CQC report explained · a residential care home
What the CQC found at The Woodlands Care Home
Rated Inadequate: inspectors found the home performing badly and the CQC has taken enforcement action.
What inspectors found, December 2022
Rated Requires Improvement; inspectors found major progress since the last visit, but the home must show that improvements are sustained.
This was a focused inspection on 10 November 2022. Inspectors checked Safe, Effective and Well-led. They reviewed records, spoke with one person living at the home, the manager, staff and the provider's representative.
The home was rated Good for Safe. Inspectors found improved risk assessments, safer medicines systems, better fire safety, suitable recruitment checks and stronger infection control. The environment had also been refurbished and was clean and well maintained.
Effective and Well-led were both rated Requires Improvement. Consent, staff training and care planning had improved, but inspectors wanted the changes to become firmly established over time. Quality checks and provider oversight were better, although the home still needed to show that this would continue.
The previous overall rating was Inadequate and the home had been in Special Measures. Inspectors found the home was no longer in breach of regulations, was no longer Inadequate and had left Special Measures. The overall rating became Requires Improvement.
Safer care systems
Risk assessments and care records were up to date. Staff understood the person's tailored care needs, and monitoring charts were being completed.
“Effective systems and processes to assess, monitor and manage risk had been embedded.” from the report
Improved environment
The home had been refurbished and inspectors found it clean, hygienic and well maintained. Fire safety and emergency equipment had also improved.
“The home had been refurbished since the last inspection. It was clean, hygienic and well-maintained.” from the report
Medicines and recruitment
Medicines were securely stored, staff had medicine training and competency checks, and recruitment checks were being completed.
“Safe medicine management processes were now in place.” from the report
Better oversight
The provider had introduced audits, action plans and feedback systems. A new manager had also been appointed and provider oversight was stronger.
“An improved governance system was in place; a greater degree of oversight had been implemented since the last inspection.” from the report
Improvements need to last
needs fixingThe home had made rapid changes after the previous Inadequate inspection, but inspectors were not yet assured that these changes would continue over time.
“we need assurances that they can be sustained over a longer period of time.” from the report
Medicine temperature records
minorThere were several missing temperature records for medicines during November. The manager said this would be addressed with staff.
“We did find several gaps across the month of November.” from the report
Registered manager application pending
needs fixingThere was no registered manager in post at the inspection. A new manager had applied to register, and CQC was still assessing the application.
“At the time of our inspection there was no registered manager in post.” from the report
- 01How are you checking that the improvements made after the last inspection are being sustained?
- 02How do you make sure medicine storage temperatures are recorded every day and that missing records are followed up?
- 03What is the progress of the new manager's application to become registered?
- 04How will you assess and meet my relative's individual care, nutrition and healthcare needs?
- 05What new audits or feedback systems will show my family that care remains safe and well managed?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and the overall rating also used ratings from the previous inspection. This explanation was written from the published report of 7 December 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, June 2022
Rated Inadequate and placed in special measures; inspectors found serious safety, care, consent and management failures.
This was an unannounced focused inspection on 10 May 2022 and 16 May 2022. Inspectors spoke with people living in the home, relatives, staff and the provider. They also reviewed care records, medicine records, staff files and monitoring records.
Inspectors found that risks were not properly assessed or managed. Care records were inaccurate, care delivery records had large gaps, emergency evacuation equipment was missing, and the building had serious fire safety problems. Medicines were not stored securely and staff medicine skills had not been checked.
People's consent had not always been sought lawfully. Staff did not have evidence of the training, induction, supervision and appraisal needed to support people safely. The provider's checks and oversight did not identify or fix important problems.
The overall rating changed from Good at the previous inspection to Inadequate. The home was placed in special measures. The provider had started some improvements, but CQC required an action plan and said it would continue monitoring the home.
Positive views from people and relatives
People and relatives said they felt safe and well cared for. Relatives also said they were kept informed about accidents and incidents.
“People and their relatives told us they felt The Woodlands was a safe place to be and that they were well cared for.” from the report
Protective equipment and visiting
Staff had enough personal protective equipment and inspectors saw it being used appropriately. Visiting arrangements followed government guidance.
“Staff had access to adequate amounts of PPE, and we observed this to be used appropriately.” from the report
Medicine administration records
Although medicines were not stored safely and staff checks were missing, the administration records themselves were completed well and included allergy information.
“Medication administration records were completed robustly. They contained photographs of people and reflected any allergies they had.” from the report
Serious risks in the building
seriousFire doors, the alarm and other safety arrangements were not adequate. The lift was not working and equipment needed for emergency evacuation was unavailable.
“Significant fire safety concerns were evident. For instance, fire doors did not close adequately, doors were wedged open, door guards no longer worked” from the report
Care records and risk management
seriousSome records did not accurately describe people's needs or risks. There were large gaps in recording care, including repositioning support, so inspectors could not be assured people received safe care.
“There were large gaps in the records of care provided, such as repositioning support.” from the report
Medicines not secured
seriousThe medicine trolley and controlled medicines were left unsecured. Storage temperatures were not monitored and staff competency checks had not been completed.
“On the second day of inspection, the medicine trolley was left unsecured, with the keys in the lock and the cupboard containing controlled medicines had been left open.” from the report
Consent and liberty safeguards
seriousConsent records, capacity assessments and best-interest decisions were not completed properly. Some applications to deprive people of their liberty had not been made appropriately.
“People's consent to their care and treatment had not been sought and recorded appropriately.” from the report
Staff training and support
needs fixingThere was no evidence of staff training during the inspection. Staff had not recently received key training, regular supervision or appraisals.
“The deputy manager confirmed that staff had not had any recent moving and handling training, fire safety, practical first aid or fire evacuation training.” from the report
Weak management checks
seriousAudits did not identify all the problems found by inspectors, and issues that had already been identified had not been fixed. The provider did not have effective oversight of the home.
“When risks had been identified on audits, there was no evidence of actions taken to reduce the risks and the same issues were identified on consecutive audits.” from the report
- 01What has been done to fix the fire doors, fire alarm, lift and emergency evacuation arrangements?
- 02What equipment is now available to evacuate people who need a hoist or other assistance?
- 03How are medicines now secured, how are storage temperatures checked, and how are staff medicine competencies assessed?
- 04How do you ensure care plans and daily records accurately describe each person's needs and the care provided?
- 05How are capacity assessments, best-interest decisions and Deprivation of Liberty Safeguards applications now completed and reviewed?
This was a focused inspection of Safe, Effective and Well-led, including infection prevention and control under Safe; Caring and Responsive were not inspected and ratings for uninspected questions carried over from the previous inspection. This explanation was written from the published report of 29 June 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of The Woodlands Care Home
5 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- December 2022Requires improvementcurrent ratingup from InadequateSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2022InadequateSafe: InadequateEffective: InadequateWell-led: Inadequate
- April 2021Inspected but not ratedSafe: Inspected but not rated
- September 2018Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- July 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 6 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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