Wrenbury Nursing Home

Updated 23 December 2020

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

This inspection took place on 27 November 2020 and was announced.

Updated 23 December 2020

The inspection took place on 20 December 2017 and 04 January 2018 and was unannounced. Wrenbury Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. Wrenbury Nursing Home is registered to provide care and accommodation for up to 36 people. At the time of the inspection there were 28 people living at the home.

The home had a registered manager who was present throughout the inspection. 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.

At the previous inspection on 01 and 04 March 2016, the overall rating for the service was Requires Improvement. We found some of areas of practice which needed to improve and two breaches of the regulations. This was because the provider had not ensured that people received person centred care and records were not always complete, accurate or contemporaneous. The provider sent us an action plan explaining how they would meet the requirements of the regulations. At this inspection we found that they had taken action to address the breaches of regulations and the quality of the service had improved.

People were positive about the care and support they received at Wrenbury Nursing Home. People felt safe and told us that they received the support that they needed, in a way that respected their wishes. We found that there were sufficient staff, who ensured that they supported people in an individualised and unrushed way. Improvements had been made to the way that staff were deployed.

Care files contained individual risk assessments which identified any risks to the person and gave instructions for staff to help manage the risks. However we found that on occasion staff had not followed guidance to mitigate risk. Some clinical records in relation to skin care needed to be more robust.

Staff had received training in safeguarding and understood their responsibilities to protect people from harm and abuse. Staff knew how to report concerns and told us that they felt able to raise concerns appropriately. The registered manager maintained a safeguarding file and where necessary, referrals had been made to the local authority to report safeguarding concerns. We found that the outcome of these had not always been recorded within the file, but the registered manager was able to provide this information verbally.

We found some minor shortfalls in the recording of medication administration, but overall medicines were administered safely. People were cared for in a clean and well maintained environment.

Staff had an understanding of The Mental Capacity Act (2005) and this was usually followed where necessary. However, we found there were occasional gaps in the staff’s knowledge around MCA and the accurate completion of assessments had not always been carried out.

We saw that staff received an induction and regular training was provided. Staff told us that they received the training and support they needed to carry out their roles effectively. Staff were also supported through supervisions and staff meetings. We found that people’s nutritional needs were being met. People’s views on the quality of the food varied but were generally positive.

People and their relatives told us that staff were kind and caring in their approach. We observed that staff were very attentive and people were treated with dignity and respect. People looked well cared for and well presented. However, we found that nail care could be improved.

People received care that was personalised and responsive to their needs. Care plans contained sufficient information to enable staff to meet people's needs. However we noted that one care plan had not been fully written. The management team were in the process of undertaking reviews and had invited relatives to take part, where appropriate. People spoken with told us that they were given choices about the way their care was provided. We reviewed a number of daily charts and records and found overall that these had been consistently completed.

People told us that there were activities going on at the home and that they could choose whether they wanted to take part. The home had an activities coordinator who organised group activities and also supported people on a one to one basis.

We found that the home was well-led. People knew who the registered manager was and felt able to raise any concerns with her. Staff told us that they felt well supported. We saw that regular team meetings were held, as well as supervision meetings to support staff. There were comprehensive quality assurance processes in place and people's feedback was sought about the quality of the care.