Wymondley Nursing & Residential Care Home

We found the following examples of good practice.

¿ The provider had developed policies, procedures and risks assessments for managing the service in relation to COVID-19.

¿People were chatting and engaging with staff regardless of staff wearing masks. People were sat in a socially distanced way in the communal areas. This had not impacted on their comfort. One person told us that staff looked after them well during this difficult time. Parts of the home had been allocated to the management of COVID-19, such as testing areas, additional staff rooms and donning and doffing stations. The home was clean and there was cleaning ongoing during our visit.

¿ There was a visitor’s centre for use when visits were permitted. This was separate to the home to help promote people’s safety. The management team were awaiting government guidance relating to the changes to visiting planned from 08 March 2021.

¿ When people tested positive for COVID-19 they had to isolate in their rooms, for a set period of time. Staff were clear on what it meant to isolate and what symptoms of COVID-19 to look out for. People returning from hospital or those new to the home had to isolate for 14 days. This was made clear to staff.

¿ Staff had received training on donning and doffing personal protective equipment (PPE), infection control and COVID-19. They told us they felt very supported and had enough information to do their jobs. Staff were knowledgeable about what was expected of them and were seen wearing PPE safely. Information was displayed about COVID-19 giving clear and accessible advice.

Wymondley Nursing Home is a purpose-built residential care home providing personal care to 53 people at the time of the inspection. The service can support up to 59 people.

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

People and relatives were happy with the care and support they received. Staff were friendly and attentive to people’s needs. People and their relatives told us there were enough staff to meet people’s needs. Staff were trained and felt supported.

People felt safe and staff were aware of how to promote people’s safety. Regular checks were in place to ensure staff worked in accordance with training and health and safety guidance was adhered to.

The environment had plenty of communal space for people to enjoy. Some people enjoyed the activities that were provided, others felt they needed to be improved. There was work in progress to address this.

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 were involved in planning their care and they, along with their relatives, felt listened to. People had end of life care plans which helped to ensure they died with dignity, when needed. Complaints were responded to appropriately and people felt confident to make a complaint if needed. Feedback was sought through meetings and surveys.

In November 2018 the home was purchased by a new provider. People, relatives and staff were positive about the change and felt there had been improvements.

Feedback about the manager and staff team was positive. There was an open culture in the home and an expectation that people were supported in a person-centred way. Staff were clear about their roles and the management team engaged well with the team and other agencies.

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

The last rating for this service was Good (published 29 June 2017). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection. At this inspection the service has remained rated as Good.

Why we inspected

This was a planned inspection based on the previous rating.

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.

Wymondley Residential and Nursing home provides accommodation for up to 59 older people, including people living with dementia. The home is also registered to provide nursing care. At the time of the inspection there were 58 people living there with another person scheduled to move in.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.

People told us they felt safe were protected from the risk of abuse as staff were knowledgeable in the subject. Individual risk assessments were completed and accidents were reviewed to help identify trends. People’s medicines were managed safely and there was regular access to health and social care professionals.

People were supported by sufficient staff who were recruited safely. Staff had received regular training, received supervision and felt supported.

People had their ability to make decisions assessed, however, best interest decisions needed to be recorded. Consent was sought before care was delivered. People said staff were kind and we saw that they were treated with dignity and respect.

People enjoyed a variety of food and support was provided appropriately. People and their relatives were involved in planning their care and confidentiality was promoted.

People’s needs were met and their care plans were up to date and detailed. There were activities offered during the afternoons but these would benefit by being developed further to include mornings and evenings.

Everyone was positive about the management of the service and there were systems in place to monitor the quality of the service. People’s complaints were responded to promptly.

The management team actively sought updates to their knowledge and skills to help ensure they complied with regulations and to work to continually provide a good quality service.

Below is a summary of what we found based on the evidence gathered during our inspection carried out on 09 April 2014. This included speaking with people who used the service, some of their relatives and members of staff who supported them and by looking at records.

The detailed evidence that supports our findings can be read in the full report.

Is the service safe?

We looked at records which showed that people's care and support needs had been assessed, documented and reviewed. They gave staff clear guidance on how to deliver safe and appropriate care that met people's individual needs. A GP with experience of the care and treatment provided at the home commented, 'Staff have a fantastic attitude and are genuinely caring. I am very confident that people are well looked after.'

We saw that care and treatment was provided in premises that were suitable and fit for purpose in terms of design and layout. We saw that the premises had been well maintained and were in a good state of repair and decoration both inside and out. However, we found that security arrangements were not as effective as they could have been because access to the premises was not restricted during daytime hours. The provider has agreed to review and improve existing security arrangements.

Effective recruitment policies and procedures had been put in place to ensure that staff employed at the home were of good character and appropriately skilled to meet people's needs. This included carrying out appropriate checks before staff began work.

Is the service effective?

At our previous inspection carried out on 12 November 2013, we found that some people had not been sufficiently involved in decisions made about whether or not resuscitation should be attempted in the event of a medical emergency. During our inspection carried out on 09 April 2014, we found that necessary improvements had been made and that the regulations in relation to how consent was obtained had been met.

People told us that staff had always obtained their consent and agreement about the support, care and treatment provided. One person who lived at the home commented, 'I have been fully consulted and involved about the care and support I need. I have agreed to it and frequently discuss my requirements with the manager, nurses and care staff.'

We saw that people had been involved in the assessment of their individual needs and in the planning, delivery and reviews of the care and support they received.

Is the service caring?

During our inspection we saw that staff treated people who lived at the home with respect and kindness while delivering appropriate levels of care and support. We also saw that care was delivered in a way that met people's individual needs and requirements.

People who lived at the home and their relatives were very positive and complimentary about the levels of care provided and the care staff who supported them. One person commented, "The care we get here is absolutely first class it really is. Everybody is so very well looked after in such a kind, patient and efficient way. Staff come quickly when you call for then and can never do enough for you.'

Is the service responsive?

People told us they liked the opportunities provided by the activities coordinators and the range of facilities available at the home. These included computer games, poetry sessions, flower arranging and gardening, arts and crafts activities and use of a music room, hairdressing salon and library.

We saw that people had been given information about how to make a complaint if the need arose and that concerns raised had been properly documented and resolved in a prompt and effective way. Everybody we spoke with told us they knew how to make a complaint but had not had the need to do so.

Is the service well led?

We found that effective systems had been put in place to assess and monitor the quality of services provided and to identify, assess and manage risks posed to the health, welfare and safety of people who lived at the home.

We saw that the home worked well with healthcare professionals such as GP's, dentists and chiropodists to make sure that people received care that met their individual needs in a joined up way.

We spoke with members of staff who told us that both the provider and manager demonstrated strong, visible and consistent leadership in a way that made them feel valued and supported.

Arrangements were not in place for establishing and acting in accordance with the best interests of people using the service in relation to their capacity to express their wishes about resuscitation in a medical emergency.

We found that people's needs were assessed and care was planned and delivered in line with those individual needs. One person who was living at the home told us, 'Everybody [staff] seems to make an effort to make you as comfortable as possible.' The relative of one person who was visiting said, 'I think they provide an exceptional service. My [relative] gets everything they need.'

We found that people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. The provider was operating a standardised medication management system which used personalised colour-coded blister packs for each of four medication rounds throughout the day. People's medication records were accurate and medicine stock numbers matched those records.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. The provider ensured that the professional registration of nursing staff was up to date.

People's care plans and other records contained up-to-date information. Records were accurate and fit for purpose. Staff records were diligently maintained.

We saw staff interacting with people used the service, listening to them and responding in a polite and courteous way and also knocking on doors before entering. People's needs were assessed and peoples likes and dislikes were identified including, the time they like to get up and go to bed, what they like to eat and drink,

Breakfast was available from 8am till 11am, people were able to eat in their room if they wished. One person who used the service said "The food was very good, we get lots of choices.at all meal times" Another person said " When my relative visits they join me for dinner in the dinning room where staff ensure we have access to our own dinning table."

The provider regularly assesses and monitors the quality of the service, regular audits are carried out and appropriate action is taken to address any issues. The provider produces a monthly newsletter informing people of what is happening within the service such as the current improvement plan regarding the installation of 27 overhead hoists and upgraded mains electricity supply.