Woodside View is a nursing home for up to twenty-six people including people who have dementia, physical and mental health needs. At the time of our inspection 15 people were living at the home.

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. The registered manager was not at the home during the time of our inspection. A registered manager from another of the provider’s services was covering in her absence.

We last inspected Woodside View in July 2016 where we found the registered provider was in breach of two regulations. These related to assessing people’s capacity to make decisions and the effectiveness of their quality assurance systems. Following this inspection the registered provider sent us an action plan of how they would address these two issues. At this inspection we found that both concerns had been addressed by the provider.

The inspection took place on 21 September 2017 and was unannounced.

There was positive feedback about the home and caring nature of staff from people who live here.

People were safe at Woodside View. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police.

Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks. In the event of an emergency people would be protected because there were clear procedures in place to evacuate the building.

There were sufficient staff deployed to meet the needs and preferences of the people that lived here. The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff received a comprehensive induction and ongoing training, tailored to the needs of the people they supported.

People received their medicines when they needed them. Staff managed the medicines in a safe way and were trained in the safe administration of medicines.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Staff were heard to ask people for their permission before they provided care.

Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

People had enough to eat and drink, and specialist diets either through medical requirements, or personal choices were provided. People were supported to maintain good health as they had access to relevant healthcare professionals when they needed them. When people’s health deteriorated staff responded quickly to help people and made sure they received appropriate treatment.

Good interactions were seen throughout the day of our inspection, such as staff talking with people and showing interest in what people were doing. Care plans gave a good level of detail for staff to reference if they needed to know what support was required. People received the care and support as detailed in their care plans. The staff knew the people they cared for as individuals, and many had supported them for a number of years.

People had access to activities and these were being further developed by the activities co-ordinator.

People knew how to make a complaint. Where complaints and comments had been received the staff had responded to try to put things right.

Woodside View is a nursing home for up to 26 people including people who live with dementia, physical needs and mental health needs. At the time of the inspection there were 14 people living at the home.

The service was run by a registered manager. The registered manager was off sick on the day of our inspection. However there was an interim manager present to cover ‘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 and associated Regulations about how the service is run.

Some people’s human rights were affected as the requirements of the Mental Capacity Act 2005 (MCA) was not always followed. Where people lacked capacity to make some decisions, people did not always have a mental capacity assessment or best interest meeting. Staff were heard to ask people for their permission before they provided care.

Where people’s liberty was needed to be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) and sent of the appropriate referrals to the local authority to ensure the person’s rights were protected.

The service was not always well led. There were not robust systems in place to monitor, review and improve the quality of care for people in the home and some recording keeping was inconsistent.

People’s medicines were administered, stored and disposed of safely. Staff were trained in the safe administration of medicines and kept relevant records that were accurate. However, people did not have guidelines in place to tell staff when and how to administer as required medicines (PRN). We recommend that for people who are prescribed PRN medicines, guidelines are put in place to enable staff to know when and how to administer in line with current guidance.

Staff did not always have written information about risks to people and how to manage these. Some risk assessments were completed, however they did not contain relevant detail to advise staff how to manage risks. We recommend that the registered manager reviews people’s risk assessments to ensure that current and detailed information is documented line with current guidance.

People were protected from avoidable harm. Staff received training in safeguarding adults and were able to demonstrate that they knew the procedures to follow should they have any concerns.

There were systems in place to ensure that staff employed were recruited safely. However one person did not have a Disclosure and Barring Service (DBS) check in place. Which meant that the staff member may have been unsuitable to work in the home.

There were enough staff to meet the needs of people.

Some people did not always receive responsive care. For some staff, English was not their first language and sometimes people said they found it difficult to make their needs and wishes known and to be understood by some staff. We recommend that the provider ensures that all staff are able to communicate effectively with people to ensure that people’s needs are met.

The registered manager had some systems in place to monitor and improve the quality of care in the home, however they was not regular and there were no action plans in place. We recommend that the registered manager review its quality assurance process to ensure that there is a continuous system in place to monitor, review and drive improvements in care.

People had sufficient to eat and drink. People were seen to be offered choice of what they would like to eat and drink. People were supported to maintain their health and well-being. People had regular access to health and social care professionals.

Staff received training and had sufficient skills and knowledge to support people effectively. There was a training programme in place to meet people’s needs. Sta

We spoke to people who used the service, their relatives and the staff during our inspection. We were told that people were happy with the care and support being delivered in the Woodside View.

One family member said "the home deserves top marks." Another person told us that "no matter what time I visit the home is always clean and tidy"

We saw that people's needs were assessed and that care and treatment was planned and delivered in line with their individual care plan.

We observed that people looked comfortable and relaxed sitting in the drawing room and looked well groomed.

We found the premises and grounds were now well maintained and clean.

The provider had made good arrangements to safeguard and protect the people who lived at the service.

The registered manager and the provider actively seek feedback about the service. One family member told us that they were always asked if they were happy with the care their relative received at the service. They said that when they had concerns the staff were happy to take on the suggestions and work with their family member to improve the way they supported them.

All the people we spoke to appeared confident, relaxed and free to express their feelings and wishes. For example, one person felt confident to tell staff not to let us see their room.

We saw staff treating people with compassion and kindness, for example, noticing that someone was distressed and sensitively providing comfort and support.

People told us that the staff were nice and they liked the home and their rooms.

People’s relatives told us that they thought the building was suitable, there were enough staff, their relative was looked after well and the staff kept them involved and informed. They also told us they felt their relative was safe there and they had not needed to raise any formal complaints. However, if they needed to raise anything, they felt listened to and action would be taken to address the situation.

We found that the building was hygienic and clean and that incidents that affect the health, safety and welfare of people had been notified to the Care Quality Commission. .

We found that although the building was generally well maintained, with work occurring on both days we visited and that the provider responded immediately to areas that that we identified as needing work to make safe, people who use the service were not always protected against the risks of unsafe or unsuitable premises because the provider had not always taken adequate steps to provide care in a home that was suitably always adequately maintained.

All people who live at the service were involved in the review of the service through either their feedback or our observations of their interactions with the service and staff. We spoke with four carers (relatives) either on the day of our site visit or via telephone following our visit. We also consulted with seven staff members. The site visit was in part facilitated by the provider and acting manager. On the day of our site visit there were eighteen people living at the service, including people who have dementia, physical and mental health needs. The service has recently started to participate in continuing care programme where people are admitted to the service to receive end of life care.

Carers noted the calmness and quietness of the service which suited their relative. People who live at the service said how much they liked living at Woodside View and that they received all the support they needed. A person said “I feel very safe living here”.

People told us about the flexibility in their daily routines and respect for their personal freedom and lifestyles. A person told us of the importance of being able to live an independent lifestyle and how the service enabled them to do this.

People described their meal on the day of our visit as “very nice” “lovely” and “the meals are always so nice we are rather spoilt”. A carer told us that the meals always look and smell nice and how they are invited to stay for a meal. A person told us about their particular dietary preferences and how the chef always accommodates this.

Carers consistently told us that staff were polite and caring. A carer commented that “sometimes their English can be difficult to understand but mum seems to understand them”. All people who live at the service that we spoke to said how kind and helpful the staff were. One person told us about the importance to them of the service employing male staff, which they were able to relate to. People told us that they were always able to get the help they needed when they wanted and that they felt staff knew what they were doing, and that they had the skills to meet their needs.

As part of this review we were provided with copies of many recent letters of complement from carers regarding their relative’s end of life care and treatment. These letters noted the kindness of staff and the good standard of care their relative had received.

People told us that if they had any concerns or feedback they felt confident that they could raise them with the acting manager. Carers told us that they have been asked their views about the service and if there was anything that could be improved upon.