Woodlands is a care home located in Poynton, which is situated between Macclesfield and Stockport, and is part of Methodist Homes (MHA). 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. People who live in the home are accommodated on both floors of the two-storey building, access between floors is via a passenger lift or the stairs. Woodlands is registered to accommodate 80 people, at the time of the inspection 77 people lived at the home.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At the last inspection the service was rated Good. At this we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating has not changed since our last inspection.

People told us that the food was good and that they had plenty to eat. The first and second days of the inspection were very hot. Although we could see that people had drinks with meals and afternoon tea, and that hydration stations were located on each of the units, we queried the availability of drinks for people who remained in their rooms. The management team provided additional guidance to staff regarding availability and recording of fluid intake.

Applications had been made under the Deprivation of Liberty Safeguards (DoLS) as required and detailed records were maintained. We found that when people received their medicines covertly (hidden) consideration had not always been given as to whether medicines administered this way resulted in a deprivation. When we returned on the third day of inspection the registered manager demonstrated that they had liaised with the relevant authorities and that action had been taken to address where necessary.

A wide range of training was available for staff including around specific health needs such as Diabetes although from the training matrix provided we found that some sessions were overdue for renewal. Champions had been nominated for specialist roles such as continence, dementia and end of life.

When agency staff were used the provider did not always obtain a profile or carry out an induction with the member of staff to ensure that safe recruitment checks had taken place and that the person had received training and had all of the information they would need.

We reviewed four staff files and saw that satisfactory recruitment and selection procedures were in place.

Records showed that the provider had generally followed the principles of the Mental Capacity Act 2005 and that, where appropriate, decisions were made in people’s best interests.

There were effective and established systems in place to safeguard people from abuse and individual risk was fully assessed and reviewed. Accidents and incidents were recorded and appropriate actions taken.

Medicines management and administration processes were reviewed during the inspection and found to be safe.

Checks were made to ensure that the environment was a safe place for people to live. These included electric, gas, Legionella compliance and fire safety.

Policies and procedures were in place to prevent and control the spread of infection. We saw that staff used gloves and aprons appropriately. The home had undergone refurbishment since our last inspection.

We found that staffing levels were adequate to meet people’s needs. A dependency tool was used to determine sta

When we carried out our unannounced visit we spoke to six people who lived in the home and five relatives.

People we spoke to expressed no concerns about their care. One told us that the home was “safe, nice, clean, good and reliable” and that “everybody is always happy and smiling”. Another said “they’ve always looked after me”

We spoke to the relative of a person living in the home who told us that their relation was treated decently, that staff “seem patient” and were “very nice”. Another relative said that they had “no complaints” and that “staff are brill”.

The relatives of another person expressed some reservations about the care provided and felt that they needed to spend time at the home on most days.

We looked at the care records for people who lived in the home and we saw that each person’s needs were assessed on admission and an appropriate care plan produced. People’s needs and care plans were reassessed as necessary.

The home had a suitable kitchen and the dining facilities were pleasant. People were supported to eat whether in the dining rooms or their own bedroom.

We looked to see if changes had been made to the management of medicines following our minor concerns at the last visit and we were satisfied that they had.

The home was appropriately designed, equipped and maintained.

Staffing levels were appropriate and the home worked to match staffing levels and skills mix with the changing needs of the people who lived there.

During our visit we spoke with people who used the service, a number of relatives who were visiting the home and a healthcare professional. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people

who could not talk with us.

We saw that staff supported and encouraged the people who lived in the home with their daily lives.

The relatives we spoke with told us that they were kept up to date with any incidents or accidents involving their family members.

The provider may wish to note that there was little evidence to show that people who used the service and/or their relatives were involved in developing or reviewing the plans of care.

The staff members we spoke with were able to show they were aware of the needs of the people who lived in the home.

Information provided by the manager during this inspection told us there were policies and procedures in place to safeguard people who used the service from harm or possible abuse.

The manager provided us with information about the staff mandatory training. This showed that staff had access to training that included infection prevention and control, dementia awareness, care plan training and medication.

During our inspection we found that medicines were not always administered or kept safely. Arrangements were not made in relation to the recording of medicines.

This inspection was unannounced and took place on the 10 November 2014. A second day of the inspection took place on the 11 November 2014 in order to gather additional information. The home was previously inspected in June 2013 when it was found to be meeting all the regulatory requirements which were inspected at that time.

Woodlands is a purpose built care home located in Poynton which is situated between Macclesfield and Stockport. It offers permanent nursing and dementia care for up to 80 people and specialises in nursing and dementia care for older people. At the time of our inspection the service as providing accommodation and care to seventy-three people.

People who live in the home are accommodated on both floors of the two storey building and access between the first and second floors is via a lift or by the stairway.

At the time of the inspection there was a registered manager at Woodlands. 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.

During the two days of our inspection, people living at Woodlands were observed to be comfortable and relaxed in their home environment and in the presence of staff. The relatives of people who lived at Woodlands also confirmed that they felt that the people who lived in the home were safe and told us that they had no concerns about the way that their family members were treated.

People using the service and relatives spoken with were complimentary of the standard of care provided at Woodlands. Comments received from people using the service included: “They listen to what you’ve got to say”; “If there are any problems you complain and they deal with it”; “I am happy here”; “Generally all the carers are so lovely”; “I am well looked after and I can do what I like”; “It’s not home but it’s fine” and “The staff are good and I have no complaints.”

Relatives of the people who lived at Woodlands also spoke highly of the care provided. One said “The staff are friendly and the care is personalised.” Another relative told us “Overall I am satisfied with the standard of care provided.”

The registered manager’s influence on the home was evident throughout the inspection. It was clear through discussion with staff and other professionals that the manager was committed to providing positive leadership and direction to ensure the ongoing development of the service and the delivery of good standards of care. One health care professional informed us that they had noted significant improvements in the last twelve months, that the service was more open and transparent, clinically focussed and that the retention of staff had resulted in greater continuity of care.

Staff confirmed staff had access to a range of induction, mandatory and other training that was relevant to individual roles and responsibilities. The training was delivered via e-learning or face to face sessions.

During the two days of our inspection we noted that a range of activities had taken place in the different units of the home by the two activity coordinators and volunteers.

We saw that there were corporate policies and procedures in place relating to the Mental Capacity Act 2005 and Deprivation of Liberties (DoLS). This helped to safeguard the rights of the people using the service.

There were effective auditing systems in place so that the service could be monitored and developed. There were also arrangements for people who lived in the home and their relatives to be consulted about their opinions and the manager was proactive in seeking this. Staff told us that they found the management of the home to be approachable and supportive.