I would first like to apologise for the distress and continued problems you are facing on this very difficult journey. We know that choosing a home is stressful and along with the worry of settling a loved one into a new environment it can become a nightmare that no one wants to face but knowing there isn’t often a choice. With this in mind, we continually look for new ways to guide and support families to manage the transition as smoothly as possible.<br><br>At Woodlands we try very hard, and it is a CQC regulation, to work transparently and honestly with families and their loved ones. We don’t work in isolation and are part of a larger team who assist with decision making, contributing to care planning and delivery, these include Safeguarding team, GP, Falls team, Physiotherapist, Occupational Therapist and Mental Health services. In this instance, and because of the complexity of needs all those people have been involved over the past 18 months, shared their expert advice and guidance, which we have followed, amending care plans, purchasing different equipment, and constantly reviewing what is available. Families are invited to be involved at all levels, contributing their vital understanding of their loved ones to get the best outcome.<br><br>We do care for many people with complex needs including falls and most of our residents do not move from our home, they remain with us moving eventually into end of life care. There are times when a level of need increases to such an extent that all options available to our team have been exhausted and we are expected by our regulators and Safeguarding to request further assessment by the GP initially and consequently a nursing assessment. Once an assessment has taken place a multidisciplinary meeting makes the decision in the best interest of the person. <br><br>When a decision is made that the level of need is such that a nursing placement is required they can no longer remain in a residential care home setting. We completely understand that it is difficult to find an appropriate nursing placement due to poor availability but it is only in these environments registered for nursing that other forms of treatment and care can be used and a nurse needs to be available to monitor the effects 24/7. <br><br>Our staffing levels are good, we are, as you mentioned comparative with nursing levels, with four living areas of 12 – 15 residents, each one has 3 team members, including a floor manager, a staff ratio of 1 – 3/5 residents. In addition, we have 2 Deputy managers, domestic team member, laundry team member and cook. Keeping someone completely safe who is consistently falling or has other complex behaviour requires 1 – 1 care and whilst we do provide this during a transitional period it is not something we can maintain for any length of time from a cost point of view and it depletes the team available to meet the needs of our other residents.  <br><br>Once again please accept our sincere apologies that we have been unable to meet your expectations and we really hope you find the right care home to meet your family’s needs.