This inspection took place on 5 and 10 April 2018 and both days were unannounced. On both days there were 24 people using the service.

Woodleigh Rest 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. The care home can accommodate up to 33 older people in one adapted building. Accommodation is provided over two floors.

The last inspection was carried out in April 2017 and the overall rating for the service was ‘requires improvement.’ The provider was in breach of two Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to ‘safe care and treatment’ (Regulation 12) and ‘good governance’ (Regulation 17). We took enforcement action and issued a warning notice in relation to the breach of regulation 17 (good governance). We issued a requirement notice in relation to the breach of ‘safe care and treatment’ Regulation. We asked the provider for an action plan, which they provided telling us how they were going to make the necessary improvements.

During this inspection we found improvements had been made.

A registered manager was in place. 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.

There were enough staff to keep people safe and to meet their care needs. Staff were receiving appropriate training and they told us the training was relevant to their role. Staff told us they felt supported by the registered manager and were receiving formal supervision.

Care plans were up to date and detailed what care and support people wanted and needed. Risk assessments were in place and showed what action had been taken to mitigate any risks which had been identified. We saw appropriate referrals were being made to the safeguarding team when this had been necessary.

People’s healthcare needs were being met and medicines were being stored and managed safely.

In the main we saw staff were kind, caring and patient. However, we did see some practices which showed a lack of respect for people.

People were offered a choice of meal and they told us the food was nice. However, we were concerned people were not getting enough to drink.

The home was clean, comfortable and improvements to the lighting were on-going. Some areas of the home had been refurbished and redecorated and this was on-going. However, we did find staff were not always following infection prevention procedures which potentially could put people using the service at risk.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The complaints procedure was displayed. Records showed complaints received had been dealt with appropriately.

Some activities were on offer to keep people occupied but these needed to be more person centred.

Everyone spoke highly of the manager who said they were approachable and supportive. The provider had a more active role in the running of the service. We saw systems had been introduced to monitor the quality of the service. We saw these had identified areas for improvement and action had been taken to address any shortfalls. People using the service and relatives were consulted about the way the service was managed and their views were being acted upon. It was too early for the provider to be able to demonstrate that the quality processes were fully embedded and that these improvements could be sustained over time.

We found one breach of the Health and Social Care A

We inspected Woodleigh Rest Home on 11 March 2017 and the visit was unannounced.

Woodleigh Rest Home is situated in the Queensbury area of Bradford. The property has been adapted and extended to provide personal care for 33 older people both in single and double rooms on the ground and first floors. The rear entrance provides disabled access to the ground floor with a stair lift enabling access to the first floor. There are two lounges and one dining room on the ground floor.

On the day of the inspection there were 26 people using the service.

There was a registered manager in post. 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.

Our last inspection took place on 8 September 2016. At that time, we found the provider was not meeting the regulations in relation to safe care and treatment, premises and equipment and good governance. The service was rated ‘requires improvement’ overall. We told the provider they needed to make improvements and they sent us an action plan telling us what they were going to do in order to become compliant with those regulations. However, on this inspection we found continued breaches in relation to safe care and treatment and good governance.

We found staff were being recruited safely and there were enough staff to take care of people and to keep the home clean. Staff were receiving appropriate training and they told us the training was good and relevant to their role. Staff told us they felt supported by the registered manager and were receiving formal supervision where they could discuss their on-going development needs.

People who used the service told us they felt safe at Woodleigh Rest Home and we found staff understood the safeguarding process.

We found action was not always being taken to mitigate risks within the service in relation to the premises. We found there were on-going issues with the heating and hot water in one area of the home. This had been reported to the provider, however, no resolution had been found. We also found two bedrooms with unpleasant odours, one with an unsuitable lock and poor lighting levels throughout the home, which all posed potential safety issues for people using the service and staff.

People who used the service were receiving personalised care and were very happy at the home. They told us staff were kind, caring and compassionate. Some activities were on offer to keep people occupied and staff provided people with some companionship. People’s healthcare needs were being met and healthcare professions spoke highly about the care and support people received.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

We found although people’s medicines were generally being managed safely, for prescribed topical lotions and creams the records did not show these were being administered as prescribed.

People who used the service told us they liked the meals, however, we found menus were limited and not everyone always received a choice of meal.

Care plans and risk assessments were not always up to date and it was not always easy to find relevant documentation. However, staff did know people well and understood their needs and preferences.

Quality assurance systems were in place, however, they were not always effective in identifying areas which required improvement such as medicines management. In addition, where risks had been identified no action had been taken to rectify the problem.

We identified two continued breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full ver

This inspection was carried out on 8 September 2016 and was unannounced. This meant the registered provider and staff did not know we would be attending. One Adult Social Care (ASC) inspector carried out the inspection. The service was last inspected on 17 June 2014 and was found to be meeting all the regulations inspected.

Woodleigh Rest Home is situated in the Queensbury area of Bradford. The property has been adapted and extended to provide personal care for 33 older people both in single and double rooms on the ground and first floors. The rear entrance provides disabled access to the ground floor with a stair lift enabling access to the first floor. There are two lounges and one dining room on the ground floor. There were 26 people living at the service on the day of the inspection.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager 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 2008 and associated Regulations about how the service is run.

We found that the service’s premises and equipment were not always safely maintained. Annual maintenance checks had not been completed for the fire alarm system. This was a breach of Regulation 12. You can see what action we told the provider to take at the back of the full version of the report.

We found that the premises were not properly maintained. Some furniture required replacing and the communal areas of the service required updating and redecoration. This was a breach of a Regulation 15. You can see what action we told the provider to take at the back of the full version of the report.

The registered provider had audits in place to check that the systems at the service were being followed and people were receiving appropriate care and support. However, we found the audits had failed to detect that equipment was broken and that parts of the premises were not adequately maintained. This was a breach of a Regulation 17. You can see what action we told the provider to take at the back of the full version of the report

Staff had a good knowledge of how to keep people safe from harm and abuse and there were enough staff to meet people's assessed needs. Staff had been employed following appropriate recruitment and selection processes. We found that the recording and administration of medicines was being managed appropriately at the service.

We found assessments of risk had been completed for each person and plans had been put in place to minimise risk. Apart from the entrance to the service all areas were clean, tidy and free from odour and cleaning schedules were in place.

Staff completed an induction process and had received a wide range of training, which covered courses the registered provider deemed essential. The registered manager understood the Deprivation of Liberty Safeguards (DoLS) and we found that the Mental Capacity Act 2005 (MCA) guidelines had been followed.

People's nutritional needs were met. People told us they enjoyed the food and that they had enough to eat and drink. We saw people enjoyed a good choice of food and drink and were provided with snacks and refreshments throughout the day.

People told us they were well cared for and we saw people were supported to maintain good health and had access to services from healthcare professionals. We found that staff were knowledgeable about the people they cared for and saw they interacted positively with people using the service. People were able to make choices and decisions regarding their care.

People had their health and social care needs assessed and care and support was planned and delivered in line with their individual care needs. Care plans were individualised to include pr

During our inspection we looked for the answers to five questions;

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

Below is a summary of what we found. The summary describes what people using the service, their relatives, visitors and the staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

Is the service caring?

People were supported by staff that were considerate and patient when dealing with people. They referred to people using their preferred names and followed what they were asked to do. We spoke with two relatives who told us staff are very caring and have positive relationships with their family members. People’s preferences and interests had been recorded and care and support had been provided in accordance with peoples wishes.

Is the service responsive?

We spoke with two family members that told us they had been involved in the care plans for their relatives. They also told us they would immediately inform the manager or a senior if they wanted to make a complaint and they felt confident this would be acted on.

Is the service safe?

People told us they felt safe living in the home. Safeguarding procedures were robust and staff were clear on the process of reporting potential safeguarding issues.

We found care plans were linked with risk assessments when potential increased risk levels were identified. This reduced and removed risk from certain situations or practices.

The service was safe, clean and hygienic and we found equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk.

Is the service effective?

Care plans showed needs had been assessed and were altered when needs changed. We saw peoples preferences were taken into account and people were involved in their plans of care. Special dietary and pressure relief equipment had been identified in care plans when necessary.

Visitors confirmed they could see their patients or family members in private if they wished and that visiting times were flexible.

Is the service well-led?

We saw evidence that the service worked well with other agencies to make sure people received their care in a joined up way. One professional visitor said they are always listened to and take advice on board.

Staff told us they were clear about their roles and responsibilities and if they had any concerns with the practices or the homes itself they would not hesitate to speak to a senior or the manager.

Our inspection on the 3 July 2013 found we had concerns that the systems to administer medicines were not robust and did not protect people against the risks associated with medication. The provider wrote to us and told us they would take action to ensure they were compliant with these essential standards. We carried out this visit to check improvements had been made and as part of our scheduled annual inspection programme.

At this inspection we found Woodleigh Residential Home had made some improvements to their systems to manage the administration of medications.

We spoke with four people who used the service and they told us they enjoyed living at the home and were very complementary about the care and support provided by the manager and staff.

We spoke with three visitors and they told us they had no concerns at all about the standard of care their relatives received. One person said "I have visited the home at various times of the day and I am always made to feel welcome by the staff".

We asked people who used the service and visitors about the meals. Most people told us they were “good”. However one person and a visitor said they would have preferred more variety.

Despite the positive comments people made, we saw evidence people were not always protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

People we spoke with during our visit were very satisfied with the care within the service. They told us the care was very good and the place was clean.

People who used the service were satisfied with the care they received. Individuals told us “Staff are very good, we have a good laugh.”

People we spoke with were aware of safeguarding procedures and systems on how to raise a concern were in place. People were satisfied that staff or the manager would take action to solve their problems.

Our observations of the service showed that staff spoke with and interacted with people who used the service in a patient and pleasant manner.

The provider should note that we saw people sitting for long periods of time with little stimulation on the morning of our inspection. We spoke to the registered manager who told us the home planned to increased the activities organiser hours to enhance the existing activity programmes.

Following our last inspection we noted that care plan documentation had been redesigned. The provider should note that further work was still required to make the information in the care plans readily accessible to staff.

We saw appropriate systems and processes, policies and procedures in place. Report writing in the care records was adequate and reflected the changes in care and treatment that people received. We also found that staff were supported and monitored in their working practice and had training and appraisals programmes in place.

We looked at the seven surveys that people living in the home or their representatives had completed in January 2012. In these people said they wanted some changes to the menu to make meals more appetising and varied and that they would like more activities.

We spoke with five people who live at the home. They told us that the home is kept clean and tidy, and the staff are pleasant and very kind. On person said “the staff can’t do enough for you.” A visitor told us that they are always made to feel welcome and made to feel at home.

Staff told us that they like working at the home and feel well supported by the manager. The visiting community matron told us that staff always follow instructions and that the care offered at the home is very good.