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Waverley Lodge Nursing Home Good

Reports


Inspection carried out on 13 October 2018

During a routine inspection

The inspection took place on 13 October 2018 and was unannounced.

Waverley Lodge Nursing Home 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.

The service is registered to accommodate 26 people and specialises in providing care, treatment and support for people living with physical disabilities. The home was split over two floors with the first floor accessible by stairs or a lift. There was a large open plan lounge and dining room which led out onto a large decked patio. There was ramp access to the outside areas. There were 26 people living at the home at time of inspection.

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 ongoing 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.

People were protected from avoidable harm as staff received training and understood how to recognise signs of abuse and the who to report this to both internally and externally if abuse was suspected.

Staffing levels were adequate to provide safe care and recruitment checks had ensured they were suitable to work with vulnerable adults. Registered nurses had the necessary permissions to practice.

Risk assessments were individual and detailed which meant that staff understood safe practices which helped keep people safe.

Medicines were administered and managed safely by trained and competent staff. Medication stock checks took place together with regular audits to ensure safety with medicines.

People told us the home was clean and staff understood their responsibilities in regard to infection prevention and control.

People had been involved in assessments of care needs and had their choices and wishes respected including access to healthcare when required. The service worked well with outside professionals.

People were involved in what they had to eat and drink. Assessments and specialist input was sought where people required it so people could be safe when eating and drinking. People were happy with the quality, variety and quantity of the food.

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.

The registered manager actively sought to work in partnership with other organisations to improve outcomes for people using the service.

Care and support was provided by staff who had received an induction and continual learning that enabled them to carry out their role effectively. Staff felt supported by the management and received regular supervision and they felt confident in their work.

People, their relatives and professionals described the staff as wonderful, kind and caring.

People had their dignity and privacy respected and independence was encouraged.

People had their care needs met by staff who were knowledgeable about their individual needs and how they communicated. Their life histories were detailed and they had been consulted.

The home had a complaints process and people were aware of it and knew how to make a complaint. The service actively encouraged feedback from people, relatives and staff.

People’s end of life needs were discussed and revisited regularly. The service had their own end of life pathway which they used with input from the GP and the palliative care team.

Activities were provided and people were involved in choosing them. Individual activities were provided for those that preferred them. The service actively encouraged people to access the community.

Inspection carried out on 1 June 2016

During a routine inspection

The inspection took place on 1 June 2016 and was unannounced. We returned on 10 June 2016 to complete the inspection. At the time of our inspection 25 people were living at Waverley Lodge. Our previous inspection took place in December 2014 when we found the service was meeting all of the standards of quality and care we assessed.

Waverley Lodge specialises in providing care treatment and support for physically disabled people.

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.

Good management was one of the strengths of the home. There was an open and inclusive atmosphere and the registered manager led by example. Senior managers also had a high profile and carried out thorough and regular audits to ensure the service was meeting its aims and objectives. There was a low staff turnover which meant staff knew people and people knew staff. Staff communicated effectively to ensure any changes in people's needs were known quickly and responded to.

People felt safely cared for and all staff understood and followed procedures to ensure people were protected from risk of harm. Risk to individuals were assessed and regularly reviewed and staff were provided with clear guidance which they followed, to ensure people were as health and as comfortable as possible. Environmental risks were also regularly reviewed, with up to date plans available for what action to take in the event of an emergency.

Most people said there were sufficient staff on duty to meet needs and we observed staff attending to people who needed support in a timely way. Recruitment practices were robust.

Medicines were safely managed and staff had suitable skills and experience to support people with their health, nutritional and care needs. Health and social care professionals were complimentary about the service, describing a professional and effective team of staff.

Staff were friendly and caring, calling everyone by name and welcoming their visitors. Staff understood the importance of maintaining people's privacy and dignity and they encouraged people to be as independent as possible. They had a good understanding of the Mental Capacity Act 2005 and applied this to protect and empower people who may lack the mental capacity to make their own decisions about their care and treatment.

Activities were tailored to reflect peoples interests and people were regularly asked for their views about how the service could improve and develop.

Inspection carried out on 9 December 2014

During an inspection looking at part of the service

We inspected Waverley Lodge Nursing Home on 22 July 2014. During that inspection, we considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

We found the service to be safe, caring, responsive and well led, however we found that training was not up to date and that nurses had not received clinical training. The provider sent us an action plan to demonstrate how they would address the issues found.

On 9 December 2014 we re-inspected Waverley Lodge Nursing Home to assess whether compliance had been achieved.

This is a summary of what we found-

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

We reported on only one of the five questions.

Is the service effective?

We found there were effective systems in place to ensure that staff received regular training updates and that nurses had clinical training booked. Staff told us they felt supported in their role.

Inspection carried out on 22 July 2014

During a routine inspection

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found-

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

Is the service safe?

People�s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People told us they felt safe.

Appropriate Deprivation of Liberty Safeguards (DOLs) applications had been made.

Is the service effective?

People told us they were happy with the care they received and felt their needs were being met. One person told us that the staff were �So caring� and �Did a wonderful job.�

Records showed that training for care staff was not up to date and that nurses had received no clinical training updates. This meant that staff did not receive sufficient training to have the right skills and qualifications to deliver care effectively. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to staff training.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers treated people with dignity and respect and support was offered discreetly and appropriately. One person told us that staff were �Wonderful.� A relative said that the home had �A lovely homely feel.�

Is the service responsive?

People�s needs had been assessed before they moved into the home. Records confirmed that people�s individual needs and preferences had been recorded and support was provided to meet these. People had access to activities which were important to them.

Is the service well led?

Quality assurance processes such as regular auditing were in place. People were able to give feedback at monthly residents meetings and more formally in an annual survey. These were responded to by management. Everyone we spoke with said they would feel comfortable raising any issues or concerns with staff or management.

Inspection carried out on 7 August 2013

During a routine inspection

During our inspection we spoke with five people who use the service, one relative, three members of staff, the Director of Care and the owner.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. People who use the service told us that staff asked for consent before providing any care or treatment.

People who use the service were positive about the care they were receiving. One person told us that the staff were �excellent� and looked after them �very well.� Another rated the staff as nine out of ten and said the staff were �very caring.�

Appropriate arrangements were in pace in relation to the recording of medicine. A medication administration record (MAR) sheet was maintained for each person who required medicine. This included a photograph of the person, the name of the medicine, the dose and frequency and daily record of who administered the medicine at the correct times.

There were effective recruitment and selection processes in place. Interview records and results were on file and staff had been given written terms and conditions of employment and job descriptions. There were policies and procedures in place in relation to the recruitment of staff.

People who use the services and their relatives are asked for their views on an annual basis. A formal questionnaire was sent out in June or July every year and feedback sought in respect of all aspects of the service.

Inspection carried out on 4 January 2013

During a routine inspection

There were twenty four people living at the home at the time of the inspection. During our visit we spoke with eight people and made observations throughout the visit.

People who used the service were very positive and were unanimous in agreeing they were treated with respect and dignity. Each person commented that they were happy to live at Waverley Lodge. One person said " it's really nice here" and another person told us they "felt safe". There was a calm and supportive atmosphere in the home.

People made positive comments about the staff and the staff were very supportive of each other and of the residents. We saw that there was a caring and experienced staff team and that staff were well supported and had undertaken appropriate training.

We were told by people who lived at the home that they felt involved in the decision making process both with regard to their own personal care and that of the home community.

Each person living in the home had a detailed plan of care that included people's individual needs and wishes and information concerning their physical, emotional and other healthcare needs. In order to meet individual needs, the home's staff worked with a variety of healthcare professionals including physiotherapists and speech and language therapists.

Quality audits were undertaken annually to ensure that the home was kept under review.

Reports under our old system of regulation (including those from before CQC was created)