Archived: Wilford House

Wilford House provides support and care for up to 30 older people. At the time of this inspection 20 people used the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The provider did not have effective systems in place to assess, monitor and improve the quality of care.

Staffing levels were sufficient to provide safe care and support to people but staff were not always offered the opportunity for up to date training or supervision with their line manager to further their learning or to discuss work related issues. Recruitment procedures ensured people of good character were employed.

People were not offered opportunities to participate in leisure and recreational activities of their choice.

The provider followed the principles of the Mental Capacity Act 2005 by ensuring that people consented to their care or were supported by representatives to make decisions.

People’s nutritional needs were met and they were supported to eat and drink sufficiently to maintain their health.

Medicines were managed safely by senior staff and people were supported to access a range of health care services. When people became unwell staff responded and sought the appropriate support.

People were supported to maintain their own level of independence and were treated with dignity. People's privacy was respected.

The provider had a complaints procedure, and people were aware of to whom they could raise any concerns or complaints.

During the inspection we sampled people's care records and spoke with staff. They helped us to answer the five questions we always ask:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

People were treated with respect and dignity by the staff. Care plans identified people's needs and were reviewed. Staff demonstrated a good understanding of people's needs. People were given choices and supported to make decisions themselves. Risk assessments were in place and control measures identified. This meant that people's needs were met and people were kept safe.

Documented procedures were in place for The Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant that systems were in place to safeguard people as required.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. Only staff that had been trained administered medication.

People received care and support from staff who had the skills experience and knowledge to meet people's needs. People we spoke with told us they felt safe at the home. One person said, 'The staff work as a team, the place is spotless and there is a nice age span of staff'. Another person said, 'I have no concerns, they make a great fuss of me'.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints and concerns. This reduced the risks to people and helped the service to continually improve.

Is the service effective?

People experienced care, and support that met their needs. People had access to aids that enabled people to maintain their independence with eating and walking. People who wanted to were able to participate in activities such as bingo and singing. A priest visited the home for those who wished to participate in Holy Communion. Records showed people, their relatives and professionals were involved in care reviews. Information sheets were in place in case people were admitted to hospital. This meant that people's needs were met.

People who were able to could move around the home freely and safely.

Regular audits and checks took place. Issues identified were acted on. This meant the service had effective systems in place to identify improvements and continually meet people's needs.

Is the service caring?

People were supported by kind and attentive staff. We saw that support workers showed patience and gave encouragement when supporting people. We saw people responded positively to staff. One person said, 'Yes the staff are caring, I don't ever feel uncomfortable'. Another person said, 'Staff are very private, they always shut the door when helping with personal care'.

People's preferences, likes, dislikes and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. The cook researched recipes to enable people to have foods they liked. People were involved in their day to day care and were supported to maintain relationships that were important to them. People's diversity and individuality were promoted and respected.

Is the service responsive?

We saw staff that responded quickly to meet people's needs and ensured people's safety was maintained. For example, call bells were responded to quickly. We saw that people were supported to express their views and these were acted on. People had the opportunity to engage in activities within the home.

People were aware of how they could make a complaint. People we spoke with told us they did not have any complaints. We were told that no formal complaints had been received.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. Staff felt supported in their roles and felt their views were listened too. Staff we spoke with told us it was a good staff team and was like one big family.

The service had a quality assurance system. A quality audit was undertaken monthly. The service had made improvements to the format of care planning documents. This meant the quality of the service was continually improving.

The provider had sent us a written report which recorded the actions they had taken to ensure improvements had been made. We spoke with the registered manager, who confirmed that the actions needed had been taken and implemented.

Staff had received training in the management of medication and equipment for the safe storage of medication had been purchased. This ensured that the service had a safe system for the administration and storage of medication.

The service now informs us of any significant events that had occured within the home, in line with their statutory duty to do so.

Although not yet fully implemented the computerised system for recording the care and support needs of people was progressing. Equipment had been purchased, information of care plans and risk assessments have been inputted onto the system and training for staff was ongoing.

We spoke with the majority of the people who used the service. We spent time in the lounge and dining areas and observed the interaction between people and staff. One person told us: "The staff are excellent nothing is too much trouble for them. We are very well looked after and couldn't be in a better place". Some people did not wish to speak with us at length but stated they were okay when we asked after their welfare.

We spoke with two visitors.They told us that their relative always looked well cared for and happy when they visited. They said the staff were helpful and friendly.

We spoke with staff about the care and support they provided each day. They gave a detailed account of the specific individual needs of people. We saw staff supported people in a caring, compassionate way.

We saw that improvements were needed in the way the service managed and stored people's medication. So that people are protected against the risk associated with unsafe use.

We saw that systems were in place to ensure staff have the skills and experience necessary for the work to be performed.

Improvements are needed to ensure systems are in place to notify us of any incidents or the deaths of people.

Records that are required to be kept to protect the safety and well being of people were missing, incomplete and lacking information and guidance.