Wellington and Longforth House

The home is divided into two units, Longforth House and Wellington House. The Longforth unit supports people with a range of mental health needs. The Wellington unit supports older people with dementia and mental health needs. Each of these units has its own staff team, communal spaces and secure outside garden for people to use as they choose.

People’s experience of using this service and what we found

Improvements had been made with the quality management systems at the home. The management team were responsive and where appropriate took swift action to address shortfalls. They had developed and improved their systems to provide people with quality care.

People and families were happy with the quality of care and leadership at the home. A relative said “Absolutely fabulous down there, extremely good during the difficult time we have been having. No complaints at all.”

The provider made sure infection control processes helped keep people safe during the COVID-19 pandemic. The home was clean and there were PPE stations situated at several points throughout the home. The service was adapted to meet the needs of people living with dementia.

Staff understood the requirements of the Mental Capacity Act 2005. 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.

Staff received robust induction, training and supervision and had the skills and knowledge to deliver care effectively.

People had a pleasant dining experience and their nutritional needs were met.

There were effective channels of communication for the staff team. People had access to other health care professionals as needed.

People received person centred care and staff knew the people they were supporting well. Care plans identified the support people needed to communicate and how they preferred their care to be delivered.

Staff had supported people to maintain relationships that were important to them. People enjoyed a range of activities. People had completed a life history with staff, so staff could work to ensure people’s interests and individual social needs were met.

Systems were in place to monitor and respond to complaints.

Staff were positive about the home and the leadership of the management team. The registered manager understood their role and responsibilities in ensuring people received high quality care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Requires Improvement (report published 24 October 2019) with one breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Ratings from previous comprehensive inspections for the key questions we did not inspect were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Wellington and Longforth House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re inspection programme. If we receive any concerning information we may inspect sooner.

Wellington and Longforth House is registered to provide accommodation with nursing or personal care, for up to 43 people. There were 39 people using the service at the time of our inspection. The service is in the town of Wellington. The home is divided into two units, Longforth House and Wellington House. The Longforth unit supports people with a range of mental health needs. The Wellington unit supports older people with dementia and mental health needs. Each of these units mainly has its own staff team, communal spaces and secure outside garden for people to use as they choose.

People’s experience of using this service and what we found

People felt safe at the home and with the staff who supported them. People told us staff were always kind and respected their privacy and dignity. Visitors said they always felt welcomed at the home and staff kept them informed about the care of their relatives.

People lived in a home where quality audits were carried out but were not always effective in ensuring people received consistent care. Shortfalls identified at this inspection had not all been identified and addressed by the provider’s own quality assurance systems. The two units were operated differently. The Longforth unit was very person centred, independence was being promoted and plenty of activities with the Wellington unit being more institutional and task orientated. After the inspection we received an action plan from the provider setting out the actions they were taking to address this concern. For example, reviewing continence support and promoting independence.

The mealtime experience was not always good across the home. Action was taken during the inspection to address the breakfast routine with further actions planned for the other mealtimes.

People had access to activities but not all were encouraged and supported to continue to pursue their hobbies and interests. Each person who lived at the home had a care plan, which gave clear guidance to help staff to effectively support people. These were regularly reviewed but it was not always clear that people and their relatives had been involved.

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. People told us staff asked for their consent before assisting them.

Staff had been recruited safely, received the provider’s mandatory training and had supervisions although the systems to demonstrate these were not always clear.

Medicines were safely managed, and people were supported to access healthcare services. Staff recognised deterioration in people's health and sought professional advice appropriately and followed it.

People lived in a comfortable home which was well-maintained and regular checks were carried out to promote people’s safety. There was appropriate control of infection processes in place which meant people lived in a home which was clean.

People knew how to make a complaint if necessary. They said if they had a concern or complaint they would feel happy to raise it with the management team.

More information is in the full report.

Rating at last inspection and update: The last rating for this service was good (published 1 March 2017).

Why we inspected: This was a planned inspection based on the rating of the service at the last inspection.

Follow up: We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Wellington and Longforth House provides accommodation to up to 43 people. At the time of the inspection there were 24 people living in Wellington House and 11 people living in Longforth House.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good:

People remained safe at the home. People told us there were adequate numbers of suitable staff to meet their needs and to spend time socialising with them. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. People received their medicines safely.

People continued to receive effective care because staff had the skills and knowledge required to effectively support them. People’s healthcare needs were monitored by the staff and people said they had access to healthcare professionals according to their individual needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The home continued to provide a caring service to people. People told us, and we observed, that staff were kind and patient. A visitor told us “I am very happy with everything. There is definitely no lack of care here.” People, or their representatives, were involved in decisions about the care and support they received.

The service remained responsive to people’s individual needs. Care and support was personalised to each person which ensured they were able to make choices about their day to day lives. Complaints were fully investigated and responded to.

The service continued to be well led. People told us the management team were open and approachable. The registered manager and provider sought people’s views to make sure people were at the heart of any changes within the home. One person told us “They [registered manager] come to see if I’m ok and if there’s anything I want to talk about. He’s very easy to talk to.” The registered manager and provider had monitoring systems which enabled them to identify good practices and areas of improvement.

We reviewed six care records and other records for the management and administration of the service. We spoke with eight people who used the service, one person visiting the service and the staff on duty. We observed how care and support was provided to people. We looked at the environment of the home and whether it met the needs of the people who lived there.

We spoke with people living in the Longforth unit of the home about the care and support they had. People said they were, 'Very pleased', 'It's fantastic' and 'It's lovely.'

The people we spoke with told us they were able to tell staff if they were unhappy or had any concerns or worries. They told us they found staff, 'Easy to talk to and very approachable.' Some people expressed great confidence in some individual staff.' I can always speak to X and it gets sorted straight away.'

The people we spoke with told us they liked their rooms and enjoyed the communal areas of the home. One person told us they found the Longforth unit, 'friendly and comfortable.'

Everyone we spoke to made various positive comments about the home. One person told us 'it's very nice, very pleasant'. One relative told us 'it's first class, ten out of ten'. Another relative told us '(person) seems happy there'.

Relatives told us they felt well informed about the person's care. We saw one instance where the person's consent was not sought before staff acted and clear guidance was not in place around consent and capacity.

We observed care being delivered in line with people's individual care plans and people told us about the various ways staff met their needs. One person told us 'staff help me to have a shower and go to bed'.

People we asked told us they received their medications at the right times. We witnessed medicines not being kept safely during medicine rounds.

People told us staff were 'very good', 'ok', 'brilliant' and one person told us staff 'have a good interest in me'. We observed that there were enough staff to meet people's needs.

People told us they knew how to make a complaint and relatives told us they felt their comments were listened to. One person told us 'if I had a complaint I know who to talk to, it's two way'. However we found that there was no clear administrative complaints system in place.