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Inspection carried out on 19 April 2018

During a routine inspection

This inspection took place on 19 and 23 April 2018 and was unannounced.

At our last inspection we rated the service ‘Good’. At this inspection we found the evidence continued to support the rating of ‘Good’ and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Wellington Park Nursing Home is a care home which provides nursing and residential care for up to 28 people. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Within the building there are four floors, each of which has separate adapted facilities. All four floors specialise in providing nursing care and support to the elderly and people living with dementia and physical health needs. At the time of this inspection there were 24 people using the service.

We observed people to be happy and relaxed in their surroundings. People and relatives confirmed that they and their relative felt safe living at Wellington Park Nursing Home.

People’s identified risks relating to their health and care needs had been assessed and clear guidance had been provided on how to reduce or mitigate risks to ensure people’s safety.

The service followed robust procedures to ensure the safe administration and management of medicines.

We observed sufficient staffing levels within the home during the inspection. Safe recruitment processes ensured that only staff assessed as safe to work with vulnerable adults were employed.

People’s needs and choices were assessed prior to admission to the home so that the service could confirm that they could effectively meet people’s needs.

Care plans were detailed, person centred and were reviewed on a monthly basis or sooner where people’s needs had changed.

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 supported this practice.

Care staff told us and records confirmed that they were supported in their role through a variety of processes including supervision, appraisals, training and team meetings.

Care staff knew people well and were responsive to their needs and wishes. We observed people had established positive relationships with other people and care staff which were based on mutual trust and respect.

All complaints received were investigated with details of the outcomes and any improvements clearly documented with a written response.

A number of audits and checks were completed by the senior management team to monitor the quality of the service people received and to ensure that where issues were identified these were addressed with a view to continuously learn and improve.

Further information is in the detailed findings below.

Inspection carried out on 5 January 2016

During a routine inspection

We inspected the service on 5 January 2016. The inspection was unannounced. At our inspection on 7 May 2014 the service met the Regulations that were looked at on the day.

Wellington Park Nursing Home provides accommodation for up to 30 people who require nursing and personal care. The service supports older people with physical disabilities and dementia. The home has four floors. Bedrooms are located on the first and second floors. On the ground floor there are further bedrooms situated alongside the registered manager’s office and a nurse’s office and on the lower ground floor there is a living room, dining room and the main kitchen. There is lift access to all floors. On the day of our inspection 29 people were living at the service.

There was a registered manager 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.

People that we spoke with were positive about living at the service and the care that they received. People were treated with warmth and kindness. Staff were aware of people’s individual needs and knew how they were to meet those needs.

The service had a number of systems in place in order to monitor and maintain people’s safety. Medicines were administered safely to people. There were systems in place to support a thorough recruitment process.

Staff had the knowledge and skills they needed to perform their roles. We saw that staff received supervision and had an opportunity to discuss any queries or concerns with the registered manager. Staff spoke positively about their experiences working at the home and with the registered manager.

People told us that they felt safe. The registered manager and staff understood how to protect people from abuse and knew what procedures to follow to report any concerns.

People’s nutritional and hydration needs were being met. However, whilst observing lunch we noted that people who required assistance within their own room, had to wait up to 30 minutes before a member of staff supported them with their meal, with their meal being left in their room on a bed side table.

Food looked appetising and the chef manager was aware of any special diets people required either as a result of a medical need or a cultural preference. People and relatives spoke positively about the food at the home.

Care plans were detailed and person centred. People’s health and social care needs had been appropriately assessed. Risks associated with people’s care were identified and plans were in place to minimise the potential risk to people. Most of these care plans had been reviewed and updated where necessary. However, there were a few care plans where significant change had been noted but this had not been updated within the person’s care plan.

There were policies, procedures and information available in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure that people who could not make decisions for themselves were protected.

An activity plan was on display within the home outlining a variety of different activities that were due to take place over the week. An activity team consisting of three staff members who were responsible for delivering activities within the home. However, on the day of the inspection we observed very little activity taking place.

People using the service and their relatives were positive about the registered manager and the overall management of the home. The service had an open and transparent culture where people were encouraged to have their say and staff were supported to improve their practice.

There was a system in place to monitor and improve the quality of the service which included feedback from people who used the service, staff meetings and a programme of audits and checks.

Inspection carried out on 9 September 2014

During an inspection in response to concerns

One inspector carried out this responsive follow-up inspection. The purpose of this inspection was to check whether people were protected against the risks of inadequate nutrition and dehydration following a concern that was raised alleging that sufficient quantities of food were not available for people who used the service. The allegations stated that there was a lack of basic food which included bread and milk and that no snacks were offered to people who used the service.

During our inspection on 9 September 2014, we spoke with four people who used the service and they told us that they were satisfied with the food provided at the home.

During our inspection on 9 September 2014, we looked at the quantity of food stored in the home and noted that there were sufficient quantities of food which included bread and other foods. We also checked the fridge and found that there were sufficient quantities of milk and dairy products available.

We spoke with the senior cook at the home and they confirmed that they carried out a weekly shop and that milk and bread were delivered three times a week to the home and we saw evidence to confirm this.

Inspection carried out on 7 May 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to gather evidence to answer five questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

During this inspection we spoke with two people who used the service, two representatives and three relatives of people who used the service. We also spoke with the Registered Provider, the general manager, three care staff and one domestic staff.

The Registered Manager has left the home but their name appears on the report. Their name will appear on the CQC register until their application for cancellation has been submitted and approved. The home has a new manager who is currently applying to the CQC to be the Registered Manager of the home. In this report, this manager is referred to as the “general manager”.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People who used the service told us that they felt safe in the home. People said that they felt comfortable in the home and that members of staff treated them with respect and dignity.

Safeguarding procedures were comprehensive. We saw evidence that all staff had received safeguarding training in April 2014.

When we discussed safeguarding with staff, they were aware of the signs of abuse and the action to take when responding to allegations or incidents of abuse. However, not all staff we spoke with were aware that they could report allegations to the local authority, police and the Care Quality Commission.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have been submitted, appropriate policies and procedures were in place.

We saw evidence that necessary employment checks had been carried out to ensure that people were cared for by suitably qualified, skilled and experienced staff.

There were sufficient numbers of staff on duty to meet people's needs and staff confirmed this. We noted that care staff were able to complete their tasks and did not appear rushed.

The service had systems in place to identify assess and manage risks related to health welfare and safety of people who used the service.

Is the service effective?

People told us that they were happy with the care they received at the home and felt that their needs had been met. One person who used the service told us "Staff are helpful and kind" and "Staff are respectful and include me". One relative we spoke with said that their relative was "fortunate to be in this home".

We looked at four care files and saw that people's care needs had been assessed and care and treatment were planned and delivered in line with their individual care plan. Risk assessments had been carried out where necessary. Care plans included information about people's preferred routines and healthcare needs. We saw that care plans included information about people’s mental state and cognition. However, we saw no evidence that mental capacity assessments had been carried out and therefore there was a risk that people's best interests were not being served.

Staff told us that they were well supported by their manager and that there was good communication amongst staff. This enabled them to carry out their roles effectively, which in turn had an impact on the quality of care people received.

Is the service caring?

People who used the service and relatives were positive about the staff at the home. They told us that they had been treated with respect and dignity in the home. One relative told us "Staff are respectful and polite. Staff interact with people". One person who used the service said "Staff are friendly and helpful". During our inspection, we saw that there was good interaction between staff and people who used the service.

People looked well cared for and we saw that the atmosphere was relaxed in the home.

Is the service responsive?

People who used the service and relatives we spoke with told us that if they had any concerns or complaints, they would feel comfortable raising them with staff or the general manager at the home.

We saw that the home had a complaints policy and procedure. Complaints were recorded, however there was no record of whether these had been resolved. The Registered Provider told us that they listened to people and acted on feedback received. We saw evidence that the provider had carried out a survey in April 2014 asking people for their views about the home. They then analysed the information from the survey and took action following people’s comments.

People's care and health progress was monitored closely. Written notes about people's health and care were completed by staff. People's care plans and their health needs were regularly reviewed with people who used the service.

Is the service well-led?

The home had quality assurance processes in place to help ensure that people received a good quality service.

People who used the service told us that they felt listened to by members of staff and the general manager.

Resident/relative's meetings were held quarterly which enabled people to discuss issues regarding the running of the home. This encouraged people to raise queries and concerns with management and members of staff.

Staff told us that staff meetings took place quarterly and the general manager confirmed that informal meetings amongst staff were held every other day and we saw evidence to confirm this. The aim of these meetings was to enable staff to raise queries and concerns with their team and share information. All staff we spoke with told us that they felt able to consult the general manager if they had concerns or queries and said that they felt supported.

Management in the home completed regular audits such as health and safety and premises risk audits.