CQC report explained · a nursing home
What the CQC found at Woodland Court
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some people were at risk because care plans and records were incomplete, inaccurate or contradictory. Medicines were managed safely overall, but several medicine procedures and records needed improvement.
- Effective?
- Good
- The report does not give a rating or separate findings for this question.
- Caring?
- Good
- People and relatives spoke positively about the care. Staff were observed treating people with dignity, respect and kindness, and supporting their choices.
- Responsive?
- Good
- The report does not give a rating or separate findings for this question.
- Well-led?
- Requires improvement
- The home had monitoring systems, but these did not always identify or manage risks. Some important care plans and contradictory records had not been corrected through the home's governance processes.
What inspectors found, September 2023
Woodland Court was rated Requires Improvement; inspectors found kind and respectful care, but risks and records were not always managed safely.
This was an unannounced inspection on 11 July 2023. Inspectors spoke with 10 people, a relative and staff. They observed care and checked care records, medicines, recruitment files, safety checks, accidents and quality monitoring.
The home was caring, and people said staff treated them with dignity and respect. Staffing levels were judged safe, recruitment checks were completed safely, and safeguarding and infection control systems were in place.
However, some care plans and records were incomplete, inaccurate or contradictory. This included information about oxygen, food and fluids, and care involving artificial feeding, pacemakers and intravenous cannulas. Medicines were given as prescribed, but some medicine records and procedures needed improvement.
The overall rating changed from Good at the previous inspection, published in December 2017, to Requires Improvement. Safe and Well-led were rated Requires Improvement. Caring remained Good. The report did not give ratings for Effective or Responsive.
Kind and respectful care
People said staff were caring and respectful. Inspectors observed person-centred support and people being involved in everyday choices.
“People said staff were caring and treated them with dignity and respect.” from the report
People's privacy and independence
Staff supported people with personal care and mobility while promoting privacy, dignity and independence.
“Staff promoted people's independence and treated them with dignity and respect when helping them with daily living tasks.” from the report
Safeguarding awareness
Staff had safeguarding training and understood how to recognise and report concerns, including how to report them outside the home.
“Staff understood safeguarding reporting processes and were able to explain how they could report concerns both internally and externally.” from the report
Safe staffing and recruitment
Inspectors judged staffing numbers safe and found that relevant pre-employment checks had been carried out. One incomplete employment history was corrected during the inspection.
“The provider and registered manager ensured there were sufficient numbers of staff deployed to meet the needs of the people at the service.” from the report
Listening to feedback
The home collected feedback and had made changes to food choices, activities and maintenance after listening to people.
“Recent records showed changes in food choices, activities provision and maintenance had happened following people's feedback.” from the report
Incomplete and contradictory care records
seriousSome records did not accurately describe people's needs or the care required. Inspectors said this placed people at risk, including people needing oxygen or support with food, fluids and complex equipment.
“People were not always protected from the risks associated with incomplete or inaccurate records.” from the report
Medicine procedures and recording
needs fixingSome medicine records were inaccurate, and the home was not always following its own medicine policy. The report also identified problems with storage, controlled drug destruction and recording as-required medicines.
“We identified the service was not operating in line with the providers policy.” from the report
Weaknesses in oversight
seriousThe home's quality checks did not consistently identify important risks or contradictory records. More reliable monitoring was needed.
“We identified some governance systems were not consistently reliable and effective.” from the report
Cleaning records for specialist equipment
needs fixingThe planning and recording of cleaning for equipment linked to oxygen and nebulisers needed improvement.
“We identified that some improvements were required in relation to the planning and recording of cleaning schedules relating to equipment associated with the use of oxygen and nebuliser equipment.” from the report
- 01What changes have you made to care plans and records for people using oxygen, artificial feeding, pacemakers or intravenous cannulas?
- 02How do you now check that food, fluid and other handover information is accurate and consistent?
- 03What action have you taken to improve medicine records, including pain patches, as-required medicines and topical creams?
- 04How do you monitor response times at night, especially when there is unplanned staff sickness?
- 05How are cleaning schedules for oxygen and nebuliser equipment recorded and checked?
This was an unannounced inspection that assessed the overall service and infection prevention and control, but the report gives ratings only for Safe, Caring and Well-led; Effective and Responsive were not rated. This explanation was written from the published report of 6 September 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, December 2017
Rated Good; inspectors found safe, kind and personalised care, with some records and activities needing attention.
Inspectors visited on 25 and 26 October 2017. The first day was unannounced. They spoke with people, visitors, staff and a healthcare professional, observed care and checked care, medicine, staffing and quality records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People and visitors said they felt safe and trusted the staff. Inspectors saw kind and respectful care, detailed care plans, suitable training and effective management systems.
There were some smaller shortfalls. Medicine records did not show the total quantity held accurately for the previous four weeks. Plans to improve activities had been delayed, although the home later confirmed that extra staff hours had started to support more individual and group activities.
Kind and respectful care
Inspectors saw positive interactions and staff who treated people with dignity, patience and kindness.
“We saw that staff were kind and considerate in their approach to each person and were sensitive to the needs of everyone.” from the report
Personalised care plans
Care plans included people's preferences, routines and personal history. Staff knew this information and used it in daily care.
“People's care plans were comprehensive, individualised and reviewed regularly.” from the report
Training and safe moving
Staff received relevant training and their practice was checked. Inspectors saw safe hoist transfers and good communication with people.
“We saw staff followed good practice guidelines and continually spoke and reassured the people they were transferring.” from the report
Effective oversight
Regular audits covered medicines, care plans, the environment and incidents. The report says action was taken when problems were found.
“There were effective systems in place to assess, monitor, and improve the quality and safety of care.” from the report
Medicine stock records
needs fixingFor four weeks, medicine administration records did not include medicines already held when recording quantities received. The quantities of three medicines checked were accurate, and managers agreed to keep accurate records.
“the quantity of medicines already in the service had not been added to the quantity received.” from the report
Activities improvement had been delayed
minorThe home offered activities, but earlier improvement plans had been delayed. Extra staff time and further activities were planned and later confirmed as started.
“The registered manager told us that their improvement plans had been delayed.” from the report
Communication support was not equally strong
needs fixingOne person used a communication board. Staff had training, but the person said some staff were better at using it than others.
“The person told us staff were very good, but some staff were better at using the board than others.” from the report
One complaint remained open
minorTwo complaints had been recorded during the previous year. One had been resolved, while the other was still being dealt with at the inspection.
“One of these had been investigated and concluded satisfactorily. The other was still being dealt with.” from the report
- 01How do you now check that medicine records show the full quantity held, as well as new medicines received?
- 02What extra activities and individual time have been introduced since the inspection, and how do you record people's participation?
- 03How are all staff kept competent to use communication aids for people who cannot communicate easily?
- 04What happened to the complaint that was still being dealt with at the time of the inspection?
- 05How do staffing levels cover early mornings and late evenings, when the inspection identified that more staff were needed?
This was an overall inspection covering all five questions and the service's overall rating; inspectors did not use the SOFI observation method because few people were in the lounge. This explanation was written from the published report of 8 December 2017 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 Woodland Court
3 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- September 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2017Goodstayed GoodSafe: GoodCaring: GoodWell-led: Good
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 23 March 2011.
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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