Wilton Lodge Residential Home

Wilton Lodge is a residential care home providing personal care to up to 36 people. The service provides support to older people, some of whom may be living with dementia. At the time of our inspection there were 33 people using the service.

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

People living at Wilton lodge were safe. Risk to people’s safety were identified and manged well. People received their medicines as prescribed. Staff had received training in a range of topics which ensured they had the skills and knowledge to meet people’s specific needs.

Accidents or incidents were reviewed and learning shared with staff to prevent a recurrence and keep people safe.

The service had effective infection, prevention, and control measures to keep people safe, including good arrangements for keeping the premises clean and hygienic.

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. The service remains rated Good.

Why we inspected

We undertook a focused inspection to review the key questions of safe, and well-led only. This was because the service had not been inspected since February 2022.

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 last report published on 28/02/2022

You can read the report from our last focused inspection, by selecting the 'all reports' link for Wilton Lodge on our website at www.cqc.org.uk. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

There were safe visiting processes which were overseen by staff when visitors entered the home. There were no restrictions on visiting.

Professionals visiting people at the home had to show their COVID-19 vaccination passes or show proof of their exemption. The registered manager checked that all staff working in the home had received their COVID-19 vaccinations.

Staff were checking people’s temperatures and oxygen levels daily to see if people had COVID-19 symptoms. The registered manager made sure people who consented to, received COVID-19 tests as directed by government guidelines. Staff promoted social distancing when possible and amongst themselves.

Staff wore personal protective equipment (PPE) correctly. The registered manager had ensured this was made available throughout the home. Staff had received recent refresher training on PPE and infection protection control (IPC).

People who needed to, were supported to shield from others when they had returned for an emergency hospital admission.

The home looked clean and there were no malodours. The staff supported people in a calm and kind way.

Wilton Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Wilton Lodge Residential Home provides accommodation and personal care for up to 36 older people, some of whom may live with dementia. It does not provide nursing care.

At our last inspection on (date) February 2017, the service was rated requires improvement and there were breaches of regulation 12, 13 and 17. This was in relation to assessing the risks to the health and safety of the service users, proper and safe management of medicines, systems and processes established and operated effectively to prevent abuse of service users and assess, monitor and mitigate the risks relating to the health and safety and welfare of service users.

At this inspection, we found that the provider had taken the required action to address these shortfalls and were meeting the required standards. The service has been rated good.

The service does have a registered manager. 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 felt safe in the service. Staff understood their responsibilities with regards to safeguarding people and they had received effective training.

Recruitment procedures were in place. Sufficient staff were on duty and were deployed effectively to meet the needs of people. Staff were competent in their roles and received support and guidance from management.

People's health care needs were met and they received support from healthcare professionals when required. Medicines were managed safely and audits were completed.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. People had been involved in planning their care and deciding in which way their care was provided, where possible. People’s care plans reflected their preferences and included personalised risk assessments to meet their needs.

People were supported to make choices in relation to their food and drink and a balanced, nutritious menu was offered.

Staff were kind and helpful. They provided care in a friendly and relaxed manner, treating people with respect. Staff promoted and maintained people’s dignity and provided encouragement to people throughout their support.

People, their relatives and staff knew who to raise concerns. Quality assurance processes were used to improve the service being provided.

There was no registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run. However the manager has started the registration process and this had been received at the time of the inspection.

Trained staff helped people to take their medicines at the right time. We found that prescribed creams were not always documented when applied and that the guidance for medicines given when required (PRN) was not detailed enough. Safe medicines practices were not always followed by staff when administering people`s medicines.

Accidents and incidents were documented but not always investigated to identify trends and patterns and to ensure people were kept safe.

Safe and effective recruitment practices were followed to help ensure that all staff were suitably qualified and experienced. However we found that written and verbal communication skills some staff had needed improvement.

Care was not always provided in a way that promoted people’s dignity and respected their privacy.

Staff obtained people’s consent before providing personal care and support, they developed positive and caring relationships with the people they cared for and knew them well. However we found that the Mental Capacity Act principles were not always followed.

Complaints were recorded and responded to in line with the service’s policy. People, relatives and staff were complimentary about the manager and how the home was run. However we found that audits did not identify shortfalls or areas of concern and had not led to the necessary improvements being made.

People were not always supported to pursue social interests and take part in meaningful activities relevant to their needs, both at the home and in the wider community.

People felt safe, happy and well looked after at the home. Staff had received training in how to safeguard people from abuse and knew how to report concerns, both internally and externally.

People received personalised care and support which took account of their preferences. Staff were knowledgeable about people’s background histories, preferences, routines and personal circumstances, however the environment was not designed to promote the wellbeing of people living with dementia.

Plans and guidance had been drawn up to help staff deal with unforeseen events and emergencies. The environment and equipment used were regularly checked and well maintained to keep people safe.

People and relatives were positive about the skills, experience and abilities of staff who worked at the home. They received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.

People were supported to access health and social care professionals when necessary. They were provided with a healthy balanced diet that met their individual needs.

People were involved in the planning, delivery and reviews of the care and support provided. The confidentiality of information held about their medical and personal histories was securely maintained throughout the home.

Complaints were recorded and responded to in line with the service policy. People, relatives and staff were complimentary about the manager and how the home was run and operated. However we found that audits had no systems in place to ensure areas identified were improved.

A relative commented, 'The staff are very good with the residents. The place is very clean. My (relative) is always clean and neatly dressed. We are very pleased with the care.'

People we spoke with said that they participated in group activities when they wanted to. A couple of them said that they enjoyed reading books. One person said, 'The books are changed once a month by the mobile library service.' Another person said, 'I usually read the books on the bookshelf in the community room.' This showed that people had been given choices and their wishes had been respected.

We observed staff encouraging people to have drinks and offering them a choice of hot and cold drinks between mealtimes. We noted that people's nutrition and hydration needs had been met. People had received their medicines on time. This indicated that people's well being had been promoted by taking account of their physical needs.

We found that work was in progress to renovate the interior of the premises and staff had ensured people's safety during the process.

When asked about choices, people told us that they had a choice of activities and menu. We were told that people participated in residents' meetings, at which they could express their opinions and raise any concerns they may have. The management had taken prompt action to address any issues raised.

A person commented, "The staff organise different type of activities. I can join in any group activities. Sometimes I prefer to play card games, but not many people like to do that, so a member of staff joins me for a game."