Archived: Wayfarers

Updated 27 November 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 6 November 2018 and was unannounced. The inspection team consisted of one inspector and an assistant inspector.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some information about the service, what the service does well and improvements they plan to make. We reviewed previous reports and notifications received by the Care Quality Commission. A notification is information about important events, which the provider is required to tell us about by law, like death or a serious injury.

We looked at five people’s care plans, associated risk assessments and medicines records. We looked at management records including two recruitment files, training and support records, resident and staff meeting records, audits and quality assurance. We observed staff spending time with people.

We spoke with the registered manager, senior team leader, team leader, three care staff and four people who lived at the service. We did not use the Short Observational Framework for Inspection as people were able to speak to us about their experience living at the service.

Updated 27 November 2018

This inspection took place on 6 November 2018 and was unannounced.

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

Wayfarers accommodates up to 33 older people requiring long or short term care, in one purpose built building. At the time of the inspection, the provider was only using one wing of the building. There were 18 people living at the service who required personal care.

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.

We inspected Wayfarers in September 2017 and the service was rated ‘Requires Improvement’ overall with three breaches of regulation. Following the last inspection, we asked the provider to complete an action plan to show how they would meet the regulations. At this inspection, we found that improvements had been made and the regulations had been met. The service was now rated Good overall.

At the last inspection, we found the registered person had failed to do all that is reasonably possible to mitigate risks to people’s health and safety. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Potential risks to people’s health, safety and welfare had been assessed. There was now detailed guidance for staff to reduce the risks and keep people safe. Checks had been completed on the environment and equipment to make sure that people were safe. Incidents and accidents were recorded and analysed for patterns and trends. Action was taken to reduce the risk of them happening again.

Previously, we found the registered person had failed to assess, monitor and improve the quality of the service and maintain accurate and complete records. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection, improvements had been made the breach of regulation had been met.

At this inspection, audits had been completed consistently by senior staff and the provider to monitor the quality of the service. When shortfalls had been identified, an action plan was put in place and signed off when completed. The registered manager had oversight of the audits and the action taken to rectify the shortfalls.

At the last inspection, we found the registered person had failed to give person centred guidance to staff to meet people’s needs. This was a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection, improvements had been made the breach of regulation had been met.

Care plans now had detailed guidance for staff about people’s choices and preferences. Care plans were reviewed regularly with people, who agreed their care and support. Care plans now reflected the care being given. Staff worked with healthcare professionals to support people at the end of their lives.

The management team met with people before they moved into the service to make sure that staff could meet their needs. Staff monitored people’s health and when there were changes, people were referred to healthcare professionals. Staff followed their guidance to keep people as healthy as possible. People had access to professionals such as the dentist and optician. People were encouraged to be as active as possible and lead a healthy lifestyle. People had a choice of meals and were supported to eat a balanced diet.

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible, the policies and systems in place supported this practice.

People’s dignity and privacy was respected, staff treated people with kindness and compassion. People and staff had developed warm relationships and staff had a genuine interest in people. Staff supported people to be as independent as possible and be involved in developing their care and support. People had access to activities and trips that they enjoyed.

People were protected from harm and abuse. Staff knew how to recognise signs of abuse and how to report concerns. Staff were confident that the registered manager would deal with the concerns appropriately. The registered manager had reported concerns to the local safeguarding authority and followed the guidance given.

People received their medicines safely and when they needed them. The service was clean and there were procedures in place to protect people from infection. The service was purpose built and met people’s needs.

There were enough staff to meet people’s needs, who had been recruited safely. Staff received regular supervision and yearly appraisals, to discuss their practice and development needs. Staff told us they felt supported by the management team. New staff received an induction, staff received training appropriate to their role and staff competency was checked.

The provider had a complaints policy that was displayed in the main reception. People told us they knew how to complain and were comfortable to talk to staff about any issues.

There was an open and transparent culture within the service, staff were focussed on people and maintaining their independence. People, staff and stakeholders were asked their opinions about the service and the feedback had been positive. People and staff attended regular meetings to make suggestions and discuss any concerns they may have.

The management team worked with agencies such as the local council and safeguarding authority to ensure people received effective care. The registered manager and senior team leader attended local forums and training to keep up to date and continuously improve the service.

Services that provide health and social care to people are required to inform the care Quality Commission (CQC), of important events that happen in the service. CQC check that appropriate action had been taken. The registered manager had submitted notifications to CQC in a timely manner.

It is a legal requirement that a provider’s latest CQC inspection report rating is displayed at the service where a rating has been given. That is so that people, visitors and those seeking information about the service can be informed of our judgements. We found the provider had conspicuously displayed their rating on a notice board in the entrance hall.