Woodland Park

The risk of people falling or developing pressure damage were not always fully assessed or monitored, which increased the potential of people being at risk of harm. Systems did not always work effectively to ensure safeguarding concerns were appropriately recorded, reported and investigated. However, we found no evidence of harm to individuals. Staff, health professionals and people's family members told us they felt clinical needs were well met. People's families were reassured their relatives were safe at Woodland Park. One said, "I feel she is safe there; they look after her pretty well." Another said, "I feel she is safe; I know all the girls, it reassures you." People received their medicines safely, however, records were not always completed in line with best practice or the provider's medication policy. This meant, for example, it was not clear when timed medication had been administered.

We recommended the provider review procedures to ensure medicines are administered and recorded in line with their medication policy.

We received mixed feedback regarding staffing levels. Some people and their families told us there were not enough staff, and that it could sometimes take a long time for call bells to be answered. Other people's family members said there were enough staff, and they had no concerns. Staff told us people received safe care, and staffing levels were generally sufficient at the planned levels. Staff were recruited safely, and appropriate employment checks were made prior to staff starting work.

We recommended the provider ensure their dependency tool considered peoples individual needs to ensure safe staffing levels.

Assessments of people's needs did not always include their personal preferences, emotional, social, cultural religious or spiritual needs. Four people who were admitted to the home in July and August 2022 had no personalised care plans in place and a fourth person had a short-term care plan in place which lacked

personalised detail. Staff told us that whilst care plans did not always contain personalised information, they did know people well, endeavour to find out their individual preferences and shared this informally as a staff team. Staff had sufficient skills and experience to meet people's needs.

People were supported to work with other health professionals and access health appointments. One relative told us how staff were working with their loved one and health professionals to alter their medication regime so the person could be better supported in the community. They told us, "They are changing it so they can open up her options, to go home with district nursing support or to a residential home."

The culture of the service was positive, and people were supported to achieve the best outcomes for them. For example, one person had made significant improvement whist at the service and was moving on to live in the community with support. Staff felt well supported by the registered manager. One staff member told us, "[registered manager] is lovely, the biggest support, she brings so much joy and her energy's great." People and their families were asked for feedback about the service. Staff worked openly with other health professionals and made appropriate alerts when things went wrong. People's families told us the registered manager was responsive when they raised concerns. One said, "When I have raised things, they have gone and sorted it out." A second family member said, "They always tell me what's happened, they have been amazing."

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.