About the service: Woodside Care Home is a residential care home. It provides personal care and support for up to 42 older people, people living with dementia or physical disability. There were 19 people living in the service on the day of our inspection.

People’s experience of using this service:

The provider met the characteristics of ‘Requires Improvement’. This has improved from a rating of ‘Inadequate’ at the last inspection in 2018. More information about this is in the full report.

• People were cared for in a clean, friendly and safe environment. Staff followed good infection control practices. People had their risk of harm assessed and staff knew how to keep them safe. People received their medicines from staff who had been assessed as competent to do so.

• There were enough staff employed with appropriate knowledge, skills and experience to look after people and care for their needs. The manager continued to actively recruit new staff.

• People’s rights were maintained and staff followed the principles of the Mental Capacity Act 2005 and were compliant with conditions laid down in Deprivation of Liberty Safeguards authorisations. The provider now notified CQC of any events that they are required to tell us about by law.

• People were provided with a nutritious, varied and balanced diet. Their risk of dehydration, malnutrition and obesity were closely monitored by staff and records were accurately maintained.

• Improvements were ongoing to the decoration and furnishings of the home environment. Peoples’ sensory, cognitive, mobility and social needs were identified and respected.

• Lessons were learnt when things went wrong. The manager and staff worked together to make improvements to the service. Good working practices had been introduced within the service. Staff worked across organisational boundaries to support peoples’ health and wellbeing.

• People were cared for by kind, caring and compassionate staff, who respected their privacy and dignity.

• People and their relatives have a say in the running and development of the service.

• The manager was an approachable and visible leader. The manager and their team were committed to improving the quality and standards of care people received. Links are being built with the local community and partner agencies. Significant improvements have been made to the governance framework; leading to improvements in the service.

• People and staff told us that the service had changed since the new manager had come into post.

The service met the characteristics of Good or Requires Improvement in all areas that we inspected. More information is in the full report.

Rating at last inspection: Woodside Care Home was last inspected on 13 and 19 June 2019 (report published 25 September 2018) and was rated as Inadequate overall. This was a responsive follow-up inspection to see if the service was Safe and Well-led. At our inspection in September 2017 (report published 05 December 2017) we rated the inspection Requires Improvement overall.

Why we inspected: We asked the provider to complete an improvement plan at our last inspection. We wanted to see if the provider had made progress with their improvement plan and that the service was safe and well-led.

Enforcement: At the time of our inspection there was on-going enforcement action. We had previously imposed a condition on the provider that they could not admit any new service users until we knew that the service was safe and well-led.

Follow up: We will continue to monitor intelligence we receive about Woodside Care Home until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Woodside 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. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide accommodation for up to 42 people, including older people and people living with dementia. There were 25 living in the home on the first day of our inspection.

We carried out a comprehensive inspection of the home in May 2015. At this inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (HCSA). This was because there were shortfalls in the monitoring of service delivery and people's legal rights under the Mental Capacity Act 2005 were not fully protected. We rated the service as Requires Improvement.

In November 2015 we carried out a focused, follow up inspection to check the registered provider had taken the actions necessary to address the breaches of regulations. We found both breaches had been addressed although the rating of the service remained as Requires Improvement.

In July 2016 we undertook a further comprehensive inspection. We found the progress noted at our November 2015 inspection had not been sustained. We found three breaches of the HSCA. This was because the registered provider was again failing to monitor the quality of service delivery effectively. We also identified concerns about the state of repair of the premises and shortfalls in infection prevention and control practice. The rating of the service remained as Requires Improvement.

In January 2017 we carried out a focused, follow up inspection to check the registered provider had taken the actions necessary to address the breaches of regulations. We found two of the three breaches had been addressed although the registered provider had still not taken sufficient action to address the shortfalls in organisational governance and improve the monitoring of service quality. The rating of the service remained as Requires Improvement.

In September 2017 we carried out a further comprehensive inspection. Again, we found the registered provider had not sustained the progress noted at our January 2017 inspection. We found two breaches of regulations. This was because the provider was still not monitoring the quality of service delivery effectively. We also found the provider was failing to assess and manage potential risks to people’s health and safety and there were shortfalls in the management of people’s medicines. The rating of the service remained as Requires Improvement. Following this inspection the registered provider wrote to us and advised us that action to address the two breaches of regulations would be taken by 31 March 2018.

On 13 and 19 June 2018 we carried out this further focused follow up inspection to check if the registered provider had taken the actions necessary to address the two breaches of regulations found at our September 2017 inspection. This report only covers our findings in relation to these issues. Our inspection was also scheduled in response to information shared with us by the local authority safeguarding and contracting teams. They had visited the home in late May and early June 2018 to investigate concerns primarily relating to the cleanliness of the home and infection control practices. Their investigation was ongoing at the time of our inspection.

At this inspection we were extremely disappointed to find that the quality of service, far from improving, had deteriorated and people were not receiving the safe, well-led service they were entitled to expect. The provider was in continuing breach of both breaches of regulations identified at our previous inspection. This was because of the provider’s ongoing failure to properly assess and mitigate risks to people’s safety and a persistent failure over several years to effectively assess,

We carried out this unannounced inspection on 11 September 2017.

Woodside Care Home can provide accommodation and personal care for 39 older people, people who live with dementia and people who have a physical disability. There were 29 people living in the service at the time of our inspection.

The service was run by a company who was the registered provider. There was a manager whom we registered to be in their post shortly before this inspection. 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. In this report when we speak both about the company and the registered manager we refer to them as being, ‘the registered persons’.

At our inspection on 21 July 2016 we found that there were three breaches of the regulations. Two of the breaches had reduced the registered persons' ability to consistently provide people who lived in the service with safe care. In more detail, we found that there were shortfalls in the arrangements that had been made to promote good standards of hygiene and to maintain particular areas of the accommodation. As a result we rated our domain ‘safe’ as ‘Requires Improvement’. The third breach referred to other developments that needed to be made to ensure that the service was well managed. Therefore, we also rated our domain ‘well led’ as ‘Requires Improvement.’ In addition to these concerns, we concluded that changes needed to be made to ensure that people consistently received effective care and so we rated our domain ‘effective’ as ‘Requires Improvement’. As a result of these ratings we concluded that the summary rating for the service was ‘Requires Improvement’.

Shortly after our inspection the registered persons told us that they had made the necessary improvements to address each of our concerns. We completed a further inspection on 26 January 2017 to check on the progress that had been made. We found that sufficient steps had been taken to address the breaches relating to the service’s ability to ensure that people received safe care. We found that new and strengthened provision had been made to promote good standards of hygiene to reduce the risk of people acquiring avoidable infections. We also noted that improvements had been made to the accommodation, although more still needed to be done to provide people with a comfortable setting in which to live. We did not change the rating of our domain ‘safe’ which remained as ‘Requires Improvement’. This was because we needed to see that the improvements which had been made would be sustained.

In relation to our domain ‘well led’, we found that the registered persons had not made enough progress to ensure that the service was robustly managed and so we concluded that the breach had not been met. Therefore, we repeated the breach and rated our domain ‘well led’ as ‘Requires Improvement’. In line with our inspection methodology we did not review what improvements had been introduced to promote the service’s ability to provide people with effective care.

After our inspection the registered persons told us that they had made further improvements to address the concerns we had raised about the management of the service.

At the present inspection we found that a number of improvements had been made to the way in which the service was run. However, these had not resulted in people always receiving a high quality service. Therefore, we concluded that the service was still not fully being managed in the right way and we decided that the breach of the regulations relating to this matter had not been resolved. You can find out what action we have told the registered persons to take in relation to this breach at the end of the full version of this report.

In addition, we f

We carried out an unannounced comprehensive inspection of Woodside Care Home on 21 July 2016. Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.

We undertook a focused inspection on 25 January 2017 to check that they had followed their plan and to confirm that they now met legal requirements. During this inspection on the 25 January 2017 we found the provider had made some improvements in the areas we had identified. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Woodside Care Home on our website at www.cqc.org.uk.

Woodside Care Home provides care and support for up to 42 people. When we undertook our inspection there were 20 people living at the home. People living at the home were mainly older people. Some people required more assistance either because of physical illnesses or because they were experiencing difficulties coping with everyday tasks, with some people living with dementia.

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. However, the registered manager was not available during our inspection and a different manager was monitoring the home.

People had not been consulted about the development of the home and quality checks had only just begun to be completed to ensure the home could meet people’s requirements. There had been few meetings with staff to ensure they were aware about the changes within the environment. The clinical governance measures were not robust enough and did not reflect whether lessons had been learnt from audits to measure the quality of the service. You can see what action we told the provider to take at the back of the full version of the report.

Some areas of the home which had been in need of repair had improved. Work had been completed to change flooring, redecorate communal areas, new furniture had been purchased and unsafe areas in bathrooms had new flooring. Schedules were in place to monitor the cleanliness of the premises. However, these had only just commenced and not been analysed for effectiveness of the programme. There was no maintenance or refurbishment plan in place to ensure people were living in premises of an acceptable standard.

Infection control prevention procedures had been put in place and staff were aware how to implement them to prevent people from being harmed.

We inspected Woodside Care Home on 21 July 2016. This was an unannounced inspection. The service provides care and support for up to 42 people. Some people required more assistance than others either because of physical illnesses or because they were experiencing difficulties coping with everyday tasks and loss of memory. When we undertook our inspection there were 26 people living at the home.

People living at the home were older people. Some people required more assistance either because of physical illnesses or because they were experiencing difficulties coping with everyday tasks and loss of memory.

There was no registered manager in post. However, an interview date was set by CQC for the following week for the current manager. 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.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. At the time of our inspection there was no one subject to such an authorisation.

We found that there were sufficient staff to meet the needs of people using the service. The provider had taken into consideration the complex needs of each person to ensure their needs could be met through a 24 hour period.

We found that people’s health care needs were assessed, and care planned and delivered through the use of a care plan. However, people were not always involved in the planning of their care and had not always had sight of their care plan. The information and guidance provided to staff in the care plans was however clear. Risks associated with people’s care needs were assessed and plans put in place to minimise risk in order to keep people safe. Care plans were currently under review to ensure all people’s needs were being met.

People were treated with kindness and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home. The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence, choices and control over their lives. Staff had used family and friends as guides to obtain information.

People had a choice of meals, snacks and drinks. Meals could be taken in a dining room, sitting rooms or people’s own bedrooms. Staff encouraged people to eat their meals and gave assistance to those that required it.

The provider used safe systems when new staff were recruited. All new staff completed training before working in the home. The staff were aware of their responsibilities to protect people from harm or abuse. They knew the action to take if they were concerned about the welfare of an individual.

People had not been consulted about the development of the home. A new audit process had been put in place and checks on the quality of the services being provided had recently commenced. Therefore the provider had limited information to judge whether the services provided met people’s needs. No systems were in place to monitor the upkeep of the building that adequate fire precautions were being maintained and there was no refurbishment plan in place. Due to building work in progress within the grounds the infection control procedures were being compromised.

We carried out an unannounced comprehensive inspection on 15 and 18 May 2015. Two breaches of legal requirements were found. After the inspection, the provider wrote to us to say what they would do to meet the legal requirements in relation to the breaches.

At the last inspection on 15 and 18 May 2015 we found that the provider was not meeting the standards of care we expect. This was in relation to ensuring people were involved in the planning of their care. Also that those without capacity were not assessed to ensure the requirements of the Mental Capacity Act 2005 were being fulfilled. There were also no systems in place to test the quality of the services being used and whether staff were working safely.

We undertook this focused inspection on 17 November 2015 to check that they had followed their plan and to confirm they now met the legal requirements. During this inspection on the 17 November 2015 we found the provider had made improvements in the areas we had identified.

This report only covers our findings in relations to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Woodside Care Home on our website at www.cqc.org.uk.

Woodside Care Home provides care for older people who require personal care. It provides accommodation for up to 42 people. At the time of the inspection there were 32 people living at the home.

At the time of the inspection there was not 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.

On the day of our inspection we found staff interacted well with people and people were cared for safely. People told us their needs were being met and they were involved in the planning of their care and treatment. Where people did not have capacity to make decisions for themselves staff had implemented the Mental Capacity Act 2005 guidelines and recorded their decision making processes. There was sufficient evidence to show the provider was testing the quality of the services being provided and they were checking staff were working safely.

People who used the service told us they were involved in putting their care plans together. They told us staff took time to sit and talk with them about their current needs. One person said, "Staff are patient and listen to me." Another person told us, " I like my time with the staff,especially when they are talking with me about what I want to do each day."

Most people we spoke with talked positively about the staff and felt they fully supported their care needs. People told us the staff spoke with them in a calm manner and listened to them. One person said, "Staff here are so good ad kind to me." Another told us, "Staff help me walk with my frame or push me in my wheelchair but they don't hurry me." Two people raised concerns. One person told us they had not received a bath and a relative told us they had, "Raised care issues" but, "They are now resolved."

People told us they had consented to any prescribed treatment from doctors, or other health and social care professionals. They told us they had been open to options given to them by care staff about how to maintain their independence. This had not always been recorded in the care plans.

The people who used the service told us they knew how to raise a concern but no one had raised any formal complaints. One person told us, "Any issue has been resolved quickly and efficiently." The complaints policy was on display.

People were not asked their opinions about staff recruitment.

As part of our inspection we spoke with people who use the service. They spoke positively about the care and support they received. They told us their views had been sought by staff speaking to them personally, residents' meetings and questionnaires.

Comments from people who used the service included, "I can always talk to staff", "I can ask staff to do anything for me and they are so kind and patient" and "I am happy enough here."

During the visit we spoke to a relative who confirmed they were asked their opinions about the quality of service offered to their family member. They told us staff were patient and willing to listen.

As part of our inspection we spoke with a number of people who use the service. They spoke positively about the care and support they received. They told us they liked living in the home and confirmed that they were supported to make choices and decisions about the care they received. Some people gave us negative comments about how their views were sought and staffing levels within the home.

Positive comments included, "The girls are wonderful here", "The staff help me with any thing I want to do" and "Staff discuss my care plan."

Negative comments included, "Sometimes staff take a long time to answer my call bell", "I cant always get someone to take me out shopping" and "Staff dont ask me if I like living here."

During the visit we spoke with visitors who expressed their satisfaction with the standards of care at the home. They told us the staff were good and they were kept informed of any changes.

The service provides care and support for up to 42 people. When we undertook our inspection there were 32 people living at the service.

People in the home were mainly older people. They had varying degrees of mobility needs, with some requiring wheelchairs and some assistance from staff to walk. A small number of people preferred to stay in their bedrooms each day. A number of people were at different stages of dementia.

We inspected Woodside Care Home on 15 and 18 May 2015. This was an unannounced inspection. Our last inspection took place on 27 October 2014 during which we found the home was meeting all the required standards.

There was no registered manager in post. The home had been without a registered manager for three months. 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.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. There were no people living at the home that were subject to any such restrictions. Staff were unaware of mental capacity and DoLS processes.

People had not been consulted about the development of the home and quality checks had not been completed. Some areas of the home and some equipment required refurbishment and there was no plan in place to ensure the environment and equipment was updated and kept clean.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to the number of staff available at times and a lack of quality assurance systems. You can see what action we told the provider to take at the back of the full report.

People were not involved in the planning of their care. We found that people’s health care needs were assessed, and care planned and delivered in a consistent way through the use of a care plan. The information was clearly written and risks identified. However, these had not been consistently reviewed and people were not involved in that process.

The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence and control over their lives.

People were treated with kindness, compassion and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home.

People had a choice of meals, snacks and drinks. Meals could be taken in a dining room, sitting rooms or people’s own bedrooms. Staff encouraged people to eat their meals and gave assistance to those that required it.

The provider used safe systems when new staff were recruited. All new staff completed training before working in the home. The staff were aware of their responsibilities to protect people from harm or abuse. They knew the action to take if they were concerned about the welfare of an individual. There were sufficient staff to meet people’s needs.