Archived: Ward House Nursing Home

Updated 26 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was completed by one inspector.

Service and service type

Ward House Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Ward House Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 13 December 2022 and ended on 30 December 2022. We visited Ward House Nursing Home on 13 and 20 December 2022.

What we did before the inspection

Before the inspection we reviewed the information we had about the service, including previous reports and notifications. Notifications are information about specific important events the service is legally required to send to us. We contacted the local authority to gain their views about the service.

We used the information the provider sent us in April 2022 in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all of this information to plan our inspection.

During the inspection

We spoke with 6 people who use the service and 4 family members. We sought feedback from the local authority and health professionals who work with the service and received responses from 4 of them. We spoke with 4 care staff members, a housekeeper, activities staff member, maintenance staff member, registered nurse, the registered manager and the provider's nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records, including risk assessments for 4 people and medicines administration records. We looked at 5 staff files in relation to recruitment and records relating to staff training. A variety of records relating to the management of the service, including audits, surveys, policies and procedures were also reviewed.

Updated 26 January 2023

About the service

Ward House Nursing Home is a residential care home providing accommodation, nursing and personal care for up to 23 older people in one adapted building. At the time of this inspection there were 17 people living at the home.

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

Quality assurance systems had not been used effectively to either identify areas for improvement and/or to bring about effective improvement.

Individual risks to people had not all been assessed, recorded and updated when people's needs changed. This included risks resulting from people's known health and care needs.

Appropriate recruitment procedures had not been followed meaning that all necessary checks had not been completed prior to staff commencing employment.

Whilst there were appropriate numbers of care and ancillary staff (housekeeping, catering, maintenance) the service did not have enough registered nurses to ensure one was provided at all times. Agency and bank nursing staff were employed to fill registered nursing shifts however, there were occasions when these staff were not available meaning no UK registered nurse had been in the service for periods of up to 12 hours.

Safe systems to manage medicines had not always been followed meaning people had not always received their medicines safely as prescribed.

There were appropriate policies and systems in place to protect people from the risk of abuse and the registered manager and staff understood the actions they should take to keep people safe.

Infection prevention and control measures were in place and followed government guidance.

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 and their family members all gave us positive feedback about the home and told us that staff were kind and caring. We observed positive interactions between staff and people.

People, their family members and external professionals said the registered manager was approachable and supportive. Staff were also positive about the registered manager.

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 good (Published 4 July 2019).

Why we inspected

This inspection was prompted by recent safeguarding concerns and the length of time since the service was inspected.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ward house Nursing Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to staff recruitment, medicines management, risk assessment and quality assurance procedures at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.