8 February 2020
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 Care Act 2014.
The inspection was carried out 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:
Wisden Court 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 had a manager who was registered with the Care Quality Commission. A registered manager 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 the 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. We did not request a provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with 12 people who used the service and four relatives about their experience of the care provided. We spoke with the registered manager, the regional operations director, and five members of staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included five people’s care records and medication records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records.
8 February 2020
About the service
Wisden Court is a purpose-built residential care home providing personal care to 54 people at the time of the inspection. The service can support up to 54 people.
People’s experience of using this service and what we found
People were mainly happy with the care and support they received. Staff were kind, friendly and attentive to people’s needs. People gave mixed views about the number of staff to meet their needs and about if they could make choices relating to timing of care. Six out of the 12 people were spoke with told us they needed to wait for support at times. Staff felt that there were enough of them to meet people’s needs in a person-centred way and would be happy for a relative of theirs to live there. Staff were trained and felt supported.
People felt safe and staff were aware of how to promote people’s safety in most cases. However, we observed one person who was at risk due to staff not adhering to guidance in the person’s plan and some less positive moving and handling observations. Regular checks were in place from the Care Team Leaders to help ensure staff worked in accordance with training and health and safety guidance was adhered to. There were governance systems in place but these were not always used effectively as systems had not identified the issues we found as part of this inspection.
The environment was decorated festively for the season and people told us they liked it. There was plenty of communal space for people to enjoy. People who were participating enjoyed the activities that were provided. There was a ‘Tools down’ and ‘Forget me not’ scheme in place to help prevent social isolation.
People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests. However, the policies and systems in the service did not support this practice. This was because the management team told us that the provider had advised them that deprivation of liberty safeguards applied to everyone living in the home, not just those who lacked capacity. While we found that this had not impacted on people’s rights or freedom, but the process needed to be amended to adhere to the principles of the Mental Capacity Act. Staff knew people well and worked in a way that promoted people’s preferences and wishes.
People were involved in planning their care when they moved into the home. However people did not always feel that they were involved throughout their stay. People had end of life care plans and there was a ‘Yellow basket’ scheme which invited people and relatives to add items of comfort for people, which were used when people were nearing the end of their lives. Complaints were responded to appropriately. Feedback was sought through meetings and surveys.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The last rating for this service was Requires Improvement (published 4 January 2019). At this inspection the service has remained the same.
The provider was required to send us an action plan after the last inspection to show what they would do and by when to improve. The registered manager had completed the action plan but this had not been sent to us to review.
At this inspection enough improvement had not been made and the provider was still in breach of regulation.
Why we inspected
This was a planned inspection based on the previous rating.
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.