We inspected the service on 21 January 2019. The inspection was unannounced. Woodsmoore 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 service accommodates six people.

On the day of our inspection six people were using the service.

The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection in May 2016 we rated the service ‘good.’ At this inspection we found the evidence continued to support the rating of ‘good’ overall but there had been a deterioration in safe which was rated as ‘requires improvement.' This was predominantly in regard to infection, prevention and control. However, 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 of the service has not changed since our last inspection.

The service was rated ‘requires improvement' for ‘safe’ at this inspection. The management of infection control was not always effective because the service was not kept clean or well-maintained to be able to be effectively cleaned. People received their prescribed medicines, however, we identified some minor issues that were addressed by the registered manager.

People continued to receive a safe service where they were protected from avoidable harm, discrimination and abuse. Risks associated with people’s needs including the environment, had been assessed and planned for and these were monitored for any changes. People did not have any undue restrictions placed upon them. There were sufficient staff to meet people’s needs and safe staff recruitment procedures were in place and used. Accidents and incidents were analysed for lessons learnt and these were shared with the staff team to reduce further reoccurrence.

People continued to receive an effective service. Staff received the training and support they required including specialist training to meet people’s individual needs. People were supported with their nutritional needs. The staff worked well with external health care professionals, people were supported with their needs and accessed health services when required. 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 principles of the Mental Capacity Act (MCA) were followed.

People continued to receive care from staff who were kind, compassionate and treated them with dignity and respected their privacy. Staff had developed positive relationships with the people they supported, they understood people’s needs, preferences, and what was important to them. People’s independence was promoted.

People continued to receive a responsive service. People’s needs were assessed and planned for with the involvement of the person and or their relative where required. People received opportunities to pursue their interests and hobbies, and social activities were offered. There was a complaint procedure and action had been taken to learn and improve where this was possible.

There was a registered manager and they promoted an open and transparent and person-centred culture with adequate leadership. People were asked to share their feedback about the action was taken in response.

Further information is in the detailed findings below

This inspection took place on the 31 May 2016 and was unannounced.

Woodsmoore is a small residential care home and provides accommodation and support for up to six people who have a learning disability. On the day of our inspection six people were using the service.

Woodsmoore is required to have a registered manager; the provider was the registered manager for the service. 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.

People using the service and the staff supporting them knew who to report any concerns to if they felt it was necessary.

People were supported by staff who had the knowledge and skills to provide them with safe care and support. Staff received supervision and support from the management team. There were enough staff with the right skills and experience to meet people’s needs.

People were supported and involved in decisions made in their best interests. The staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). When required, applications had been made to the local authority for assessment and authorisation.

There were effective systems in place to safeguard people and keep them safe. Safe staff recruitment procedures were in place and followed. Pre-employment checks were undertaken to ensure staff were able to work within the care sector.

Medicines were stored, administered and managed safely. Staff received appropriate training and were observed by a member of the management team, to ensure their practice was safe when administering people’s medicines.

People were supported by staff who were kind and caring. Staff treated people with dignity and respect. Staff had information available to assist them in supporting people who had signs of anxiety or distress. People were supported to remain as independent as possible. There were no restrictions on family and friends visiting people at the service. The atmosphere within the service was calm and welcoming.

The provider had auditing systems and checks in place to ensure the service was safe and of good quality. There was a positive, open and inclusive culture at the service. People were involved in giving their views on how the service was run.

As part of our inspection we spoke with three out of the five people that lived at Woodsmoore as well as staff working at the service. We also observed people receiving care and examined records at the service.

Is the service safe?

We found that medicines were safely administered and that appropriate arrangements were in place in relation to the recording of medicine. However the provider should note that temperatures for the storage of medicines were not being recorded. We discussed this with the manager who made arrangements for temperatures to be recorded. It is important to store medicines correctly as medicines may deteriorate when they are not stored in line with recommended temperatures.

We found appropriate recruitment checks were undertaken before staff began their employment. We saw five staff files that contained evidence that the provider had checked people’s identity, employment history, obtained character references and satisfied themselves of the person’s suitability for the job. This meant that people living at the service were cared for by people suitable for the role.

Is the service effective?

People at Woodsmoore had some health conditions that required help and advice from other health professionals. We found that care records recorded other health professionals involvement in people’s care and recorded when and why meetings had been arranged. We found that the provider had assessed people’s care and health needs accurately and had incorporated advice and information from other professionals into people’s care plans. This meant that people living at Woodsmoore had their care and health needs assessed appropriately. This helped to protect people from the risk of unsafe and inappropriate care.

Is the service caring?

Some people who lived at the service could become anxious or upset and care plans were in place to support these issues. We spoke with four members of staff who were able to tell us about the care needs of people they cared for including situations that could trigger anxiety in people. Staff told us what actions they took to minimise the chances of people becoming upset or unwell.

Is the service responsive?

We looked at the information people were given when they first came to live at Woodsmoore. We found information on how to complain and further information on what to do if people did not think their complaint had been resolved. One person we spoke with who lived at the service told us, "I know how to complain, I was told about it when I first arrived here." Other people told us they would talk to staff if they had a comment or concern about the service. This meant that people were aware of how to comment and complain.

Is the service well-led?

We found the manager had arranged regular supervision of staff. When we read staff supervision notes we found the manager checked that staff were up to date with their training. The manager had identified improvements to record keeping and discussed this with staff. The manager had also arranged regular meetings with different staff groups. These actions reduce risks to people and help the service to run effectively.

Woodsmoore is a purpose built building with much of the accommodation having been opened in the past twelve months. At the time of our visit there were four people living at Woodsmoore with one empty bedroom. We found that the home was well maintained and provided comfortable, spacious and suitable domestic living arrangements.

We spoke with one person who lived at the care home. They said they were happy living there, and said they had a really nice flat. They showed us their flat which consisted of a bedroom with an en-suite bathroom, a kitchenette, and a sitting area.

Two staff members who we spoke with said they were happy working at Woodsmoore. They said that there was a good staff team, and lots going on. Staff also said that there were good training opportunities available and they felt well supported. Both staff members said that they were able to raise any issues with the provider, and one staff member said: “that the organisation was built on good core values, which put people first, and valued them as individuals.”

We found that people received care and support that protected their rights and met their needs from staff that were properly trained and supported.

Woodsmore was made up of two self contained flats and also a communal living and staff area. There was only one person living at Woodsmore at the time of our visit. We did speak with this person however in order to protect their confidentiality we have based our decisions on our observations and review of records relating to Woodsmore.

The person living at Woodsmore had discussed their care and treatment with staff and their preferences for their care had been recorded in their care plan.

Staff working at Woodsmore received input from a multi-disciplinary team to ensure that the person’s needs were being met and that the person was involved in decisions about any health care or treatment they required.

Regular quality monitoring reviews were completed by members of staff and the provider. This included a range of aspects of the service being provided at Woodsmore such as, reviewing medication charts and care plans, communication with staff and people living in the home and team working.