The inspection of Woodlands Lodge Care Home took place on 14 January 2019 and was unannounced. This meant the registered provider did not know we were coming.

Woodlands Lodge Care Home 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.

Woodlands Lodge Care Home is registered to provide accommodation and personal care for up to 55 people, some of whom are living with dementia. There were 44 people living at the home at the time of our inspection.

The home is split into three different units; one of which is a locked unit, specialising in care for people living with dementia. Each unit has communal areas such as lounge and dining areas and one unit has a large sun-lounge.

The last comprehensive inspection took place in February 2018 and the service was rated as requires improvement. We identified one breach of regulation. This was because staff did not act in accordance with the requirements of the Mental Capacity Act (MCA) 2015. Following the last inspection, we asked the registered provider to complete an action plan to show what they would do to improve the key questions effective, responsive and well led, to at least 'good'. The action plan told us this would be completed by October 2018.

At this inspection we found some improvements had been made. Staff had been trained and were following the requirements of the MCA. Records showed, where appropriate, Deprivation of Liberty Safeguards (DoLS) applications had been made and authorised, for people living at the home. However, we found improvements were required in relation to the administration of medicines, staffing numbers and care planning. The service continues to be rated 'requires improvement.' This is the second time the service has been rated 'requires improvement.'

You can read the report from our last inspections, by selecting the 'all reports' link for ‘Woodlands Lodge Care Home’ on our website at www.cqc.org.uk.

The home had 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.

Medicine audits were not sufficiently robust and did not always identify errors and omissions on medication administration records, so we could not be assured people always had their medicines safely.

Elements of risk were identified in the care plans and plans were put in place to mitigate this risk through the care instructions. Where the level of risk was deemed to be more significant (choking for example) specific risk assessments were put in place. However, we found one instance where this was not completed in a timely manner.

In the main, there were sufficient staff on duty to meet people's assessed needs. However, there had been occasions when staffing numbers were lower than those assessed as needed. The registered manager and provider said they were monitoring this closely to prevent people being put at risk from unsafe care.

Incidents and accidents were recorded and reviewed by the registered manager to look if there were any patterns, themes or trends. This would help to prevent a re-occurrence.

People had choice and control of their lives and staff were aware of how to support them in the least restrictive way possible; the policies and systems in the service were supportive of this practice.

Staff received the training and support they needed to carry out their roles. Supervision meetings had been held on a regular basis. Staff enjoyed working at the service and said the registered manager was approachable and would listen to any ideas or concerns they had.

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The inspection of Woodlands Lodge Care Home took place on 7 and 12 February 2018 and was unannounced. This meant the registered provider did not know we were coming.

Woodlands Lodge Care Home is registered to provide accommodation and personal care for up to 55 people, some of whom are living with dementia. There were 48 people living at the home at the time of our inspection. The home is split into three different units; one of which is a locked unit, specialising in care for people living with dementia. Each unit has communal areas such as lounge and dining areas and one unit has a large sun-lounge.

Woodlands Lodge Care Home 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.

The home had previously been inspected during January 2016 and was rated good in all of our five key questions at that time.

The home had 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 told us they felt safe living at Woodlands Lodge Care Home. The registered manager and staff were aware of relevant procedures to help keep people safe and staff could describe signs that may indicate someone was at risk of abuse or harm. Staff had received safeguarding training.

Staff were recruited safely and there were sufficient numbers of staff deployed to meet people’s needs. Staff told us they felt supported and we saw evidence staff had received induction, training and ongoing supervision. The registered manager had identified improved methods of training were required and was working towards implementing these.

Risks to people had been assessed and measures were in place to reduce risks. However, the quality of risk assessments was variable. Some moving and handling plans lacked detail to provide staff with sufficient information for staff to safely assist people to move. The registered manager had already identified this and work was continuing to improve these.

The building was well maintained and regular safety checks took place. The environment, particularly for people living with dementia, had recently improved.

Staff responded appropriately to emergency situations. Accidents and incidents were analysed and lessons were learned and shared.

Medicines were managed, stored and administered safely and appropriately, by staff who had been trained, and assessed as competent, to do so.

Our observations showed people were supported to have choice and control of their lives and we observed staff supported people in the least restrictive way possible. However, the principles of the Mental Capacity Act had not been followed. We identified a breach of regulation in this area.

People received appropriate support in order to have their nutritional and hydration needs met.

People told us staff were caring and we observed staff to be kind and considerate. We observed people’s privacy and dignity was respected. People were encouraged to maintain links with their family and community. People’s diverse needs were considered.

The quality of care records was variable and we found the registered manager was working to improve these. People told us they could make their own choices in relation to their daily lives.

There was a complaints policy in place and we found the registered manager had responded to complaints appropriately and in line with policy.

Staff told us they felt supported and people and their relatives spoke positively about the registered manager. Meetings such as staff meetings and residents’ and relatives’ meetings were held re

We carried out this inspection on 15 December 2015 and it was an unannounced inspection. This means the provider did not know we were going to carry out the inspection.

Since April 2013, Care Quality Commission inspectors have carried out three inspections. This was because we found areas of non-compliance with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. At the last inspection in January 2014, we found the home to be compliant with the regulations inspected at that time.

Woodlands Lodge Care Home is registered to provide residential care for up to 56 older people. On the day of our inspection, there were 51 people living at the home, three of who were on short-term respite.

It is a condition of registration with the Care Quality Commission that the home has a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run. The registered manager was present on the day of our inspection.

People and their relatives told us they felt the service was safe, effective, caring, responsive and well led.

People were protected from abuse and the service followed adequate and effective safeguarding procedures. Care records were personalised and contained relevant information for staff to provide person-centred care and support.

Staff received regular supervisions and appraisals and told us that they felt well supported by the deputy manager, registered manager and registered provider. Training was well maintained and updates were completed by staff, when required.

We found good practice in relation to decision making processes at the service, in line with the Mental Capacity code of practice, the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

Regular quality-monitoring systems were in place and audits were carried out at the home. We saw that, where issues had been identified, the registered manager and registered provider had taken (or were taking) steps to address and resolve them. The registered manager and deputy manager told us they would ensure all actions, identified through audits, were signed off when completed.

This inspection was a follow up inspection to check that improvements had been made in the training and supervision of staff as the provider was non-compliant following our last two inspections on 4 April 2013 and 30 July 2013 and compliance actions were issued.

The inspection included reviewing training and supervision records and speaking with the manager and four members of staff.

We found that staff had received relevant training and supervision in order to develop and improve their skills.