Archived: Widecombe House

As part of this inspection we spoke with three people who lived in the home, five relatives, the manager, four staff, and two visiting healthcare professionals. The registered provider also visited the home during our inspection. We reviewed records relating to the management of the service which included three care plans, daily care records, training records, and quality assurance records.

Below is a summary of what we found. The summary describes what people who used 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 supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff. During our inspection we spent 30 minutes observing people in the dining room. We noted the interactions were good and showed staff respected people at the home. People told us they felt safe at the home. Safeguarding procedures were robust and staff understood how to safeguard the people they supported. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The manager told us they had not needed to submit any applications. Proper policies and procedures were in place. The manager knew when an application should be made, and how to submit one. Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, concerns, and investigations. This reduced the risks to people and helped the service to continually improve.

Is the service effective?

People who used the service and their relatives told us they were happy with the care they received. Comments included "This is a good home' and "They look after me". One relative told us 'The care is excellent. They genuinely care about each and every person'. We spoke with staff who told us how they met people's care needs. We looked at care plans and observed the care provided. This gave us evidence that staff knew people well. People's health and care needs were assessed. Care plan reviews had been carried out to ensure they reflected people's current needs. Staff had received appropriate training to ensure they were able to deliver care and treatment to people safely.

Is the service caring?

People were supported by kind and attentive staff. Staff were patient when assisting people with their needs. People's preferences had been obtained by the home and were included in people's care plans. When we spoke with staff it was clear they genuinely cared for the people they supported and knew them well.

Is the service responsive?

People's needs had been assessed before they started to receive care. The service carried out an assessment to ensure it was able to meet people's needs. We saw evidence that people's care was adjusted when their needs changed. We saw the complaints procedure was available in the home. People and their relatives told us they felt able to speak to the manager or staff if they were unhappy about something. They felt confident that the service would deal with any matters to their satisfaction.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. We spoke with two visiting healthcare professionals who told us the manager and staff at the home contacted them if they had concerns and followed their advice and instructions. Staff told us they were clear about their roles and responsibilities. Staff we spoke with told us they felt well supported and had regular discussions with the manager. They told us they were able to approach the manager at any time. This helped to ensure that people received a good quality service at all times.

We found people were being cared for well by sufficient care workers who understood them and their needs. Most people were still awake and enjoying chatting with care workers or watching television. We saw people were well groomed and were offered evening drinks. A care worker told us that it was people's choice when they got up in the morning. They also told us they worked with people's own routines as far as they could.

We found that the management of the home were able to respond quickly to support care workers and that care workers could contact them at any time.

We found there were enough care workers with access to appropriate management support to support people effectively.

We did not substantiate or identify any concerns.

On the day of our inspection 15 people were living at the home and receiving care from the service. We, the Care Quality Commission (CQC) spoke with two people, one of the home owners, the home manager and one care worker. We looked at three care plans.

People had clear assessments of their needs and plans and strategies were in place to meet them. We saw that care workers interacted with people in a relaxed and respectful manner. People had access to age appropriate social activities. During our visit we saw that people were offered choices throughout the day which supported their independence and provided a meaningful quality of life.

The home was clean and free from offensive odours.

There was sufficient, suitably trained staff on duty to meet the needs of the people living there.

The records that were in place were up to date and fit for purpose.

Many people who lived at this home had dementia. We saw that people were relaxed in the company of staff. One person told us 'the staff are very kind'.

We found that although people liked living at the home and looked well cared for, some of their needs were not met adequately.

We looked around all areas of the home. We saw that some of the facilities were an infection control risk.

We found that mandatory staff training was out of date which meant that staff did not always have the skills to look after people properly. There were not enough suitably trained staff on duty to meet people's needs fully.

Not all care records were completed properly.Care plans contained some information about people but poor organisation of files and gaps in information could result in a risk of unsafe or inappropriate care. People's individual needs were not always met due to a lack of documented assessments.

We did not speak with people living at the home on this visit.

We found that the home's management had carried out training for all staff in safeguarding and addressing concerns about people's wellbeing appropriately. We saw records that showed us this had been done.

We spoke with a member of staff on duty who told us they understood what to do in case of a safeguarding concern.

We saw that all staff had been given information about what to do if abuse was suspected or if they saw anything they were uncomfortable with while at work. We were told that the training and policies, including whistleblowing, would be followed up with staff individually. We saw that staff were receiving 1:1 sessions of supervision with the manager frequently where this would take place.

Contact numbers of agencies who had a role in safeguarding had been provided so that these could be accessed quickly if needed.

We found that the home's management were clear about what actions to take to help protect people living there, or who to report any concerns to to ensure they could be addressed.

At the last inspection we found the home were not taking up references on new staff or having appropriate systems in place for risk assessing any possible convictions. On this visit we found that this had been corrected and staff were being employed following a full recruitment process. This helped to ensure people were being care for by staff who were suitable to be working with potentially vulnerable people.

Also on the last visit the home's whistleblowing procedures and safeguarding policies needed updating to include agencies outside of the home to whom safeguarding issues or allegations of abuse should be referred.

On this visit we found that the home had implemented the needed changes. We also found that they had acted robustly to protect people living at the home where concerns were raised about the practice of one member of staff. However they had not followed their own policies and had not informed CQC or the local safeguarding team when allegations were raised.

We saw people interacting well with staff. We saw staff caring for people and supporting their mobility and communication with good humour and understanding. People were enjoying having manicures and chatting with staff on our visit.