Wilton House Residential and Nursing Home

Updated 16 February 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This included checking the provider was meeting COVID-19 vaccination requirements. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was completed by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Wilton House is a ‘care home’. 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was asked by CQC to complete a Provider Information Return (PIR) during this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection-

We spoke with three people who used the service and 10 relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager, nurses and care workers. We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 16 February 2022

Wilton House is a residential and nursing home providing personal and nursing care for up to 51 people. At the time of our inspection 43 people were living at the home. Wilton House accommodates up to 51 people across two floors, each of which have their own dining and living space. Individual bedrooms have an en-suite.

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

Infection prevention control measures were poorly managed. Staff were not wearing personal protective equipment (PPE) in line with the guidelines. Where people were positive of COVID-19, measures were not in place to mitigate the risk of spreading the infection. This was addressed at the first inspection visit and improvements had not been made on the second visit.

The provider and registered manager had a governance system in place, which included various audits and monitoring. However, actions were not always documented, and it was unclear if actions were completed. In addition, immediate improvements in relation to infection prevention control were not actioned between inspection visits which posed a risk to people.

People had risk assessments in place, which detailed how to support them. People received their medicines when they needed them. However, records for medicines prescribed for when needed were not present which did not offer clear instruction as to when it was appropriate for the person to have this medicine. Staff received training to help ensure they were sufficiently skilled.

People and relatives felt staff provided care that was safe, and systems were in place to report concerns. The staff team had been safely recruited. Systems were in place to report and respond to accidents and incidents.

Staff felt morale was good and felt supported by their manager. The registered manager had built positive relationships with professionals and was dedicated in making sure people got input from health professionals when needed. The registered manager gave examples of where professional involvement benefited the people they supported.

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 24 December 2019)

Why we inspected

We undertook a targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about infection prevention control measures. A decision was made for us to inspect and examine those risks.

We inspected and found there was a concern with infection prevention control, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe infection prevention control practice at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.