CQC report explained · a nursing home
What the CQC found at Woodland Manor Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks, medicines, staffing and infection control were managed safely. The home had improved from an earlier breach of Regulation 12 and was no longer in breach.
- Effective?
- Good
- Staff had better induction, training and supervision, and people's health and nutritional needs were generally met. Further training was still planned on the Mental Capacity Act, and some best-interest decisions were not recorded consistently.
- Caring?
- Requires improvement
- Inspectors did not review this question at this inspection. They observed staff being kind, caring, gentle and responsive, and the previous rating was used in calculating the overall rating.
- Responsive?
- Good
- Care plans generally covered people's needs, preferences, activities and end-of-life wishes. Some plans lacked enough detail about behaviours that challenged and communication needs.
- Well-led?
- Good
- Management, teamwork, staff morale and quality monitoring had improved. Some relatives remained unhappy about communication and the management style, and a few records were still contradictory or incomplete.
What inspectors found, October 2020
Woodland Manor Care Home is rated Good; inspectors found major improvements from an earlier Inadequate rating, but some care records and training still needed work.
This was a focused inspection on 29 September 2020. Inspectors checked whether the home had acted on its improvement plan and met legal requirements for Safe, Effective, Responsive and Well-led care. They reviewed records, medicines, infection control, staffing and the environment, and spoke with people, relatives, staff and health professionals.
The home was found to be safe, effective, responsive and well-led. Medicines, staffing, infection control, risk management and audits had improved. People and most relatives were happy with the care. Staff were seen to be kind and responsive, and activities helped people stay in touch with relatives during the pandemic.
Some work was still needed. Mental capacity training and records were not always complete. Some care plans lacked enough detail about behaviour and communication needs. Some people and relatives also raised concerns about food, communication or the management style.
The overall rating changed from Inadequate to Good. The home was no longer in breach of regulations and was no longer in Special Measures. The Caring question was not reviewed at this inspection, so its previous rating was used in the overall result.
Infection control
Inspectors were assured that the home had effective measures to prevent and manage COVID-19. These included screening visitors, using protective equipment, enhanced cleaning and an isolation unit.
“The home locked down quickly and I feel very confident at the measures they have put in place and that are ongoing” from the report
More consistent staffing
Staffing levels were maintained and reliance on agency staff had reduced. Inspectors saw enough staff available to support people and noted better continuity.
“You definitely see the same staff more, and they always come when I call them.” from the report
Improved management
Inspectors found clearer management structures, better teamwork and improved staff morale. Audits and action plans gave managers oversight of areas needing further work.
“Staff are happier, motivated, appreciated, supported and morale is good” from the report
Mental capacity records and training
needs fixingStaff understanding of the Mental Capacity Act was mixed. Some best-interest decisions were documented in letters rather than clearly recorded as best-interest meetings, and more training was planned.
“However, further training was required, and this had been identified by the provider to ensure all staff worked to the principles of the MCA.” from the report
Behaviour support plans
needs fixingSome care plans did not explain clearly enough what behaviour might occur or how staff should respond. This could make it harder for all staff to provide a consistent approach.
“However, care plans for those individuals lacked detail as to the presenting behaviour and action to take to deescalate the behaviour.” from the report
Food choice and quality
needs fixingAlthough menus offered options and feedback was collected, some people and relatives were unhappy with the choice and quality of meals.
“There is a lack of choice and often the food is of poor quality.” from the report
Communication information
minorSome care plans referred generally to gestures or pictures without explaining what these meant for the individual. The home was working on this.
“There was no indication what this meant for the person.” from the report
How relatives raise concerns
minorMost relatives knew how to complain, but one relative said they did not know who to contact. Inspectors directed them to the home and provider.
“We never know who to contact if there is an issue.” from the report
- 01What further Mental Capacity Act training has been completed, and how do you check that staff use it correctly?
- 02How do you make sure best-interest decisions are recorded clearly and consistently?
- 03How are behaviour support plans being improved for people whose behaviour can be difficult to manage?
- 04What changes have been made to food choice and quality since relatives raised concerns?
- 05Who should our family contact if we have a concern, and how will it be followed up?
This was a focused inspection of Safe, Effective, Responsive and Well-led only; Caring was not reviewed and its previous rating was carried forward. This explanation was written from the published report of 24 October 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. The report was longer than we could read in one go; the later sections may not be reflected.
What inspectors found, September 2020
Woodland Manor Care Home is rated Inadequate and is in special measures; inspectors found unsafe care, poor oversight and repeated failures to improve.
Inspectors visited unannounced over two days in November 2019. They spoke with people, relatives and staff, observed care, and checked care records, medicines, staff files, rotas and management records.
They found serious problems with medicines, risk management, staffing and record keeping. Some people did not receive medicines at the right time. Risks linked to falls, nutrition, pressure damage, infections and medical conditions were not always managed. Staff shortages and agency staff contributed to delays and inconsistent care.
Some staff were kind and respectful, and people were generally positive about meals and activities. However, care was not consistently personalised, consent processes did not always follow the law, complaints were not always recorded or used for learning, and management checks had not found or fixed repeated problems.
The overall rating was Inadequate. Safe and Well-led were rated Inadequate, while Effective, Caring and Responsive were rated Requires Improvement. The home was placed in special measures, with warning notices issued and a further inspection expected within six months unless the provider's registration was at risk.
Kind interactions
People and relatives described staff as kind and caring. Inspectors saw staff being respectful, attentive and encouraging when supporting people.
“Staff were respectful and attentive when they were supporting people.” from the report
Clean environment
The home was described as clean and hygienic by people and relatives.
“People and their relatives told us the service was kept suitably clean and hygienic.” from the report
Fire and maintenance checks
Environmental checks, fire safety checks and equipment servicing were recorded as up to date.
“Fire safety was promoted with regular checks of equipment and fire drills taking place.” from the report
Activities available
People could take part in a range of activities, including music, trips, exercises and massage, although feedback about access was mixed.
“The activity programme provided showed a range of activities were provided which included art, pat a dog service, trips out, music, massage and exercises.” from the report
Unsafe medicines and risk management
seriousMedicines were delayed, stored incorrectly or not administered in line with instructions. Risks linked to medical conditions, pressure damage, falls, fluids and infections were not consistently managed.
“Safe medicine practices were not promoted, and the service did not work to best practice or their own policy in relation to medicine management.” from the report
Insufficient staffing
seriousRequired staffing levels were often not met. People and relatives reported delays, inconsistent care and heavy use of agency staff.
“Sufficient staff were not consistently provided, and some staff were not suitably trained and supported.” from the report
Inadequate care plans
seriousCare plans often lacked specific instructions about health conditions, nutrition, behaviours, communication and end-of-life care. Staff did not always follow the information that was recorded.
“Person centred care was not consistently provided. The service used electronic care plans.” from the report
Weak management checks
seriousRecords were incomplete or contradictory, and audits had not identified problems found by inspectors. The provider had not dealt effectively with repeated failures from the previous inspection.
“The provider failed to learn from previous inspections and bring about the required improvements.” from the report
Complaints not used for learning
needs fixingNot all complaints were recorded, and records did not consistently show what the home had learnt or changed.
“Not all complaints were logged or showed learning to demonstrate complaints were managed effectively.” from the report
- 01What changes have been made to ensure every shift has the staffing levels and staff mix identified as necessary?
- 02How are medicine timings, storage, competency checks and errors now monitored?
- 03How do you make sure care plans contain clear instructions for each person's medical conditions, risks, nutrition and communication needs?
- 04How are Mental Capacity Act assessments, best-interest decisions and Deprivation of Liberty Safeguards applications recorded and kept up to date?
- 05What evidence can you show that the warning notices and repeated breaches identified in this report have been resolved?
This was an unannounced planned inspection that looked at the premises and care provided and assessed all five key questions; it followed the previous Requires Improvement rating. This explanation was written from the published report of 16 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Woodland Manor Care Home
6 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- October 2020Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Good
- September 2020Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- June 2018Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- March 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2015
Registered with the Care Quality Commission on 31 December 2015.
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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