About the service: Woodspring House is a residential care home that was providing accommodation and personal care to 27 people at the time of the inspection.

People’s experience of using this service:

The risks to the quality and safety of the service were identified and acted on. There was enough staff on duty to enable people to remain safe and receive care in a timely way. The environment was safe and people had access to appropriate equipment where needed. People were supported to take their medicines in a safe way.

People, their relatives and staff told us the provider’s directors and registered manager were approachable and they felt listened to when they had any concerns or ideas.

Staff had received appropriate training and support to enable them to carry out their role safely. Peoples health was well managed and staff had positive links with professionals, which promoted well-being for them.

Staff were kind and caring and promoted people’s dignity. Staff understood the importance of treating people with respect and ensured they did this. People were observed to have good relationships with the staff team. Staff actively ensured people maintained links with their friends and family.

People's records clearly identified their preferences. Staff provided effective care for people, which met their needs through person-centred care planning. This enabled people to achieve positive outcomes and promoted a good quality of life. People enjoyed an extensive programme of activities both in the home and the local community. Complaints were managed within the providers stated process.

Staff were motivated and enjoyed strong team work. Information from audits, incidents and quality checks was used to drive continuous improvements to the service people received.

Rating at last inspection: Good (Published September 2016)

Why we inspected: This was a scheduled inspection based on our previous rating.

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

This inspection was unannounced and took place on 1 September 2016.

Woodspring House is a care home that provides accommodation and care for up to 28 people. The care is provided over two floors. There are a number of separate communal areas for people to reside in and two dining rooms. There were 28 people living at the home during our inspection visit.

There was a registered manager working at 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 and associated Regulations about how the service is run.

People received care from kind, caring and compassionate staff who had received enough training to enable them to provide people with good quality care. People were treated with dignity and respect.

The provider and staff had developed a culture in the home that was open and welcoming. People felt able to raise concerns if they wanted to and these were listened to and dealt with. People were treated as individuals and the care was delivered to meet their individual needs and preferences.

People were supported to participate in activities that they found stimulating and interesting. These enhanced their well-being and quality of life.

People were given choice about how they wanted to be cared for and these choices were respected. They received enough food and drink to meet their needs and were supported to maintain their health.

There were enough staff working in the home to meet people’s individual needs and there were systems in place to protect people from experiencing abuse and avoidable harm.

The staff were happy working in the home and knew what was expected of them. All of the people, staff and visiting relatives we spoke with recommended Woodspring House as a place to live.

There were effective systems in place to monitor the quality and safety of the care provided. People’s feedback on how to improve the quality of care they received was regularly sought and acted upon.

We have made a recommendation about calculating the number of staff required based on people’s individual needs.

A single adult social care inspector carried out this inspection to follow up concerns raised during our previous inspection of 21 and 22 May 2014 and to establish whether improvements had been made. We reviewed the evidence we had obtained during this inspection and used it to answer four key questions we always ask: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Our May 2014 inspection established that the systems in place were not always effective at identifying people at risk of malnutrition. We found substantial gaps in staff training. We also found minimal systems in place to assess and monitor the quality of the service provided for people.

During this inspection we spoke with the manager and the provider. We viewed care records in relation to four people and other records relating to the management of the service. We were satisfied that improvements had been made.

Is the service safe?

Following the May 2014 inspection new scales for weighing people had been purchased and were in use. Staff could rely on the accuracy of the readings and were able to monitor people’s weights on an ongoing basis. People’s weights were recorded centrally and comparisons made with weights from previous months to ensure that when people’s health changed, staff were aware and able to take prompt and appropriate action.

Is the service effective?

This inspection found that substantial improvements had been made to ensure that staff received appropriate and timely training. The vast majority of outstanding staff training had been completed, as had staff appraisals. People could be assured that they were cared for by staff who were trained and supported appropriately by the service.

Is the service responsive?

The manager told us they were able to discuss any concerns they had about people’s nutritional requirements with the nurse led practitioner, who visited the service weekly. We noted where advice had been given and we found that this advice had been followed. We saw where, following the advice given, one person had re-gained weight they had lost whilst they had been unwell.

Is the service well-led?

Improvements had been made in relation to assessing and monitoring the quality of the service provided for people. Audit systems were now in place that were carried out by the manager or the provider on a regular basis. The provider may find it helpful to note that some of these audits required further development to improve their effectiveness.

During this inspection we found that people's needs were assessed prior to them moving into the home to ensure the home could meet those needs. There were care plans in place that were personalised and suitable communication methods were used to ensure staff were kept up to date with any changes to those care needs. Risks had been identified and information was logged to minimise or remove the risks.

The home had procedures in place for suitable management of medication. We observed an administration process, looked at records and saw safe storage which ensured that medication practises were managed safely.

The building was maintained appropriately by checks carried out by the provider. Records and safety certificates were stored and available for us to see which showed the home was up to date with safety checks and that the home was suitable for people it provides care for.

The provider had robust recruitment procedures in place that ensured all staff were suitable and able to do their job to an appropriate standard.

Although the home had not received any formal complaints the people who lived in the home and families of those people had information that told them how to complain if they needed to. One person told us "I have no complaints whatsoever. All the staff are good and I see the manager all the time and could talk to her if I needed to. She will listen and sort it out."

We made a follow up visit to this home to check that the provider of this service had achieved the action set in their plan of improvements and that they were now meeting the essential standards required following their last inspection of May 2012.

Although this was a short visit we were able to observe the improvements that had been made for the people living in this home. We noted that they appeared more content, their appearance had improved. More care was now taken by staff who were now using the new improved care plans and monitoring sheets to deliver the support and care safely and appropriately that would ensure individual, person centred needs, were met.

During this visit on 21 May 2012 we spent time observing people who live in the home who were not always able to verbally tell us how their lives were now they were living in Albany House.

We noted that people appeared contented. Any anxiety shown was dealt with appropriately by the staff who had a suitable approach to reassure people. We saw plenty of smiles and suitable support to help people as they spent their day in the communal areas of the home.

Group activities were enjoyed and a large number of people were participating.

Visitors seen during the visit were full of praise for the way the care was offered at the home.

The interaction between the provider/owner and staff of the service and the people living in the home showed how, through smiles and positive body language, people were happy with the staff team who supported them with their care needs.

We reviewed the evidence we had obtained during our inspection and used this to answer five key questions we always ask: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

This is a summary of our findings. If you would like to see the evidence supporting this summary please read the full report.

Is the service safe?

We found that sufficient staff were on duty during both days of our inspection to meet people's needs. Where there had been periods where staff numbers were short during April we saw that substantial progress had been made from the beginning of May to increase staff on duty.

Staff were safety conscious and observant. We noted one staff member leaving the activities room giving their scissors to a colleague for safe-keeping until they returned. Where one person was attempting to walk unaided staff quickly spotted this and went to their assistance promptly.

The manager was aware of their responsibilities under the Mental Capacity Act 2005 and had taken appropriate action in relation to one person in accordance with the Deprivation of Liberty Safeguards.

Is the service effective?

It was clear from our observations and speaking with staff that they knew people well and understood what people's individual support needs were. The computerised care records system generated person centred, detailed care plans, which helped guide staff to look after people safely and effectively.

We found that there were substantial gaps in staff's training records, appraisals and supervisions which we discussed with the manager. They had been managing the service for four months and were aware that these areas needed considerable and prompt attention.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to staff training records, appraisals and supervisions.

Is the service caring?

We were impressed by the attention to detail in the way people were dressed and groomed. When supporting people we noticed that staff were patient and encouraging. We spent time in the dining area when activities were being undertaken and in an area which contained three adjacent lounges. Staff were always on hand to do activities with people in the dining room. We noted that staff were frequently popping in to the lounges to make sure people were okay. Everybody was spoken with or given individual attention periodically from staff.

Is the service responsive?

A high proportion of people were engaged in activities inside the home on both days of our inspection. People clearly enjoyed the activities they were participating in.

We saw where a complaint had been made that the manager took prompt action to investigate the concerns raised. A written response was made which was timely and appropriate to the situation.

Is the service well-led?

People were not protected against the risks of inappropriate or unsafe care because a quality assurance system was not in place to identify, assess and manage risks to people’s health, safety or welfare. Substantial improvements were required.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to assessing, identifying and managing risks to people.