This inspection took place on 26 and 28 March 2018. The first day was unannounced, however we informed staff we would be returning for a second day to complete the inspection and announced this in advance.

Woodlands Court is owned by Minster Care Management Limited and is located in the New Springs area of Wigan. Woodlands Court offers accommodation for up to 40 people who require assistance with personal care and support.

At the time of the inspection there were 32 people living at the home.

Woodlands Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At our last inspection of Woodlands Court in June 2017, the home was rated as ‘Inadequate’, with multiple breaches of the regulations identified. These were with regards to person centred care, dignity and respect, safe care and treatment, safeguarding people from abuse, premises and equipment, good governance and staffing. Warning notices were issued due to the concerns relating to safe care and treatment and good governance.

Since then the home had entered a Service Improvement Plan (SIP) with Wigan local authority which involved a series of multi agency meetings to support the home to make the improvements needed. This comprehensive inspection checked to see if the concerns from the previous inspection had been addressed. We found significant improvements had been made across all areas of the home.

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 about how the service is run.

People who used the service and their relatives told us they felt the service was safe. There were appropriate risk assessments in place with guidance on how to minimise risk. Staff recruitment was robust with appropriate checks undertaken before staff started working at the home.

Everybody we spoke with told us there were sufficient amounts of staff working at the home. There was a dependency tool used and this determined how many staff were required to care for people safely. During the inspection we observed staff attending to people’s care needs in a timely way.

We found staff received sufficient training, supervision and induction to support them in their role. The staff we spoke with told us they were happy with the training they received and felt supported to undertake their work. Appraisals had not yet been undertaken, however these were scheduled at the time of the inspection to be completed in April 2018.

The home were working within the requirements of the mental capacity act (MCA), with applications for deprivation of liberty safeguards (DOLS) made where people had been deemed to lack the capacity to consent to their care and treatment.

The people we spoke with said the food served at the home was of good quality and we saw people being supported to eat by staff at meal times. People were weighed on a regular basis and more frequently if they were identified as being at risk of losing weight.

We found the home worked closely with other health professionals and made appropriate referrals if there were concerns. Details of any visits from other professionals was recorded within people’s care plans.

We received positive feedback from people we spoke with about the care provided at the home. Visiting relatives said they they had no concerns with the care being delivered at the home. People said they felt treated with dignity and we observed staff treating people with respect during the inspection.

Each person living at the home had their own care plan in place which provided an overview of the

This inspection took place on 13 June 2017 and was unannounced. At our previous inspection in April 2015 we found no concerns and had rated the service as Good. At this inspection we found breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 as the service was not safe, effective, caring, responsive or well led. The service will be rated as Inadequate and placed into special measures.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration. For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Woodlands Court Care Home is registered to provide accommodation for up to 40 people who require assistance with personal care and support. There were 34 people using the service at the time of the 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 about how the service is run.

People were not always being safeguarded from abuse as not all incidents of suspected abuse had been referred to the safeguarding authority for further investigation. Risks of harm were not always minimised following incidents and accidents and staff did not always follow people's risk assessments to keep them safe from harm.

People's medicines were not stored and managed safely and medication audits had been ineffective in ensuring continuous improvement.

There were insufficient suitably trained staff to support people safely. The registered manager was in the process of recruiting to new positions. New staff were employed though safe recruitment procedures.

Infection control measures were not sufficient to ensure the environment and equipment in use was clean. As a result of this people were not protected from the risk of infection.

Health care advice was gained when people became unwell or their needs changed, however people's health care records were not always up to date and reflective of people's needs.

People were offered choices of food, however when people required their food and fluid monitoring this was not always completed. Some people were at risk of choking as they were being given food and drink which put them at risk of harm.

People were not always treated with dignity and respect and their right to privacy upheld. People were not always receiving care that met their needs and reflected their ind

This unannounced inspection took place on 20 April 2015.

Woodlands Court is a care home in the New Springs area of Wigan and is owned by Minster Care Group. The home is registered with the Care Quality Commission (CQC) to provide care for up to 40 people. The home provides care to those with residential needs on the ground floor of the home and care to people who live with dementia on the first floor. We last visited the home on 14 July 2014 and found the home was meeting the requirements of the regulations, in all the areas we looked at.

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 about how the service is run.

The people we spoke with and their relatives told us that they felt safe whilst living at the home. One person said to us; “I don’t know why, but I feel very safe living here”.

We found medication was handled safely and that people received their medicines at the times they needed it. Despite this, we saw that records for the temperature checks of both the treatment room and medicines fridge were inconsistent on a number of days. This meant that medicines may not work properly if they are not stored at the correct temperature. We raised this issue with management who told us they would address this with staff in the team meeting which was due to take place the day after our inspection.

During the inspection we spoke with staff about their understanding of safeguarding vulnerable adults. Each member of staff was able to describe the process they would follow if they suspected abuse was taking place. One member of staff said; “I would report anything straight to my senior or the home manager”.

We looked at staff personnel files to ensure that staff had been recruited safely, with appropriate checks undertaken. Each file we looked at contained application forms, CRB/DBS checks and evidence that at least two references had been sought from previous employers.

The home used a matrix to monitor the training requirements of staff. This showed us that staff were trained in core subjects such as safeguarding, moving and handling, infection control and health and safety. Each member of staff we spoke with told us they were happy with the training and support available to them.

There was a dining room on each floor of the home and we observed lunch being served in both rooms during the inspection. We saw staff displayed a good understanding of people’s nutritional needs and offered choice where necessary. Some people required a ‘pureed’ diet and we saw this was provided for them in order for them to consume their food safely.

We saw that staff received regular supervision as part of their on-going development. This provided an opportunity to discuss their workload, any concerns and any training opportunities they may have. We saw appropriate records were maintained to show these had taken place.

The people we spoke with and their relatives told us they were happy with the care provided by the home. One person said to us; “They’re good with us. Very good”.

We saw that people were treated with dignity, respect and were allowed privacy at times they needed it. We saw people looked clean, were well presented and were able to choose how they spent their day which was respected by staff.

During the inspection we found the home were responsive to people’s care needs and requirements. For example, where people had been assessed as being at risk with regards to their nutrition, we saw appropriate referrals were made to Speech and Language Therapy (SALT) and that a pureed diet was then provided by staff.

We found that complaints were responded to appropriately, with a policy and procedure in place for people to follow when they needed it. Additionally, we saw that a response had been provided to the complainant, letting them know of any action that had been taken.

The staff we spoke with were positive about the leadership of the home. One member of staff said; “Management are very approachable and are there when you need them. The introduction of a deputy manager has definitely helped”.

There were various systems in place to monitor the quality of service provided to people living at the home. These included audits, unannounced spot check of staff, surveys and competency assessments of staff. These covered medication and staffs ability to assist people with their food and drink.

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 effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

We looked at the staff training matrix which showed staff had completed training related to the safeguarding of vulnerable adults. This helped ensure staff had the skills and knowledge to keep people safe at the care home.

We spent time walking around the care home and found it to be safe, clean and hygienic. All equipment, including lifts and hoists were regularly inspected and maintained which minimised any possible risk to people who used the service.

Deprivation of Liberty Safeguards (DoLS) become important when a person is judged to lack the capacity to make an informed decision related to their care and treatment. The provider told us no applications for DoLS had been made recently but knew the procedure to be followed if an application needed to be made.

Is the service effective?

People who used the service had undergone a pre-admission assessment. We observed care plans and consent forms had been signed which showed people had been involved in developing them. People`s choices and preferences had been recorded which helped ensure their care needs were met in accordance with their wishes.

People`s needs were taken into account with appropriate signage and the layout of the care home. This helped ensure people could move around the care home freely and safely. We spoke to two family visitors who told us they could meet people in private or in communal areas.

Is the service caring?

During our inspection, we observed staff members treating people in a dignified and caring manner. Staff were patient when caring for people and offered encouragement when they thought it was needed which promoted the person`s independence.

We saw staff who supported people with their personal needs. At lunch time, staff assisted people who needed help to eat their meals. One person who used the service told us, "All the staff are so kind and friendly."

Is the service responsive?

The activities co-ordinator was not on duty on the day of our inspection and we did not observe any activities taking place. However, the manager told us about a buddy system which helped ensure people were regularly involved in community activities. Each Sunday, a church service was held for all who wished to attend at the care home. One the day of our inspection, we noted one person going out into the community and another person who was supported to attend a hospital appointment.

Accidents, incidents and complaints were recorded and responded to appropriately. One person who used the service and a family member who was visiting told us, "We would just go and see the manager if there was a problem."

Is the service well-led?

We saw the care home worked well with other professional agencies. This included recording any visits from doctors and community nurses. This helped ensure people who used the service received care and support when they needed it.

The provider had quality assurance procedures in place which were aimed at continually improving the quality of service being provided to people who used the service. We saw records of both internal and external audits and checks that had been completed on a regular basis.

We spoke with the people who used the service. People spoken with said that the food was "good,"food very nice,””and "the food is not too bad and if you dont like it they can get you something else to eat."

Comments such as“this is a very nice place,”“It is a good place to live ”I like it here it is smashing” were made.

People spoken with said "staff are really nice" "the people who look after me are great."

People spoken with said that they knew who to speak with if they had any problems Comments such as "I can talk to any of the staff and they will sort out stuff for me" "you can speak to Jeanette any time you like" were made.

We visited Woodlands Court Care Home because we had received some information of concern. The concerns related to the care of the people at the home, including protecting vulnerable adults staffing levels and from abuse. There were also concerns around the management of medicines and staffing levels.

People told us that they were happy with the care they received at the home. We were told “the staff are lovely”; “The girls are smashing”; “staff help me every way they can” and “staff come as soon as you ring the call bell.” We did not find any evidence that people’s care and support needs were not being met

We found that the home had a system in place to protect vulnerable adults from abuse. People and relatives, who we asked, told us they had no concerns about the home. One person told us “I feel safe here. I have no worries about the staff at all.”

People told us that they had no problems or issues in relation to medicines. There was system in place to ensure that medicines were stored and administered safely. Staff had been trained to give medicines and there was evidence that competency had been checked.

Some people told us that they thought there should be more staff at the home. We found that people had their care and support needs met and we did not find any evidence of the home being understaffed.

The people we spoke with said that they liked living in Woodlands Court and could make choices about how they spent their day

People said “the home is great, the staff ask me what I want to do all the time.” “ I have not been here long and the staff are marvellous they discuss with me the best way to support me”

“We have started to go out more for pub lunches it is lovely.”

People spoken with said “ this is a lovely place to live” “ the sitting room has been changed and it is more like home “ “ the staff treat me with dignity and respect and never make me feel like a nuisance, I mean all the staff from the manager ,care staff , kitchen staff and domestics, the handyman is also very helpful. ” “ The food is second to none and I have enjoyed being here.”

“ the staff talk to you all the time and treat you like a person.”

People were complimentary about the staff team. Comments such as “ the staff are marvellous;” “ the staff are brilliant;” “ all the staff are wonderful;” “ we have a lot of laughter here” were made by people living at the home.

People we spoke with at Woodlands Court said they have meetings with the manager to discuss anything they want to. They said that they often go and sit in the office chatting to the manager.

People told us that they were content with the standard of care. Comments included:

'Can't complain, can't fault them in any way, they are very caring and very obliging and nothing seems too much trouble for them –we’re well looked after.’

People who use the services at Woodlands told us that they felt safe and protected from harm. They felt that if there were any problems staff at the home would listen to them and take the correct action to promote their wellbeing and safeguard them from harm.

People told us

' Staff are fabulous, I'm very friendly with them, it’s quite calm here really.’

‘If I had a complaint, who I'd speak to would depend on what it was about, never had a complaint really. They’re a good bunch on the whole they seem to know what they’re doing.'

When asked about the atmosphere at Woodlands the people living there said:

'I feel safe, nothing I see or hear is of a worry and I can talk to the manager anytime.’

'If I was upset I would tell whoever was in charge but I'm quite happy as I am. No one is especially friendly or unfriendly and there's an open door policy visitors can come when they want’.

And visitors who were spoken to said:

'All seems fine when we’ve been here. Staff are friendly and helpful and always asking if we want a cup of tea.'