CQC report explained · a nursing home
What the CQC found at Woodend Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks were assessed and monitored. Inspectors found enough staff, safe recruitment, safe medicines systems, checked equipment and good infection control.
- Effective?
- Good
- Staff had training and support, and people’s health, nutrition and hydration needs were met. Inspectors found appropriate involvement from health professionals and that consent and legal safeguards were managed properly.
- Caring?
- Good
- People and relatives described staff as kind, caring and respectful. Staff knew people’s preferences, offered choices and supported dignity, independence and cultural needs.
- Responsive?
- Good
- Care plans gave staff guidance about people’s needs and preferences. Activities were provided across the week, communication needs were recorded and complaints were investigated.
- Well-led?
- Good
- The home had regular audits, action plans and meetings to review risks and incidents. Managers were visible and relatives and staff said communication with the management team was good.
What inspectors found, March 2023
Woodend Care Home is rated Good; inspectors found safe, kind care, with some care-record issues to watch.
Inspectors visited without notice on 6 and 7 March 2023. They spoke with people living in the home, relatives, staff and visiting professionals. They reviewed care and medicines records, incidents, audits and the building, and observed care.
All five areas were rated Good. Inspectors found people were safe, medicines were given as prescribed, staffing was sufficient and the home was clean. Staff had suitable training and people’s health, nutrition and communication needs were being supported.
People and relatives described staff as kind, caring and respectful. Care was personalised, activities were available throughout the week and relatives said communication was good. One electronic care record had not updated on staff devices, but this was fixed during the inspection.
This inspection followed a Requires Improvement rating published in September 2020. The ratings for Safe, Effective, Caring, Responsive and Well-led had all improved to Good.
Safe medicines and staffing
Inspectors found that medicines were managed safely and there were enough staff to meet people’s needs.
“People received their medicines as prescribed. There were enough staff to meet people's needs.” from the report
Clean and well-managed infection control
The home was clean and infection control arrangements were working well. An external local authority audit found 96% compliance.
“The home was clean throughout. The local authority infection control team had recently visited Woodend and their audit resulted in a score of 96% compliance.” from the report
Kind and personalised care
Staff offered choices, explained what they were doing and knew people’s preferences. People and relatives spoke positively about the care.
“We observed positive, warm interactions between people and all members of staff throughout our inspection.” from the report
Activities and social contact
The activity team had grown and a planned programme covered all seven days. Activities included one-to-one time, baking and visits from entertainers.
“The activity team had recently been increased to 4 members. This meant more activities could be arranged across all 7 days.” from the report
Quality monitoring
Audits and action plans were used to identify and follow up improvements. Managers also reviewed incidents and clinical risks.
“Where issues were identified, an action plan was automatically generated.” from the report
End-of-life plans could fall behind
needs fixingInspectors found that support plans did not always reflect people’s quickly changing needs at the end of life. The management team agreed to consider a shorter plan that could be updated more quickly.
“As people's care and support needs changed quickly at the end of their lives, the support plans did not always reflect the current support needed.” from the report
One electronic record did not sync
minorOne updated care record was not showing on the hand-held devices used by care assistants. The issue was fixed straight away and its cause was identified.
“One care plan had not synced correctly to the hand held devices used by the care assistants.” from the report
Staff supervisions were infrequent
minorStaff said formal supervision meetings did not happen often. However, the staff spoken with felt well supported and could speak with managers when needed.
“Whilst supervisions were said to be infrequent, all the staff spoken with felt there were good levels of support provided” from the report
- 01How do you make sure care plans are updated quickly when someone’s needs change at the end of life?
- 02What checks make sure updated care plans are visible on all staff hand-held devices?
- 03How often will staff receive supervision and how is their support monitored?
- 04How will you involve my relative and our family in reviewing their care plan?
- 05What activities would be suitable for my relative, including any one-to-one support?
This was an unannounced inspection that looked at all five CQC areas, including the care and the premises, and followed a previous Requires Improvement rating. This explanation was written from the published report of 21 March 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 2020
Woodend Care Home is rated Requires Improvement; inspectors found safer care and a positive culture, but sustained improvement is still needed.
This was a focused inspection on 27 August 2020. Inspectors checked Safe and Well-led, including medicines, staffing, infection control, risk management and quality systems. They spoke with people, relatives, staff and managers, and checked care records, medicines records, recruitment records and audits.
The home had improved since the previous inspection. Medicines were managed safely, staffing levels were considered safe, infection control was well managed and oral care concerns had been resolved. People and relatives gave positive feedback, and staff described stronger leadership and communication.
Both Safe and Well-led were rated Requires Improvement. The home was no longer rated Inadequate or placed in special measures, and it was no longer breaching the regulations checked. CQC said the improvements needed to be sustained over time before a Good rating could be given.
Safer medicines
Medicines were stored, recorded and managed safely. Inspectors found that people received medicines in the right way.
“Records showed that people received their medicines in the right way.” from the report
Infection control
The home was visibly clean and had infection control procedures in place. Staff had access to protective equipment and had received extra training during the pandemic.
“The premises were visibly clean and hygienic. Thorough cleaning took place throughout the day.” from the report
Staffing and recruitment
Staffing levels had improved and were reviewed when needed. Recruitment checks were completed before new staff started work.
“Staff were recruited safely and had the appropriate pre-employment checks in place before employment commenced.” from the report
Leadership and oversight
The home had introduced stronger auditing and clearer systems to check quality and deal with earlier concerns.
“Regular and effective auditing was now in place to ensure the service was always improving.” from the report
Positive feedback
People, relatives and staff gave positive feedback about the manager, staff and atmosphere in the home.
“We received positive feedback from people and their relatives about the manager and the staff.” from the report
Improvements need to last
needs fixingThe home had improved but had not yet shown that the changes had been sustained for long enough for a Good rating.
“In order for the service to be rated good sustained improvement is required over a period of time.” from the report
- 01How are you checking that the improvements to medicines management continue?
- 02How do you review staffing levels on each floor, and what happens if staffing needs change?
- 03How are oral care needs recorded and checked now that earlier concerns have been resolved?
- 04How do you make sure infection control procedures and protective equipment remain effective?
- 05What evidence can you show that the improvements found at this inspection have been sustained?
This was a focused inspection of Safe and Well-led, including infection control; Effective, Caring and Responsive were not assessed and their previous ratings carried over. This explanation was written from the published report of 25 September 2020 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 Woodend Care Home
8 rated inspections over 8 years: the service has improved, from Inadequate to Good.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2020Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- March 2020Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2015InadequateSafe: Requires improvementEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- July 2014
Report published without a new overall rating.
- October 2013
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.
- June 2012
Report published without a new overall rating.
- April 2011
Report published without a new overall rating.
- October 2010
Registered with the Care Quality Commission on 1 October 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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