CQC report explained · a nursing home
What the CQC found at Woodlands Neurological Rehabilitation
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found systems to provide enough trained and skilled staff, including the use of bank and agency staff. Incidents were reported, investigated and reviewed, but the inspection only examined staffing and learning from incidents.
- Effective?
- Good
- Staff were trained for their roles and followed guidance for people's individual needs. Some training had expired, although action plans were in place and inspectors found no impact on people.
- Caring?
- Good
- Caring was not assessed during this targeted inspection.
- Responsive?
- Good
- Responsive was not assessed during this targeted inspection.
- Well-led?
- Good
- Well-led was not assessed as a full key question. The inspection did consider management of staffing and found daily meetings and a clear staffing structure.
What inspectors found, March 2020
Woodlands Neurological Rehabilitation was inspected but not rated; inspectors found safe staffing and skilled care, while some training and role clarity needed attention.
This was an unannounced targeted inspection on 3 and 6 January 2020. It looked at specific concerns about staffing levels, staff skills and how the home was managed. The inspector spoke with people, relatives, visitors and staff, and checked staffing records, training information and management documents.
The inspectors found systems to make sure enough suitably trained staff were available. Staff skills were matched to people's needs, and extra bank or agency staff were used when needed. Training had sometimes expired, but there were plans to bring it up to date and inspectors found no impact on people.
People and relatives were generally very positive about the care. Inspectors found that incidents were reported, investigated and used to make improvements. Some staff were unsure about their responsibilities, and some were not confident about raising concerns through the home's internal whistleblowing process.
The home was inspected but not rated in this targeted visit. Its previous overall rating was Good, published in July 2019, and the report says that rating remained Good. The other parts of the service were not assessed during this inspection.
Staffing matched to needs
The home used a tool to assess people's needs and updated rotas when those needs changed. Staff were available to respond to high-risk situations.
“A 'safer nursing decision making tool' was used to evaluate and categorise each person's needs.” from the report
Skilled care
Inspectors found staff had the skills needed for their roles and followed clear guidance for people with specific health risks.
“Staff followed clear guidance to meet people's individual needs.” from the report
Learning from incidents
Incidents were reported, investigated and discussed with staff. The home made changes to paperwork and took action to reduce the chance of problems happening again.
“Incidents were reviewed and investigated with actions taken to prevent further occurrences.” from the report
Positive experience
People and relatives were generally positive about the care and the staff's ability to meet people's needs.
“People and their relatives were overall very positive about the service they received” from the report
Expired training
needs fixingSome staff training had expired. The provider had an action plan, and inspectors found no impact on people at the time of the inspection.
“The registered manager told us some staff training had expired.” from the report
Unclear staff responsibilities
needs fixingSome staff were unsure about the boundaries of their roles, particularly after clinical leadership changes. Daily meetings had been introduced to improve clarity.
“Some staff told us they were unsure of their remits associated with their roles.” from the report
Confidence in whistleblowing
needs fixingSome staff were not always confident about raising concerns through the home's internal whistleblowing process, although a policy was in place.
“Staff told us they would whistle blow any concerns of bad practice” from the report
- 01Which staff training had expired, and has all of it now been completed?
- 02How are staff responsibilities and reporting lines explained after the recent clinical leadership changes?
- 03How can staff raise concerns confidentially if they do not feel able to use the internal whistleblowing process?
- 04How do you decide when bank or agency staff have the right skills for each person's needs?
- 05How are incidents reviewed, and what changes have been made as a result?
This was a targeted inspection of specific concerns about staffing levels, staff skills, learning from incidents and management; it did not assess all five key questions, so the previous ratings carried over. This explanation was written from the published report of 7 March 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.
What inspectors found, July 2019
Woodlands Neurological Rehabilitation was rated Good, with kind and effective care, but inspectors found some records, medicines and access arrangements needed attention.
This was an unannounced inspection over 6 and 10 June 2019. Inspectors spoke with people, a relative, visitors, staff and managers. They observed care and reviewed care records, staff files, medicines information and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People were generally safe, treated with kindness and supported by a multi-disciplinary team to work towards rehabilitation goals and greater independence.
Inspectors found some problems during the visit. These included incomplete records for thickened fluids, care records that needed updating, locked doors on the first day and mixed views about food and recent staffing changes. The home took action during or shortly after the inspection.
The overall Good rating was unchanged from the previous inspection, published on 21 December 2018. The inspection did not examine the circumstances of a death because that incident was subject to a criminal investigation.
Kind and respectful care
People were treated with kindness and compassion. Inspectors found that privacy, dignity, equality and personal choices were respected.
“People were supported by kind, caring, compassionate staff and their privacy and dignity was maintained.” from the report
Rehabilitation and independence
People were supported to set goals, take part in therapies and build everyday skills. The home encouraged positive risks where this could support independence.
“People were encouraged and supported to take positive risks to develop or maintain their independence.” from the report
Team-based support
People's care involved nursing, therapy and other health professionals. Their needs, goals and progress were discussed across the team.
“People were supported by a multi-disciplinary team of health care professionals relevant to their changing needs.” from the report
Action when problems were found
The management team responded during the inspection to issues with medicines, supervision, care records and protected mealtimes.
“The provider has taken action to mitigate the risks and this has been effective.” from the report
Care records needed updating
needs fixingSome records did not reflect changing needs. The management team said a full review and rewrite was taking place, and inspectors were told this had been completed by the second day.
“We found not all people's care records had not been reviewed or updated as their needs changed.” from the report
Medicines records and protocols
needs fixingRecords did not always show when prescribed thickeners had been used. Some 'as required' medicine protocols and competency checks also needed improvement, although action was taken during the inspection.
“However, records were not always completed when thickening fluids for people with swallowing problems had been used.” from the report
Restrictions on garden access
needs fixingThe doors were locked on the first day because of a pond-related risk. They were unlocked from 9 am until early evening after a further review, but inspectors recommended continued review so liberty was not unnecessarily restricted.
“We recommend this continues to be reviewed to ensure people's liberty is not restricted.” from the report
Recent staffing changes
minorChanges to staff deployment caused anxiety for some people and staff. People and staff gave mixed feedback about whether there were enough suitably skilled staff.
“This had caused anxiety for some people using the service and some staff.” from the report
Mixed views about food
minorPeople did not all agree about the food. Inspectors also found that protected mealtimes were not working on the first day, although this was put back in place on the second day.
“On day one of the inspection we received mixed feedback about the food and protected mealtimes were not in place, this was re-instated.” from the report
- 01Have all care records been reviewed and kept up to date when people's needs change?
- 02How are thickened fluids and 'as required' medicines recorded now, and how are staff checked as competent to administer medicines?
- 03How is access to the gardens managed, and how do you review any restrictions on people's freedom?
- 04What changes were made to staffing deployment and skill mix, and are there enough staff with the right rehabilitation and ventilation skills?
- 05What changes were made to the food and mealtime arrangements after the mixed feedback?
This was an unannounced inspection covering all five CQC questions and both the premises and care; it did not examine the circumstances of a death that was subject to a criminal investigation. This explanation was written from the published report of 6 July 2019 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 Woodlands Neurological Rehabilitation
4 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- March 2020Inspected but not ratedcurrent ratingSafe: Inspected but not ratedEffective: Inspected but not rated
Read what inspectors found at Woodlands Neurological Rehabilitation →
- July 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Woodlands Neurological Rehabilitation →
- December 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- January 2012
Registered with the Care Quality Commission on 3 January 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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