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Archived: Wallfield

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Inspection Summary


Overall summary & rating

Updated 3 September 2014

Wallfield is a care home for up to 14 adults with learning disabilities.  Two beds are used for respite services and 12 for permanent placements. On the day of our inspection visit there were twelve people living at the home and no people receiving respite care. There was a registered manager in post who was present for part of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law like the provider. The registered manager is also referred to as ‘the manager’ throughout this report.

People told us they were happy living at the home and they felt the staff met their needs and were kind and caring. Staff knew people well and were able to communicate with people in a range of ways depending on people’s needs.

There were up to date and relevant care plans in place for people that reflected their individual needs. People were actively involved in care planning and in all decisions about their care. The home’s staff involved other professionals, families and advocates where appropriate. We saw that staff understood people’s care and support needs, were interactive, kind and friendly towards them and treated people with dignity and respect.

A range of activities were offered to people either in groups or on an individual basis. People were given the opportunity to provide feedback on the activities and were happy with the range of activities provided. Staff were skilled at communicating with people who used non-verbal forms of communication so they could interpret which activities people enjoyed and whether or not they wanted to join in or repeat activities.

We found that staffing levels were adequate to meet people’s needs and the manager had an effective system in place to plan this in advance.

The home was meeting the requirements of the Deprivation of Liberty Safeguards. People’s human rights were properly recognised, respected and promoted. Staff had a good understanding of mental capacity and consent and how this affected people who lived there.

There were suitable procedures in place to ensure that medicines were stored, handled and administered safely.

The home was well run and there was an open culture in the home. Staff and people living in the home said they could speak to the manager if they had any concerns and felt involved in the running of the home.

Inspection areas

Safe

No action required

Updated 3 September 2014

The service was safe because the home had systems and processes in place to protect people from unsuitable staff. For example, the recruitment procedures included face to face interviews, references and criminal record checks being undertaken prior to them starting work.

People who used the service told us they felt safe living at the home. They said “I like it here” and “I really like my key worker because they are nice.”

Staff were trained in safeguarding, whistle blowing and the Mental Capacity Act 2005. They showed a good understanding of these topics and this was reflected in people’s care plans and risk assessments. The home had processes in place to monitor incidents and learn from them.

They also received training in medicines management and only those trained and deemed as competent were able to administer medicines.  There were processes in place to ensure medicines were handled safely and we saw records to show these worked in practice. This meant people living at the home were protected against the risks associated with these areas. We found one medicine where the home’s records did not match the doctor’s prescription. The person had been given the medicine, which was an ‘as required’ medicine, once since moving into the home. The manager agreed the guidelines should have been more accurate but felt no harm had come to the person because the medicines had not been needed. The manager stated she was planning to have the medicine reviewed by the GP as the person no longer needed it.

Effective

No action required

Updated 3 September 2014

The service was effective because people had their needs assessed and the staff understood what people’s care needs were. People were involved in decisions about their care and encouraged to be as independent as possible. People told us they were involved in decisions and they felt listened to.

We found care records were detailed, up to date and regularly reviewed. Social workers attended review meetings, as did close relatives and key workers. People were enabled to be involved because there was pictorial and ‘easy read’ documentation and staff understood their individual communication needs.  

Effective systems were in place to support people with their healthcare needs and other professionals were involved if appropriate. For example we saw that some people had been referred to speech and language therapists.

Caring

No action required

Updated 3 September 2014

The service was caring because people told us they liked living at the home. They said things like, “I really like it” and “I feel happy here”. We observed that staff treated the people using the service well and supported them in a way which was respectful and kind. People told us staff were kind to them and listened to them.

There was a relaxed and friendly atmosphere in the home. Some of the staff and people who lived there had been at the home for many years and built good relationships. We also saw that a new person had settled in well and their relative commented on the good relationship they both had with the staff and management. We noticed that staff communicated well with everyone living in the home. They were particularly skilled at communicating with people who used non-verbal forms of communication, such as Makaton (a sign language which can be personalised for the individual using it). People looked happy and responded positively when staff interacted with them.

Responsive

No action required

Updated 3 September 2014

The service was responsive to people’s needs because people had personalised care records that had been written in collaboration with the person and their key-worker. They were produced in easy read and pictorial formats and were reviewed and updated as changes occurred. We saw some good examples documented on how the service responded to people’s changing needs. For example, the health care needs of people who had lived there for a long time had changed over time. We saw this was reflected in their care plans and support was given which reflected these changes.

Staff had been trained in the Deprivation of Liberty Safeguards and the Mental Capacity Act 2005. There was evidence that this training was effective in responding to people’s needs. Staff we spoke with showed a good understanding of the issues around consent and capacity and appropriate documentation was in place where necessary.

We found that concerns and complaints were encouraged. People told us they could talk to the manager or their key worker if they had any concerns. A relative we spoke with also said they would not hesitate to speak to the manager if they were concerned.

We looked at records and found  people were given the opportunity to express their views in ‘resident’ meetings, quality assurance questionnaires, complaints processes and daily discussions with staff and these concerns were responded to. There was an open and relaxed culture in the home. Visiting professionals told us staff responded to people’s requests, for example, in relation to activities.

Well-led

No action required

Updated 3 September 2014

The service was well led because there was a registered manager in post who was present on the day of our inspection and had suitable arrangements in place to ensure the service was well led at all times. Staff told us they felt well supported and “The manager’s door is always open”.

We saw there was an effective system in place to monitor and review the service provided. Such as; surveys, team meetings, analysis of incidents and staff supervision. Views were sought from people using the service, staff and other professionals. People who lived at the home told us they knew how to complain and we saw there were suitable procedures in place to enable this to happen. Staff said they were able to support people who used non-verbal communication to make their views known and this was confirmed by what we observed and what other professionals told us.

People living in the home told us there were always enough staff on duty to meet their needs. Staff confirmed this and we saw staff duty rotas that showed this was planned in advance and based on the needs of people living in the home.

Staff had regular one to supervision meetings with a senior member of staff and felt supported. They said they received appropriate training and records we saw confirmed this. We also saw that staff were confident and competent in supporting people, such as with moving and handling and communication.