Archived: Walcot Hall Nursing Home

Walcot Hall is a residential care home providing personal and nursing care to 32 people aged 65 and over at the time of the inspection. The service can support up to 42 people.

Walcot Hall is a large adapted period house on the outskirts of a village and has extensive and pleasant grounds for people to enjoy. There are communal dining and recreation areas. Accommodation is arranged on two floors.

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

The provider assessed and managed risks well and people were safe. We brought one potential risk to the registered manager’s attention and they took prompt action to address it. Staff had a good understanding of safeguarding procedures and monitored the safety of the environment through regular checks. There were enough staff, although in recent weeks the service had struggled with staffing and some people who used the service commented on the impact of this. Staff were recruited safely.

Staff were knowledgeable, well trained and worked collaboratively as one large team. Pre-admission assessments were good and ensured people had appropriate care in place before they were admitted or readmitted. People's physical and emotional healthcare needs including their eating and drinking needs were very well managed

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff had a good understanding of consent. Where people needed to be deprived of their liberty for their own safety, an appropriate application had been submitted to the local authority.

Staff were very kind and respectful and included people in decisions about their care and support. Families were involved in decisions if people were not able to do this for themselves.

People received person-centred care which met their individual needs. End of life care was good, and staff had appropriate end of life training. People had things to do and small group activities worked well. Some people would have liked more to do. Complaints were well managed.

Leadership was strong and the manager was a role model to all staff. The registered manager was aware of small areas for improvement and was open, honest and transparent about these. Audits showed good oversight and enabled the registered manager to identify patterns and trends and take appropriate action, if needed.

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 15 February 2017.)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This inspection took place on 8 December 2016 and was unannounced.

A registered manager was in post at the time of our inspection. 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.

The home had sufficient staff to meet the needs of the people living there. There were a suitable amount of staff on duty with the skills, experience and training in order to meet people's needs.

Staff had received training in how to recognise and report abuse. The registered manager knew how to report any safeguarding concerns to the appropriate local authority if necessary.

The home followed safe recruitment practices to ensure only suitable staff were employed to work with people who lived at the home. The home had ensured risks to individuals had been assessed and measures put in place to minimise such risks.

Staff were well trained and knowledgeable regarding people's needs. Staff felt well supported by management and felt able to speak with senior staff at any time.

Caring relationships had been built between people and staff. Staff knew the needs and preferences of the people they cared for and people were given reassurance and encouragement when they needed it. Where people needed support in order to make their own day to day decisions this was provided by staff. People's rights to privacy, dignity and independence were taken into account by staff in the way they cared for them.

Where possible people or their relatives had been involved in the assessment and planning of their care. Care records were detailed and gave staff the information they required so that they were aware of how to meet people’s needs. There was a good level of detail for staff to reference if they needed to know what support was required.

People's ability to make important decisions was considered in line with the requirements of the Mental Capacity Act 2005. Staff interacted with people in a positive manner and their consent was sought before any care was carried out.

There was a strong ethos within the home of treating people as individuals and with respect. Information was given to people about how to raise any concerns they may have and where concerns were raised these were dealt with speedily and in detail. Relatives said they felt welcomed at the service and felt their family member was well cared for.

The home was extremely responsive to people’s needs. Staff potential to deliver additional tasks such as activities was recognised and promoted by the registered manager. Activities were planned by staff who worked to ensure that all people were able to be involved. People were supported to take part in activities of their choosing.

The registered manager had implemented a range of assurance systems to monitor quality and effectiveness of the service provided. Leadership within the organisation was very strong. The registered manager was very experienced and led by example. Staff were respectful of management and demonstrated a commitment to working towards the shared values of the home.

One person told us that their decision to move to the service was, 'The best day's work I ever did. I love it.' Another person said, 'I would definitely recommend this home to others.' A further person said, 'I don't know what isn't good, they (the staff) work so hard to make things comfortable.'

We saw that staff interacted with people in a kind and caring manner. People's care needs had been assessed and they had access to other healthcare professionals such as doctors when needed.

People had a choice of food and individual needs were accommodated. Where there was a concern regarding people's nutrition and hydration, their food and fluid intake was monitored to ensure that it was adequate for their health needs.

Medication was stored securely and it was administered to people when they needed it.

People told us that the staff were kind and caring. We saw that the appropriate recruitment checks had been conducted to ensure that staff were of good character and had the necessary skills and knowledge to perform their role.

A complaints system was in place. The service had dealt with complaints in a timely and appropriate manner.

We looked at care records and found these to be comprehensive with a lot of detail around people's medical needs although we found that the care records did not have much detail on social aspects of their care. We were told of new documentation that was being introduced that will remedy this.

Staff were well supported and had received a range of appropriate training and quality assurance measures identified where improvements could be made.