This inspection was carried out on 11 December 2018 and was unannounced. At their last inspection on 23 April 2018, they were found to not be meeting the standards we inspected and were rated as requires improvement with well led rated as inadequate. This was because they had failed to take the action they assured us they would in relation to people’s safety and welfare. At this inspection we found that they had made improvements in some areas however, they were not complying with all regulations and meeting fundamental standards. This was in relation to person centred care, promoting people's dignity and the management of the service.

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

Woodlands View Care Home provides accommodation for up to 120 older people, this included people with nursing care needs and some people living with dementia. At the time of the inspection there were 102 people living there.

The service did not have a registered manager. An experienced manager had been managing the home for six months with the brief to improve and stabilise the service while the provider recruited a permanent manager. They did apply to register, however as a new permanent manager was employed they withdrew their application. The new manager explained that he was planning to apply to the Commission for registration. A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

The provider’s quality assurance systems were not always used effectively and did not provide the management team with a complete overview of the quality and safety of the service. Systems had not identified shortfalls in relation to personalised care and ensuring people were treated with dignity and respect. People’s care was not always fully carried out and not all needs were responded to. Care provided was not always person centred and people’s care plans were not developed in a way that promoted this.

Staff supporting people knew how to recognise and report risk to people’s wellbeing. However, not all staff were able to tell us how they would report concerns outside of the organisation.

People and staff were positive about the recently appointed manager and how the service was currently managed. Staff had received training updates in relation to fire procedures and oxygen management. Further development was needed for some staff with regard to evacuation techniques. Management reviewed accidents and incidents to reduce any reoccurrence.

People were supported by staff who were recruited safely. Feedback about staffing was not always positive. Staff had received an induction, ongoing training and felt supported. Staff did not always work in accordance with their training and some updates were still needed.

Medicines were mainly managed safely and people received them promptly. However, there were some discrepancies that needed to be addressed. Infection control practice was adhered to by most staff but we did observe some not following their training in relation to this.

People enjoyed a variety of food which looked and tasted appetising but choices and preferences needed to be responded to by staff. There was appropriate access to health and social care professionals. Staff had an understanding of the Mental Capacity Act 2005 and adhered to its principles.

People told us that staff were kind and caring. However, communication, mainly on one unit, needed improvement. Privacy and dignity was not always promoted. Confidentially was promoted and visitors were made welcome.

The activi

This inspection was carried out on 24 April 2018 and was unannounced. At their last inspection on 3 January 2018, they were found to not be meeting the standards we inspected. This was in relation to person centred care, governance systems and managing people’s safety. Following the inspection we issued the provider with a warning notice stating that they must comply with the regulations by 1 March 2018. They sent us an action plan stating how they would make the required improvements. At this inspection we found that although they had made some improvements there were some areas that required improvement and continued to not meet all the standards. This was in relation to people’s safety and governance systems. We also found that areas such as promoting people’s dignity required improvement.

On 3 February 2018 there was a major incident at the home. An investigation into the incident remains on going and the Commission continues to work with other agencies in regards to this.

Woodlands View 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 service accommodates up to 120 people in four adapted buildings. At the time of the inspection there were 87 people living there. One unit remained closed following an incident on 3 February 2018.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run. However, people and relatives we spoke with did not know the registered manager.

There were systems in place to monitor the quality of the home. However, they had not identified the areas of concern or those that required improvement that we found on inspection or fully addressed the shortfalls from the previous inspection.

Staff knowledge and procedures in relation to fire safety and oxygen management needed to be addressed. Medicines records were not always accurate and the process for reordering of stock was not robust. People had their risk assessed in most cases; however, staff did not always follow the assessments. Staff knew how to recognise and report any risks to people’s safety internally. However, staff were not always clear how to report to external agencies.

There were additional numbers of staff on duty and this would reduce when the fourth unit reopened. There was a recruitment process in place. However, they needed to ensure employment gaps were consistently explored and references were always verified. Staff were due updates to their training and had not received any updates since the incident in February. However, staff supervision had recently commenced.

Most people were supported in accordance with the principles of the Mental Capacity Act 2005; however, this was not consistent. Staff asked people for their consent before supporting them.

People told us that they enjoyed the food and their health needs were met.

People were addressed by staff with respect and kindness. However, people’s dignity was not always promoted. People needed to be consistently involved in the planning of their care and consideration was needed to support people with their relationships. Confidentiality, in regards to records, was not always promoted.

People received care which they told us met their needs but gave mixed views about the activities provided. Care plans were in the process of being changed to the provider’s new format and those changed included appropriate information to help staff meet people’s needs. There was a complaint’s process and we found that the response to complaints ha

This inspection was carried out on 3 January 2018 and was unannounced. At their last inspection on 20 June 2017, the provider was found to not be meeting the standards we inspected. At this inspection we found that although some improvements had been made there were some areas that continued to not meet the standards.

Woodlands View 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 service accommodates up to 120 people in four adapted buildings. At the time of the inspection there were 112 people living there.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

The provider changed in December 2017. HC One limited, purchased some Bupa Limited Homes including Woodlands View Care Home.

Medicines were not always managed safely. Some people received care in a person centred way but we observed some people who did not. People, and their relatives where appropriate, were not always involved in planning their care. People gave mixed views about the activities provided.

There was a complaint’s process which people and their relatives knew how to use. However, people were not confident that they would receive feedback from the registered manager.

There were not always sufficient staff available to meet people’s needs in a timely way. Most people were supported in a safe way, however, some assessments and processes did not always promote this.

Staff knew how to recognise and report any risks to people’s safety and staff were recruited safely. However, staff were overdue updates to their training.

Most people were supported in accordance with the principles of the Mental Capacity Act 2005, however, this was not consistent. People gave mixed views about the food and relatives raised concerns about staff response to changes in people’s health at times.

People were addressed by staff with respect and kindness. We found that confidentiality was promoted. Further development was needed to help ensure people’s dignity was always promoted.

There were systems in place to monitor the quality of the home. However, they had not identified the areas that required improvement that we found on inspection. People, relatives and staff were not all positive about the running of the home.

Following our inspection we were made aware of an incident on 03 February 2018 involving a fire on one of the units at the home. One person sadly died during this incident. We are working with other agencies looking into the circumstances surrounding this.

This inspection was carried out on 20 June 2017 and was unannounced. This was the first inspection under their new registration. Prior to registering with the CQC there were breaches of regulation. At this inspection we found that although they had made some improvements, they were not meeting all the standards.

Woodlands View Care Home provides accommodation for up to 120 older people, including people living with dementia. The home also provides nursing care. At the time of the inspection there were 116 people living there.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

People’s individual risks were assessed, however, this was not consistent and some needs were not risk assessed. Staff knew how to recognise and respond to abuse, however, there were some issues observed and documented that had not been reported.

There were sufficient staff to meet people’s needs however during the evening needed to be reviewed and recruitment processes were robust. Staff had received training but some of this needed to be developed and updated. Staff felt supported but one to one supervisions were infrequent. People’s medicines were mainly managed safely but there were issues that needed to be addressed.

The service was made up of four units. We found that standards differed significantly across the units. For example, interaction between staff and people they supported was positive on some units, and not so positive on other units.

People did not always have their dignity and privacy promoted. We found that confidentiality was not always promoted.

People told us that staff were kind and we saw staff speak kindly with people. However, people and their relatives were not always involved in planning or reviewing their care.

The service did not always adhere to the principles of the Mental Capacity Act or conditions imposed by DoLS authorisations.

People who were at risk of not eating and drinking enough had their intake monitored, however we found that this may not be identified as a need by staff on one unit. People had access to health and social care professionals as needed.

People’s personal care needs were met but there was a lack of person centred care in some instances. People’s care plans were in place but some areas of needs did not have a plan and people’s views on activities were mixed.

There were quality assurance systems in place and we found that in some areas these had been effective. However, we noted that many issues identified by audits or regional manager visits remained an issue so the process had not been effective. Formal complaints were responded to. There were systems in place that had identified some issues within the home. However, these were not yet resolved.

People, relatives and staff were positive about the management team. Staff felt the home had improved since the last inspection.