Archived: St Wilfrid's Care Home

At our previous inspection in July 2014 we identified some issues in relation to the care and welfare of people and in relation to compliance with the Mental Capacity Act. The provider sent us an action plan after this inspection setting out how they planned to address these issues. We conducted this inspection to check that improvements were being sustained in accordance with the provider’s latest action plan. We found that improvements had been made.

St Wilfrid’s Care Home is a care home for up to 44 older people. There are three floors at the home, all overseen by the general manager and the registered manager. There were approximately 15 residents on each floor. The first floor was home to approximately 15 older people, some of whom had mobility problems and the second and third floors were home to those with more advanced needs including dementia.

There was a registered manager at the service. 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 observed some unsafe practices in relation to how medicines were administered on the first day of our inspection and there were some errors in the recording of controlled drugs. All other aspects of medicines management were dealt with appropriately.

Risk assessments and support plans contained clear information for staff. All records were reviewed every month or where the person’s care needs had changed.

Staff demonstrated knowledge of their responsibilities under the Mental Capacity Act 2005.

Staff demonstrated an understanding of people’s life histories and current circumstances and supported people to meet their individual needs in a caring way.

People using the service and their relatives were involved in decisions about their care and how their needs were met. People had care plans in place that reflected their assessed needs.

Recruitment procedures ensured that only staff who were suitable, worked within the service. There was an induction programme for new staff, which prepared them for their role. Staff were provided with appropriate training to help them carry out their duties. Staff received regular supervision. There were enough staff employed to meet people’s needs.

People who used the service gave us good feedback about the care workers. Staff respected people’s privacy and dignity and people’s cultural and religious needs were met.

People were supported to maintain a balanced, nutritious diet. People were supported effectively with their health needs and were supported to access a range of healthcare professionals.

People using the service and staff felt able to speak with the management team and provided feedback on the service. They knew how to make complaints and there was a complaints policy and procedure in place.

People were encouraged to participate in activities they enjoyed and people’s feedback was obtained to determine whether they found activities or events enjoyable or useful. An activities programme was in place and this included a mixture of one to one sessions and group activities.

The organisation had adequate systems in place to monitor the quality of the service. Feedback was obtained from people through monthly residents meetings and annual questionnaires about the service and the results of these were positive. There was evidence of auditing in many areas of care provided and actions were taken to rectify issues.

We made a recommendation to the provider with regard to documenting the learning and development needs of staff.

Below is a summary of what we found. The summary describes what people using the service and their relatives/friends told us, the records we looked at and what staff we spoke with also told us.

If you would like to see the evidence that supports our summary then please read the full report.

Is the service safe?

St Wilfrid's Care Home is a registered care home for older people. There were 34 residents living at the home at the time of our visit. We looked at nine care records and saw that these contained a variety of risk assessments which included those in relation to the environment, personal care and fire safety. However, risk assessments did not reflect people's changing needs and care records did not provide an accurate account of the care people were receiving or required to receive.

The service had a safeguarding policy and procedure in place. All staff we spoke with were aware of their responsibilities to report any concerns they had about potential safeguarding issues and were able to describe potential signs of abuse.

There were arrangements in place to deal with foreseeable emergencies. All senior staff had received first aid training. There was a policy in place for dealing with accidents and incidents and we were told that a senior staff member was always on call in case of an emergency. We spoke with 13 members of staff and each person correctly explained the policy for handling an accident or incident.

Is the service effective?

We spoke with three members of staff about how they obtained consent from people using the service on a daily basis. We were given examples of the routines of some people as well as some people's general likes and dislikes.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Staff were aware of the policies and procedures relating to the Deprivation of Liberty Safeguards and understood when an application should be made and how to submit one. No applications had been submitted at the time of our visit. Staff demonstrated an understanding of the Mental Capacity Act 2005 and its requirements. However, staff were unable to correctly answer our questions in relation to whether specific people had decisions made in accordance with the Act.

Is the service caring?

People were generally happy with the care being provided at St Wilfrid's Care Home and we observed positive interactions between staff and people using the service.

There were a range of activities available for people who used the service, which included board games, painting sessions and pampering sessions for example manicures. However, people's participation in activities and the outcomes related with their participation was not monitored. It was therefore not possible to determine if people were taking part in activities that were meaningful to them.

Is the service responsive?

Staff told us that they organised resident's meetings where issues such as the range of activities, food choices, the home environment, staffing and well-being were addressed. We observed a resident's meeting on the day of our inspection and heard this being discussed.

Is the service well-led?

The service had a registered manager in post. Staff we spoke with told us that the manager was 'supportive' and 'accommodating.'

Staff meetings took place every month and a separate residents meeting took place once a month. We saw that quarterly audits took place and people using the service were asked for their feedback in an annual survey.

The home had sufficient arrangements in place to share and obtain up to date information about a person's care and treatment if they were being transferred from another service.

Staff received appropriate professional development. We saw staff records for supervision, appraisals and training and staff we spoke with confirmed that they received these regularly. One person who used the service told us 'staff support me extremely well'.

The home had adequate arrangements in place to monitor and support a person if they were at risk of inadequate nutrition and dehydration.

People we spoke with knew how to raise complaints. One person told us they would speak to the manager if they had any concerns.

People told us they felt safe in the home and that they knew how to raise concerns if they needed to. Relatives told us they felt their relatives' were safe in the home and were well cared for. One relative said that their relative had reported an incident in the past and this had been followed up on.

The manager and staff said they felt supported by their respective managers. Several staff members described the relationship with management as 'very good' and 'open and supportive''.