they needed and wanted it and were not kept waiting by staff. The provider had recruitment processes in place to make sure staff were suitable to work at the home.

Staff knew the needs of the people they supported and had received training to meet their needs effectively. Managers supported staff in their roles and monitored their training needs.

People’s right to make their own decisions and choices was respected by staff. Staff understood how to support people to make their own decisions about their day to day care.

People enjoyed the food they received and had a choice of what they could eat and drink. Staff were aware of people’s preferences and made sure they received food that met their needs. Staff sought professional advice when they had concerns about people’s ability to eat and drink safely. People were supported to maintain good health and healthcare appointments were arranged at the home when they needed it. People were also supported to attend healthcare appointments outside of the home.

Staff were caring and considerate. They cared for people with dignity and they respected their privacy and choices. Staff supported people to be involved in their own care and to maintain their independence.

People spent their time how they wanted to and staff supported them to do this. People identified how they wanted their care delivered and this information was used by staff to make sure they received a personalised service.

People and their families had not made any complaints in the last 12 months about the quality of care they received. Feedback and comments were encouraged by the provider and people were supported to give their opinions.

The home had a positive culture which put people first and staff worked for the benefit of the people who lived there.