Archived: Wells House Nursing Home

We carried out the visit in response to concerns that had been raised in relation to the care and welfare of people that used the service. During the visit we met and talked with people that used the service and their relatives/representatives, the recently appointed new manager, the nurse on duty, a senior care staff and care staff. They helped answer our five questions;

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records. We found overall that action had been taken and improvements had been made by management and staff since our last inspection visit.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The service was safe. Since the appointment of the manager, improvements had been made in conjunction with an action plan that had been drawn up for the development of Wells House.

People were treated with respect and dignity by the staff. People told us that they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

There were on-going procedures in place to maintain people's safety. Care records in relation to pressure area wound care had been reviewed. Further auditing and reviewing of the plans of care was being undertaken to ensure that people were protected against the risks of inappropriate or unsafe care and treatment.

Improvements were being introduced to ensure that arrangements were in place in relation to the management and recording of medicines.

Staff training records showed that staff needed to refresh their training, and the manager provided evidence that training had been booked for all staff, which included subjects such moving and handling and medicine administration in the next couple of months.

We found that records required to be kept to protect people's safety and wellbeing were maintained, held securely and available when required.

Is the service effective?

The service was effective. People's health and care needs were assessed with them and/or their representatives. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

People had the care and treatment that they needed. Staff referred people appropriately to their GP and other health and social care professionals.

Is the service caring?

The service was caring. We saw that staff interacted well with people and knew how to relate to them and how to communicate with them. Positive comments had been received about the service and included 'It is very nice and very friendly here. It is like having a family again', 'I am happy here, I do not have any concerns' and 'The food is good and I can always have something different, if I do not fancy what is on the menu'.

We saw on the notice board cards of appreciation. Comments included 'Thank you very much for all the care and attention you gave to X' and 'We would like to thank everyone at Wells House for all the care and kindness you gave to X to make her time with you the very best it could be',

Is the service responsive?

The service was responsive. The staff listened to people, and took appropriate action to deal with any concerns.

People's health needs were being met. Care plans showed that the care staff noticed if someone was unwell, or needed a visit from a health professional such as a dentist or optician. The staff acted promptly to make appointments for people.

The manger was responding to issues of concern that had been made. She was working with other professionals to make sure that the action plan that had been drawn up for the development of Wells House was carried out.

Is the service well-led?

The service was well-led. The manager had previously been a registered manager with the Commission for another service owned by the provider. Before coming to Wells House he had had previous experience of working in Wells House. One member of staff said 'The manager is making a difference', and another member of staff said 'I feel a lot more confident here with the new manager. It is a change for the better'.

There were systems in place to provide on-going monitoring of the home. This included checks for the environment, health and safety, fire safety and staff training needs.

The staff confirmed that they had had a staff meeting since the manager started at Wells House. This enabled them to share ideas and concerns. The action plan that had been drawn up for the development of Wells House indicated that staff supervisions were to commence in August 2014.

People we spoke with told us that they were happy with the care and support they received. One person told us "being a small home it becomes like a family. Staff are very kind, very loving; I'm not just a number'. A visitor told us about the care provided by the home and the support that the staff had provided to their relative. They said the staff had shown 'care, patience and kindness' and had 'gone beyond what they had to do'. They said 'nothing compares to this home; it is absolutely wonderful'.

We found that care plans were individualised, were reviewed regularly and contained detailed guidance for staff about the care and support people required. Risk assessments were in place to identify and minimise risks as far as possible to people who used the service.

We spoke with people who told us there were enough staff on duty and that they had a good understanding of people's needs. One person told us 'they have a gentle, nice attitude; no rushing, they are patient'. We found that there were sufficient staff employed in the home, who were appropriately trained to support people's needs.

People we spoke with told us that they were happy with the care and support they received. One person told us "they are the type of staff who will come up and say goodnight before they go off duty; it's like being in a family'.

A visiting relative said 'the care is good' and spoke of one particular member of staff, commenting they were 'very good, very caring'.

People told us that they were supported to make their own day-to-day decisions and were involved in how their care and support was provided.

We found that care plans were individualised and contained people's choices and preferences. Risk assessments were in place to identify and minimise risks as far as possible to people who used the service.

We found that the home had arrangements in place to protect people from the risk of abuse and people told us that they felt safe.

People told us that the home had sufficient staff on duty, and we found that staff had received appropriate training to support people according to their individual needs.

The home had a complaints policy in place and people told us that they knew how to make a complaint. A procedure was followed that enabled complaints to be addressed in a timely way.

At our previous inspection we found that there were gaps in some of the care records. We saw that this had now been resolved. Staff told us that due to staff vacancies they had not implemented a care records audit to ensure that care records were always completed correctly, but they hoped to do this now that new staff had started. We saw that although the home had been using agency staff, there were processes in place to ensure that all staff were aware of people's needs and the care that should be provided.

At our previous inspection we found that a number of areas of the home were in need of repair or refurbishment. We also found that although the home had provisions in place to minimise the harm to people in the event of a fire, the evacuation plans were not consistent which may put people at risk. We saw that the service had addressed most of the maintenance issues, and had had a satisfactory inspection from the local fire service.