CQC report explained · a residential care home
What the CQC found at Woodfields Residential Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, June 2023
Requires Improvement; inspectors found medicines were not always given by trained staff, although improvements had been made.
This was an unannounced focused inspection on 23 May 2023. One inspector and an Expert by Experience spoke with people, relatives and staff, and checked care records, medicines records, recruitment files and quality records.
The home was rated Requires Improvement overall. Safe and Well-led were also rated Requires Improvement. People did not always receive medicines from staff who were trained and assessed as competent. Some flooring could not be cleaned properly, which created infection control concerns.
There were enough staff, recruitment checks had been completed, and risks to people were generally assessed and managed. Medicines recording and storage had improved since the last inspection. The home had complied with the previous Warning Notice about governance, but inspectors found a new breach relating to medicines.
Staffing and recruitment
Inspectors found enough staff to meet people's needs. Staff had been safely recruited and had time to support and talk with people.
“There were enough staff to meet people's needs and staff had been safely recruited.” from the report
Risk management
Staff knew people well and understood changes in their health and wellbeing. Risks were monitored and care was adjusted when needed.
“Risks were assessed and managed by staff who knew people well.” from the report
Medicines records
Recording and storage systems had improved since the previous inspection. Records checked for controlled medicines were accurate.
“Systems used for the recording and storage of medicines were effective.” from the report
Positive relationships
People and relatives generally spoke positively about the staff and management team. Staff said they could share concerns and views.
“People and relatives spoke positively about the home.” from the report
Medicines given by untrained staff
seriousSome medicines were given at night or early in the morning by staff who were not trained or assessed as competent. Inspectors said this placed people at risk of harm.
“Where people required support with their medicines at night, or early in the morning, these were not always administered by staff who were trained or assessed as competent in medicines administration.” from the report
Infection control and flooring
needs fixingSome flooring was torn or had an odour and could not be cleaned in line with infection control guidance. The home was working on replacing flooring in several areas.
“These concerns included odorous, or torn flooring in some areas which could not be cleaned in accordance with infection control guidance.” from the report
Quality monitoring
needs fixingAudits identified some health and safety issues, but there was not always clear planning about who would deal with them or when. This meant improvements were not always made promptly.
“This meant improvements were not always made in a timely way.” from the report
Unresolved concerns
needs fixingSome concerns raised by people had not been resolved. In one case, requested support for a deteriorating health condition had not changed the person's experience.
“Although the manager had made some enquiries about this, the person's experience had not changed, and further action was required to ensure the person received support that met their individual needs.” from the report
- 01Which staff now give medicines between 10pm and 8am, and how do you check that they are trained and competent?
- 02What is the timetable for replacing the torn or odorous flooring, and how are infection risks managed until this is done?
- 03Who is responsible for each action identified by your audits, and how do you check that actions are completed on time?
- 04How do you record, investigate and resolve concerns raised by people and relatives?
- 05What improvements have been made since the inspection, and what evidence can you show that the action plan has been completed?
This was a focused inspection of Safe and Well-led, with infection prevention and control also checked; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 23 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, March 2021
Woodfields Residential Home rated Requires Improvement; inspectors found improved personalised care but continuing medicines and governance problems.
This was an unannounced focused inspection. Inspectors visited on 19 January 2021 and made telephone calls on 01 February 2021. They spoke with seven staff, reviewed care plans, medicine records, staff files and management records, and checked infection prevention measures.
The home was rated Requires Improvement overall. Safe and well-led were also Requires Improvement. Responsive was rated Good. The inspection found enough staff, suitable infection control arrangements and kind, personalised support, but medicine records and risk records were not always accurate or acted on.
The home had improved since the previous inspection, especially in personalised care, communication, activities, complaints and recording people's end of life wishes. However, the previous breach relating to governance continued because checks had not reliably found and corrected errors.
Enough staff
Inspectors found enough staff to meet people's needs, and staff were observed supporting people in a timely way.
“People were supported by enough staff. Staff told us they always tried to support people in a timely manner, and we observed staff meeting people's needs.” from the report
Infection control
Inspectors were assured about most infection prevention arrangements, including PPE, testing, admissions and outbreak planning.
“We were assured that the provider was using PPE effectively and safely.” from the report
Personalised support
Care had become more personal to people's needs and preferences. Communication needs were assessed and support was provided in accessible ways.
“People received care which was personal to them and met their needs.” from the report
Relationships and activities
People were supported to keep in touch with relatives during the pandemic and were offered activities based on their interests.
“People were also supported with communicating with their relatives through telephone and video calls whilst visits were not taking place.” from the report
Positive staff culture
Staff showed a positive, person-centred approach and said managers were approachable and supportive.
“Staff demonstrated a shared culture which was positive and person-centred.” from the report
Incomplete medicine records
seriousStaff did not always record topical medicines or where patches were applied. This meant the provider could not be sure creams had been applied or that all medicines were given correctly.
“This meant the provider could not be sure that the creams had been applied.” from the report
Risk records not always acted on
seriousOne person's records showed they had not opened their bowels for seven days, but did not say when staff should contact a GP. The manager acted during the inspection.
“One person's records showed they had not had their bowels open for seven days.” from the report
Weak quality checks
seriousAudits did not reliably identify medicine and bowel-recording errors. This was a continued breach of Regulation 17.
“The systems in place had also failed to identify errors in the recording of people's bowel charts, this meant there was a risk to people's health and improvements were not identified.” from the report
- 01How do you now check that staff record topical creams and the application sites of medicine patches every time?
- 02What action is taken if a resident has not opened their bowels, and when would you contact a GP?
- 03What changes have you made to quality audits since this inspection, and how do you know they find errors?
- 04What was the outcome of the Warning Notice, and has CQC confirmed that Regulation 17 is now met?
- 05How are activities and contact with relatives arranged for each resident, including people living with dementia?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings carried over into the overall rating. This explanation was written from the published report of 10 March 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 Woodfields Residential Home
5 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- June 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- March 2019Requires improvementdown from GoodSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2016Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 30 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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