Archived: Wenham Holt Nursing Home

Wenham Holt Nursing Home is a family run nursing home for up to 50 people. The home provides nursing care and rehabilitation to older and younger adults, some of whom may also be living with dementia, a physical disability or a learning disability. At the time of our inspection there were 42 people living at Wenham Holt. There is a 16 bed continuing healthcare unit which is part of the home.

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

People told us they felt well cared for by staff. People’s feedback included, “The staff are really nice and caring here” and “Definitely. I like living here.”

The providers had systems and processes in place to safeguard people from the risk of abuse. Staff assessed risks to people and supported them to stay safe, whilst respecting their rights. There were sufficient numbers of suitable staff to support people safely. People’s medicines were managed safely. The providers had processes in place to minimise the risk of people acquiring an infection.

People’s care needs were assessed and their treatment and support was delivered in line with guidance, standards and legislation. Staff had the required skills, knowledge and experience to deliver people’s care effectively. Staff supported people to eat a varied and balanced diet. Staff worked across organisations and ensured people’s healthcare needs were identified and met. The service was well decorated and maintained and people had access to ample space both indoors and outside.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support

• Model of care and setting maximises people’s choice, control and independence. People were supported to make their own decisions about how they wanted their care provided wherever possible. People had an advocate to represent their views if required and who had oversight of how their care was provided. People had regular contact with both members of their family and significant people where they wished.

Right care

• Care is person-centred and promotes people’s dignity, privacy and human rights. People received person-centred care, based on their interests and preferences about their care. Staff cared about people and ensured they were cared for with dignity. They understood and upheld people’s human rights.

Right culture

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. Staff had received relevant training to enable them to support people in a person-centred manner. The provider matched the skills of specific staff to people when allocating who was to work with them. Staff worked well with external services to ensure people’s health and social care needs were identified and met.

People were treated with kindness, respect and compassion. Staff supported people to express their views and to be involved in decisions about their care. Staff ensured people’s privacy, dignity and independence were respected.

People received personalised care which was tailored to meet their identified needs. Staff supported people to identify their interests and to engage in relevant activities. Staff worked with other professionals to ensure people were appropriately supported at the end of their lives.

The providers promoted a positive culture, focused on achieving good outcomes for people. They had processes in place to enable them to monitor the quality of the care provided against current guidance and to identify areas for improvement. Incidents were reviewed to identify any learning. People were provided with information about how to raise any concerns. Staff worked openly with other agencies to support the delivery of people’s 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 good (published 11 October 2017).

Why we inspected

We undertook this inspection as part of a random selection of services rated good and outstanding to test the reliability of our new monitoring approach.

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.

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.

Wenham Holt Nursing Home is a care home providing accommodation with nursing and personal care for up to 50 people living with dementia, a physical or learning disability, or other frailty.

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

We were assured that the provider’s systems and processes for identifying, assessing and managing risks were suitable to keep people safe and respect their freedoms. Appropriate processes were in place for risks relating to the premises and equipment, and for individual risks affecting people’s safety, health and wellbeing.

The provider had made necessary changes to the service to protect people from the risk of the spread of COVID-19. We identified the following areas of good practice.

The provider had installed a visiting “pod” attached to a conservatory which allowed family visits to take place in a sheltered, enclosed environment. The conservatory doors made a floor to ceiling sealed screen with microphones and speakers to assist conversation. The visitor side had heating, refreshments and hand sanitiser, all of which could be cleaned or replaced between visits.

The provider had supported staff to maintain high standards in protecting people in their care against the spread of COVID-19. There were changing and showering facilities so that staff could wear scrubs while on duty. Their scrubs were laundered on site. This reduced the risk of the virus entering the home on people’s clothes.

The provider helped staff who could not get home delivery of groceries by ordering food and cleaning products for collection at the home. The provider took steps to reduce the financial impact of government required measures such as furlough and self-isolation. This reduced the risk of staff contracting the virus outside of work. The provider took similar steps where part time staff could not work at Wenham Holt Nursing Home during the pandemic because they worked at another service and would risk transferring the virus.

Rating at last inspection

The last rating for this service was good (published 11 October 2017).

Why we inspected

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question where we needed to seek assurance. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

This targeted inspection was prompted by notification of an incident following which a person sustained a serious injury. A review of the incident concluded there were no grounds for CQC to take action in response to that incident, but we should seek assurances that the provider’s risk processes were robust. A decision was made for us to inspect to examine those processes.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe section of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wenham Holt Nursing Home 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.

Wenham Holt Nursing Home is a family run residential care and nursing home for up to 50 people with a range of needs. The home provides nursing care to older people with dementia, people with a terminal illness, and people with learning and physical disabilities. At the time of our inspection there were 44 people living at Wenham Holt. There is a 16 bedded continuing healthcare unit which is part of the home, (continuing healthcare is care outside of hospital that is arranged and funded by the NHS). This is referred to in the report as the ‘unit’. The home is set in extensive grounds providing peaceful and attractive outside areas for people to enjoy.

Rating at last inspection

At the last inspection, the service was rated Good.

Rating at this inspection

At this inspection we found the service remained Good.

Why the service is rated Good

People were protected from the risk of potential abuse and appropriately supported by staff to manage assessed risks to their health and wellbeing. Staffing levels and recruitment processes were appropriate to support people safely. People’s medicines were managed safely. The environment was monitored and managed to minimise the risks to people from emergencies such as fire and other health and safety related hazards including infection control.

Staff completed training and received supervision to maintain and develop their skills and knowledge to support people according to their 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 support this practice. The service had made improvements in their systems and records to ensure people’s health needs were consistently monitored, evaluated and any concerns were acted on.

People were cared for by kind and caring staff. Staff knew people well, their preferences and changing needs and people were treated with dignity and respect. People nearing the end of their life received compassionate and supportive care and their decisions were known and respected.

People’s care and support needs were set out in a written plan that described what staff needed to do to make sure personalised care was provided. People received care and support in line with their care plan to achieve positive outcomes in their health and wellbeing. A range of activities was available to meet people’s interests and needs for social interaction and stimulation. A system was in place for people and/or their representatives to raise concerns and make complaints and any received had been acted on. People told us they felt the registered manager and business manager listened to them and had addressed any concerns they raised.

The home provided a welcoming, inclusive and homely environment with a friendly and positive ‘can-do’ culture. Staff understood and acted in accordance with the provider’s values to promote personalised care for ‘everyone’ including people their relatives and staff. Systems were in place to make sure the service was managed efficiently and to monitor and assess the quality of service provided. Feedback from people, their relatives and other professionals was gathered, evaluated and acted on to drive continuous improvement to the service.

Further information is in the detailed findings below

We spoke with the registered manager, the business and environmental manager, two registered nurses,

four care workers, the activities co-ordinator and the chef.

We spoke with two people using the service who told us about their experiences of the care they received. One person commented, "I am well looked after here". They added, "All the staff are very good, if you have a problem they sort it out'there is nothing they could do better".

We spoke with four relatives; they were all positive about the care their family member received. One told us, "There is always a good atmosphere... staff are always very helpful, always there for you". Another relative told us that staff, "Always spoke to [their relative] as if they were a person". They added, "It would be hard to find anything they could do better; I was lucky and fortunate to have found this home".

We found that people were treated with dignity and respect and their care was delivered in a person centred manner. People's needs were assessed and care was delivered in a manner that took account of people's preferences. People were supported to be as independent as possible. We found that the service placed a strong emphasis on providing people with good nutrition, which helped to promote the wellbeing of people who used the service.

There were effective staff recruitment and selection processes in place and new staff were given an induction so that they understood the aims and objectives of the service and what was required of them. Staff told us that they felt supported by the management of the service.

The service had some arrangements in place for monitoring the quality of care so that people were protected against the risks of inappropriate or unsafe care and treatment. However we found some care records, including care plans, contained inaccurate or incomplete information.

We saw that staff treated people who lived in the home with respect. We saw staff gave people choices throughout our visit and they asked people before providing care.

People told us: 'The care is very good; I have no complaints at all'.

We spoke with relatives of a person living at the home. They told us: 'Staff are very attentive, they are always coming around offering drinks and food to the residents. It's really good, the care is good'.

Another relative told us: 'The care provided is absolutely ace'. And 'It's [Wenham Holt] an up beat place'.

We found that people's needs were assessed before they moved to the home and each person had a detailed and individualised care plan.

We found that the home was sufficiently staffed. One person who lived at the home said: 'Yes there is always plenty of staff around'.

Staff told us they enjoyed working at Wenham Holt Nursing Home. One person said, 'I really enjoy my job and I get a great deal to job satisfaction.' And, 'We make sure the people who live here have a good quality of life'.