CQC report explained · a care home with nursing
What the CQC found at Woodchurch House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and reviewed, staffing was sufficient, medicines were managed safely and infection control was effective. They found no evidence during this inspection that people were at risk of harm from the concern about unwitnessed falls.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was carried forward into the overall rating.
- Caring?
- Good
- People and relatives described staff as kind, caring, friendly and respectful. Inspectors saw people being involved in decisions, treated with dignity and supported to remain independent.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was carried forward into the overall rating.
- Well-led?
- Good
- Inspectors found a clear management structure, regular audits and an open culture where people, relatives and staff could share their views. A new manager was visible and approachable, but was not yet registered with the CQC.
What inspectors found, June 2023
Rated Good; inspectors found safe, caring care and good leadership, while a new manager's registration was still being assessed.
This was an unannounced focused inspection on 7 June 2023. Inspectors looked at whether people were safe, treated with kindness and whether the home was well led. They spoke with people, relatives, staff and visiting professionals, observed care, and checked care, medicines, staffing and management records.
The overall rating was Good. Inspectors found that risks were assessed, medicines were managed safely, infection control was effective and there were enough staff. People and relatives said they felt safe and described staff as kind, caring and respectful. People were involved in decisions and encouraged to remain independent.
A new manager had been in post for one month and had applied to register with the CQC. The application was still being assessed. The inspection followed information about a serious injury after an incident, but the inspection did not examine what happened. The report says the overall Good rating remained because ratings for areas not inspected were carried over from the previous inspection.
Risk management
Care plans and risk assessments were clear, comprehensive and up to date. Staff knew people's risks and how to support them safely.
“Risk assessments were clear, comprehensive and up to date.” from the report
Safe staffing and medicines
Inspectors found enough staff to meet people's needs, with call bells answered quickly. Medicines records were accurate and staff administering medicines were trained and assessed as competent.
“There were enough staff deployed to meet people's needs.” from the report
Kind and respectful care
People and relatives spoke highly of staff. Inspectors found that people were treated with dignity and encouraged to do as much as they could for themselves.
“People told us staff were kind, caring and treated them respectfully.” from the report
Open management
The manager was visible and encouraged staff, people and relatives to share concerns and suggestions. The home used audits, meetings and improvement plans to monitor care.
“The manager promoted a positive culture in the service and there was a commitment to continuous improvement.” from the report
Manager registration pending
minorThere was no registered manager at the time of the inspection. A new manager had applied to register, but the CQC was still assessing the application.
“At the time of our inspection there was not a registered manager in post.” from the report
Serious injury investigation
needs fixingThe inspection was prompted partly by a serious injury following an incident. The CQC said this was still being investigated and that this inspection did not examine the circumstances.
“This incident is subject to further investigation by CQC as to whether any regulatory action should be taken.” from the report
- 01What is the current position of the new manager's application to register with the CQC?
- 02What happened in the serious injury incident, and what actions have been taken while the CQC investigation continues?
- 03How do you identify and reduce the risk of unwitnessed falls for my relative?
- 04How are changes in people's needs shared with all staff during handovers?
- 05What improvements have resulted from feedback from relatives and the working group?
This was an unannounced focused inspection of Safe, Caring and Well-led; Effective and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 30 June 2023 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, September 2021
Rated Good; inspectors found safe, kind care and effective management, although a new manager was not yet registered.
This was an unannounced, focused inspection on 10 August 2021. Inspectors looked at Safe and Well-led. They spoke with eight people, one relative and 11 staff, and reviewed care, medicine, recruitment and management records. They also sought feedback from 10 relatives after the inspection.
People said they felt safe, staff were kind and they liked living at the home. Inspectors found up-to-date care plans and risk assessments, safe medicines systems, suitable staffing, prompt responses to call bells and good infection prevention arrangements.
The new manager had an open-door policy and staff found the management team supportive. Daily handovers, audits and action tracking were in place. The service was rated Good overall, with Safe and Well-led also rated Good.
The other three areas were not inspected during this visit. Their previous ratings were carried forward when calculating the overall rating.
People felt safe
People and relatives told inspectors that staff were kind and that people were safe. Staff understood safeguarding and knew how to report concerns.
“People told us they felt safe in the service, staff were kind to them, and they liked living there.” from the report
Good risk and medicines checks
Care plans and risk assessments were current. Medicines were stored, given and recorded safely, with regular audits.
“Care plans and risk assessments were comprehensive and up to date.” from the report
Strong day-to-day management
The home had daily handovers, regular audits and action tracking. Staff said the manager was approachable and supportive.
“There was a clear management structure, nurses and care staff understood their responsibilities to meet regulatory requirements.” from the report
Infection prevention
Inspectors were assured that the home had arrangements for visitors, testing, protective equipment, hygiene and managing outbreaks.
“We were assured that the provider was preventing visitors from catching and spreading infections.” from the report
Manager registration
minorThere was no manager registered with the CQC at the time of inspection. A new manager had started and had begun the registration process.
“The service did not have a manager registered with the CQC.” from the report
Recent management changes
minorRelatives reported that there had been several management changes. Most knew about the new manager, but not all had met them.
“Relatives told us there had been a lot of changes in management recently.” from the report
- 01Has the new manager now completed CQC registration, and who is legally responsible for the service while this is being completed?
- 02How are call bell response times monitored, and what action is taken when a response takes longer than five minutes?
- 03How will the home keep families informed during recent management changes?
- 04How are care plans and risk assessments kept up to date for each person?
- 05How are lessons from falls, wounds, accidents or other incidents shared with staff and followed up?
This was an unannounced focused inspection of Safe and Well-led only; the other three key question ratings were not inspected and previous ratings were used for the overall rating. This explanation was written from the published report of 16 September 2021 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 Woodchurch House
10 rated inspections over 7 years: the service has improved, from Inadequate to Good.
- June 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2021Goodstayed GoodSafe: GoodWell-led: Good
- January 2021Goodstayed GoodSafe: GoodWell-led: Good
- March 2020Goodup from Requires improvementSafe: GoodCaring: GoodWell-led: Good
- March 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2017Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2017Inadequatestayed InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2016Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateWell-led: Inadequate
- October 2016Requires improvementup from InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2016InadequateSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- September 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- May 2012
Registered with the Care Quality Commission on 8 May 2012.
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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