Woodville Residential Care 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.

Woodville Residential Care Home is registered to provide personal care and accommodation for up to 46 people. At the time of our inspection 45 people were using the service. The service accommodates people in one building over two floors and had adapted facilities to meet people’s needs. This included two lounges, one with a dining area, a separate dining room and a conservatory. An enclosed rear garden was also available that people could access.

The service had a registered 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. The registered manager was not available on the day of the inspection.

At our last inspection in September 2017 the provider had been in post at the home since August 2017 and we found that the fundamental care standards were not being fully met. This resulted in the service being rated as requires improvement. This was because the staffing levels in place at that time were not sufficient, medicines were not managed safely, social opportunities for people to participate in activities were limited and quality monitoring systems were not in place.

At this inspection improvements had been made in these areas but further improvements were needed. Quality monitoring systems were in place and this included the recording and analysis of falls. However, further improvements were needed to ensure patterns and trends were identified. This was to enable actions to be taken, to minimise risk and keep people safe. We have made a recommendation about the management of falls.

The staffing levels had increased but the deployment of staff required improvement to ensure sufficient numbers of staff were available in all areas of the home. Although improvements had been made to the social opportunities provided to people; further improvements were needed to ensure opportunities were available throughout the day to enhance people’s well-being. We have made a recommendation for the provider to review the current guidance on meaningful activities for older people.

Improvements had been made in the management of medicines. We saw these were managed safely and people received their medicines as required. Staff understood what constituted abuse or poor practice and knew how to report concerns. Thorough recruitment checks were done prior to employment to ensure the staff were suitable to support people.

Staff understood people’s care and support needs to enable them to support people in their preferred way. Staff received support from the management team and were provided with the relevant training to ensure people’s needs could be met.

Plans to respond to emergencies were in place to enable staff to support people in accordance with their needs, in an emergency situation. People had the equipment they needed to enable staff to assist them safely. The provider checked that equipment was regularly serviced to ensure it was safe to use.

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. People and their representatives were involved in their care to enable them to make decisions about how they wanted to receive support in their preferred way. People received a balanced diet that met their preferences and assessed needs. People were supported to access healthcare services and received coordinated support, to ensure t

Woodville Residential Care Home is registered to provide accommodation for up to 46 people who require personal care support. At the time of our inspection there were 45 people using the service. Some people that were using the service were living with dementia.

This inspection took place on the 26 September 2017. This was an unannounced inspection. Prior to this inspection we received information of concern regarding the management of medicines. Our last comprehensive unannounced inspection took place on 12 August 2015 and the provider was rated as good overall and were meeting all the regulations that we checked relating to the Health and Social Care Act 2008.

Since August 2017 the organisation Greenacres Nursing Homes Limited that owns Woodville Residential Care Home had been purchased by Prime Life. This means that the changes to registration are that of the company directors and the nominated individual. A nominated individual acts as the main point of contact with us on behalf of the organisation and carries responsibility for supervising the management of the service.

The service did not have a registered manager in post at the time of 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. A manager had been appointed under the new directors and confirmed they were in the process of applying to register with us.

People’s needs were not always met in a timely way as the staffing levels were insufficient. The limited staff numbers meant opportunities for people to receive social stimulation were limited. This had been identified by the new providers and was being addressed. We could not be assured that identified risks to people were minimised; as some information was conflicting and not updated when people’s needs changed. The medicine practices in place did not demonstrate that people always received their medicine as prescribed. Checks to monitor the support and services provided were limited. Those that had been undertaken were not always effective in analysing any themes and trends, to ensure risks to people were minimised. This had been identified by the new provider and systems were being put in place to address this.

Staff understood their responsibilities to keep people safe and checks had been completed before staff commenced employment, to ensure they were suitable to support people. The provider checked that the equipment was regularly serviced to ensure it was safe to use. Staff told us that they were supported by the management team and were provided with the relevant training to ensure people’s needs could be met.

Staff gained people’s verbal consent before supporting them with any care tasks and helped people to make their own decisions. Where people were unable to make decisions the staff supported them in their best interests. People received food and drink that met their nutritional needs and preferences and were referred to healthcare professionals to maintain their health and wellbeing.

People told us that they liked the staff and we saw that people’s dignity and privacy was respected by the staff team. Visitors told us they were made to feel welcome and that staff were approachable and friendly

People and their relatives were involved in discussions about how they were cared for and supported. Complaints were responded to and the provider’s complaints policy and procedure was accessible to people. The provider had ensured that people and their representatives had been consulted regarding the changes in home ownership and the improvements planned. Plans were in place to gather people’s views through satisfaction questionnaires.

We found breaches of the Health and Social Care Act 2008 (Regulate

This inspection was an unannounced and took place on 12 August 2015. At our last inspection in August 2014 compliance actions were issued as we identified that improvements were needed regarding decision making when the person has not got the capacity for consent and records being up to date. At this inspection we found that improvements had been made in relation to both these areas.

The service was registered to provide accommodation for up to 46 people. People who used the service had physical health needs and/or were living with dementia. At the time of our inspection 45 people were using the service.

The service had a registered 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 and associated Regulations about how the service is run.

People were protected from avoidable harm because risks to people’s health and wellbeing were identified, and managed and the staff understood how to keep people safe. People’s medicines were also managed safely.

There were sufficient staff to meet people’s needs and they received training that provided them with the knowledge and skills to meet people's needs effectively.

People were supported to make decisions and where there was a lack of capacity to make decisions, people were protected under the Mental Capacity Act 2005.

People were supported to maintain their nutrition and staff were monitoring and responding to people’s health conditions.

People were treated with dignity and respect and had their choices acted on. We saw staff were kind and caring when supporting people.

There was a good range of activities and social stimulation which people felt engaged in. People also know who to speak with if they had a concern and they felt it would be taken seriously.

There was a positive homely atmosphere at the service and the manager and provider regularly assessed and monitored the quality of care to ensure standards were met and maintained.

At the time of this inspection there were 46 people using the service. We spoke with two people receiving care and one relative, the manager and two staff working at the service. We also observed people receiving care and examined records at the service. Below is a summary of what we found.

Is the service safe?

People who used the service told us they felt safe living at the service and were able to describe what they would do if they were worried about anything. Staff had received training on keeping vulnerable people safe.

People told us that staff usually talked things over with them before and during carrying out their care. However, adequate arrangements were not in place for decisions to be made on people’s behalf when they did not have the capacity to consent. We have asked the provider to tell us what they will do to meet the requirements of the law in relation to mental capacity.

Is the service effective?

Care plans provided staff with guidance in meeting most people’s needs. Recorded risk assessments were in place to address risks to which people may have been exposed. However, these records were not in place for everyone. This meant that staff were not being provided with up-to-date guidance as to how they should safely manage risks for everyone. We have asked the provider to tell us what they will do to meet the requirements of the law in relation to assessing people’s needs and risks they may be exposed to.

Staff had positive views on the service. One member of staff told us that, “it’s up to us to make [the service] happy and safe.”

Is the service caring?

People told us they thought that staff knew their personal wishes, interests and preferences and thought that their needs were met at the service. One person said, “I can pretty well do as I like.” Staff told us that most activities reflected people’s individual preferences.

We observed, and heard, staff interacting warmly and sensitively with people who used the service.

Is the service responsive?

People’s personal records showed that staff were encouraged to take an approach to people which was centred on their individual needs. People’s personal preferences and interests were identified and acted on and care and support was provided that met people’s wishes.

One staff member we spoke with gave us an example of action the service had taken following a suggestion they had made. Another member of staff told us, “If I have a problem it will be sorted.” Staff told us they felt listened to by the manager.

Is the service well-led?

The service had a quality assurance system which identified, assessed and managed risks to people’s health, safety and welfare.

Staff described a sound set of values upon which the service was based. These included meeting people’s needs for privacy, confidentiality and empathy and providing a clean and tidy environment.

We spoke with four people and observed others. We spoke with two visitors and three staff. People living at the home told us they were given choices as to how they preferred to spend their day. They told us they were able to get up with assistance when they needed this. They said they were asked about their preferences and made choices about their bath times or the type of meals they liked.

People were provided with a comprehensive care plan that looked at what they needed and guided care workers as to how they should meet people’s needs. Those who spoke with us told us they were satisfied with their care and were happy with staff who provided their care.

People said doctors and nurses visited the home when they needed them. They also confirmed visits by the chiropodist, dentist and optician.

We asked a visitor to the home if they had any concerns about any of the staff employed at the home. They told us they had no concerns and added “staff know what to do and they do it well”.

People who spoke with us told us they were aware of care workers making daily notes about them. They also indicated they had no concerns in this area.

A relative told us, “if my relative is unwell someone from the home will ring and let me know”.

One person living at the home told us, “the home is kept spotlessly clean through out just look at my bedroom”. We could see the room was well maintained and clean in appearance.

Everyone we spoke with was happy with the standards of the care service. People told us that they liked using the service, that it was 'absolutely marvellous' and that staff were 'well organised' and 'helpful'. One person said ' I feel safe' and another that they were 'very pleased' with the care. Relatives told us that the care was 'good' and that the service was 'welcoming'.

People enjoyed their food and the activities that the service provided. One person said the food was 'very good' and another that 'I've enjoyed the meals all the tine I've been here'.

Visiting professionals told us that they had 'no concerns' about the care. They told us that the service responded well to professional advice and guidance.

People told us the premises were odour free and tidy and that they were 'clean' and 'homely'.