We carried out a review of the data available to us about Welford Court on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Welford Court, you can give feedback on this service.
Welford Court is a residential care home providing accommodation and personal care to up to 14 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 14 people using the service. The service is a detached property that has accommodation over 2 floors. Some people’s bedrooms had en-suite facilities and people shared communal lounges, dining room and have access to a large garden.
People’s experience of using this service and what we found
Some environmental risks were not always mitigated. The registered manager addressed these concerns immediately during our inspection. Staff received safeguarding training and knew what to do if they thought someone was at risk. Medicines were managed safely. There were safe systems of recruitment in place. People's needs were assessed, and clear risk assessments were in place to guide staff.
People were cared for by staff who were well trained and skilled to deliver the support they needed. Staff had regular supervision and were encouraged to develop their knowledge and skills. Staff supported people to eat a healthy diet and access other health professionals when needed.
Feedback about the service, staff and management was very positive. Staff worked in effective partnership with external professionals. The management team had oversight of the service and demonstrated commitment to the continued development of the service. Staff were supported within their roles and the registered manager supported staff with their development.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 14 April 2020).
At our last inspection we recommended that the provider implement an effective range of quality assurance processes and audit checks which cover all key aspects of the service. At this inspection we found that improvements had been made to the quality assurance processes.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Welford Court on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Welford Court Limited is a residential care home providing personal and nursing care in an adapted building. At the time of inspection 14 older people were using the service. The service can accommodate up to 14 people on two floors.
People’s experience of using this service and what we found
Quality assurance and audit processes did not cover all aspects of the service which meant some issues relating to people's care and safety were not promptly identified and followed up. There had been some recent changes to the managerial structure, including a new management level post which needed time to become embedded.
We have made a recommendation about quality assurance and audit processes in the service.
Risks associated with people’s care were assessed and reviewed regularly. We found items in people's rooms such as denture cleaning tablets and prescription cream which were not stored in cupboards. This increased risk to people's safety if others entered the room and accidentally used or consumed these products.
All staff had up to date checks with the disclosure and barring service (DBS). Medicines were administered by trained staff. Protocols were in place for people who received medicines 'as needed' but these were not always up to date. Staff followed infection control practices to reduce risks to people, however, storage of toiletry items in communal shower/bathrooms presented a risk of cross contamination.
Referrals were not always made promptly when people's health needs changed. People did not have mental capacity act assessments and evidence of best interest decisions in place when they were not able to make decisions for themselves, or had fluctuating capacity.
Staff received training suitable for their roles, including specialist training, and were up to date with annual refresher training. Feedback was mixed about whether people felt there were enough activities for them to do.
The service was working on an action plan with the local authority to make improvements in a number of areas. Some improvements had been made to the exterior of the property so there was a level access pathway to the front door. Access to the garden remained difficult from the main living area of the service.
The CQC rating was not displayed on the website and notifications to the CQC of certain incidents did not always take place promptly.
People felt staff cared for them safely. Staff were aware of their responsibilities and how to keep people safe from the risk of abuse. People received care from kind and caring staff who knew them well.
People's privacy and dignity were respected, and their independence was promoted. People received choice in their daily menus and staff were aware of people's dietary needs.
Care files contained a range of care plans which set out people's care needs and how people wanted to receive their care. No complaints had been received in the last twelve months. People and staff felt confident they could raise any issues and these would be dealt with appropriately. People and their relatives were supported to discuss end of life preferences if they wished.
People and staff spoke positively about the registered manager, staff enjoyed working at the service and felt team work and communication was good. People's views were gathered via regular resident meetings and annual surveys. Regular staff supervision had been recently introduced, along with regular team meetings.
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.
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 8 October 2019).
Why we inspected
The inspection was prompted due to information received from the Local Authority. The Local Authority funded some people’s care and they found the service was not complying with their contract. We decided to undertake an inspection and look at all areas of the service.
We have found evidence the provider is not complying with the requirement to display their CQC rating on their website. We also found evidence that the provider needs to make and embed improvements. Please see the safe, effective and well led sections of this full report for further details.
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.
Welford Court is a residential care home providing personal care for 14 people aged 65 and over at the time of the inspection. Many of the people using the service were living with varying stages of dementia, alongside other healthcare needs. The service can support up to 14 people.
The service supports people in one residential building which has been adapted and extended. The first floor is accessed by a stair lift.
People's experience of using this service
People's safety was promoted; staff understood how to protect people from the risk of harm and understood potential signs of abuse. People were involved in assessments of potential risks to their safety and in identifying measures to keep them safe. Care plans provided clear guidance for staff to follow.
Medicines continued to be managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately. People were protected from the risk of infection through staff working practices.
People were supported by a consistent team of staff who were safely recruited. Staff continued to receive essential training and there were opportunities for additional training specific to the needs of people. Staff continued to tell us they felt supported, records showed they had regular supervision.
People were provided with care and support which ensured they had good nutrition and hydration, and access to healthcare that maintained their health and wellbeing.
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.
Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support. People’s privacy and dignity was maintained at all times.
Care plans supported staff to provide personalised care. People were encouraged to take part in activities and interests of their choice. There was a complaints procedure in place and systems in place to deal with complaints effectively. The service provided appropriate end of life care to people.
The service continued to be well managed. The provider had systems in place to monitor the quality of the service. Actions were taken and improvements were made when required. Further developments were planned to support staff to provide care that achieved the best possible outcomes for people.
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 10 February 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.
Welford Court provides residential care to older people including people recovering from mental health issues, sensory impairment and people who are living with dementia. Welford Court is registered to provide care for up to 14 people. At the time of our inspection there were 13 people living at the home.
A registered manager was in post. 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 last inspection of the service on 6 August 2014 we asked the provider to make improvements in how medicines were stored. We received an action plan from the provider which outlined the action they were going to take. This advised us of their plan to be compliant by November 2014. At this inspection we found that improvements had been made and medicines were stored appropriately
At the last inspection we also asked the provider to take action to ensure staff gained people’s consent prior to care being offered. We found that improvements had been made to how people were asked for their consent to care prior to their admission to the home. This was in addition to staff agreeing their actions prior to each caring intervention.
People were provided with a choice of meals that met their dietary needs. The catering staff were aware of people’s dietary needs, and sought people’s opinions about the menu choices in order to meet their individual dietary needs and preferences. A range of activities tailored to people’s interests were provided by staff and external professionals on a regular basis. Staff had had access to information and a good understanding of people’s care needs. People were able to maintain contact with family and friends and visitors were welcome without undue restrictions.
Relatives we spoke with were complimentary about the registered manager and staff, and the care offered to their relations. People were involved in the review of their care plan, and when appropriate their relatives were included. We observed staff positively interacted with people at lunch, where people were offered choices and their decisions were respected. Staff had access to people’s care plans and received regular updates about people’s care needs. Care plans included changes to peoples care and treatment and people were offered and attended routine health checks, with health professionals both in the home and externally.
Staff were subject to a thorough recruitment procedure that ensured staff were qualified and suitable to work at the home. They received induction and on-going training for their specific job role, and were able to explain how they kept people safe from abuse. Staff were aware of whistleblowing and what external assistance there was to follow up and report suspected abuse.
Staff were aware of the reporting procedure for faults and repairs and had access to the maintenance contractors to manage any emergency repairs. The provider had a clear management structure within the home, which meant that the staff were aware who to contact out of hours if an equipment repair was necessary.
The provider carried out quality monitoring checks in the home supported by the registered manager and home’s staff. The provider had developed opportunities for people to express their views about the service. These included the views and suggestions from people using the service, their relatives and health and social care professionals.
We received positive feedback from the staff from the local authority with regard to the care and services offered to people at Welford Court.
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
At the last inspection 22 May 2013 the service was found to be fully compliant with the regulations we looked at.
We inspected the service 6 August 2014. This was an unannounced inspection. Welford Court provides accommodation and personal care for up to 14 people with needs related to mental health, dementia and sensory impairment.
On the day of our visit there were 13 people living at the service There was a registered manager in post at the time of this inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
People who used the service were complimentary about the care and support they received. There were a range of activities provided to ensure that people were engaged in activities that were meaningful to them. Throughout our inspection we observed staff to be caring and attentive to people’s needs. Staff were respectful and demonstrated a good understanding of people’s needs.
The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found the provider had not acted in accordance with the DoLS legislation and had not made appropriate applications to the supervisory body.
People’s health and well-being was supported by staff arranging appointments with external healthcare professionals when required, such as a doctors . Staff communicated effectively with people who used the service and with their relatives where appropriate.
Risks associated with people’s needs such as malnutrition and risk of developing pressure sores had not been properly assessed.
People received their prescribed medicines safely and as prescribed by the doctor. Controlled medicines were not stored in accordance with legal requirements.
The provider did not carry out checks to assess and monitor the quality of service provision.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.
We found people's needs were identified within their care plan and that people's health and welfare was monitored by staff and external health care practitioners.
We found people were served hot and cold drinks and snacks throughout the day. People were seen to eat and enjoy their lunchtime meal and were supported by staff where appropriate. The chef was aware of the specialist diets of people and people's individual likes and dislikes.
We spoke with two people who were visiting people who used the service. They told us they were happy with the care and support provided by staff and that they felt informed about the persons needs and the care there relatives received. They told us they were made to feel welcome and were confident in the service provided.
It was difficult to talk with people however, People when asked about their views of the service told us, via staff or relatives: - 'It's a good place.' and 'you can ask any time of the day if you need something and they get it for you.' One person also told us that they thought it comfortable and the staff were kind.
People who use the service told us staff were helpful and that they could talk to them. During the inspection we saw people approach the deputy manager and staff members seeking reassurance and assistance about aspects of their daily lives.
The people at the home enjoyed the games that the activities coordinator tried to encourage all people to join in (three days per week). She was good at involving individuals and groups depending on their preferences.
No negative comments were made by people living at the home. They expressed positive views about key aspects of care provided at the home. This included the home itself and the people who worked in it.
People are encouraged to engage in a range of activities which helps them to keep mentally alert and physically active. People who live at Welford Court enjoy each others company and interact well with each other.
Staff have a good understanding of the needs of people and have an in depth knowledge about the people they care for which helps them to support and care for people well.