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Menwinnion Country House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 23 October 2019

About the service

Menwinnion Country House is a residential care home providing personal care to 39 people aged 65 and over at the time of the inspection. The service can support up to 40 people in one adapted building.

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

People did not always receive their medicines in a safe way and medicines management systems could have put people at risk. Staff did not always have the correct guidance or skills to support people with complex or challenging needs. People’s records did not all contain up to date information about risks to them, or how to help reduce them. Staff had not always been recruited safely.

People’s capacity had not always been assessed following the principles of the Mental Capacity Act 2005 (MCA). People were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The manager did not have an understanding of the accessible information standard. We have made a recommendation about this.

There was not a person-centred culture throughout the service. Records did not show that people were regularly offered a shower or bath. People did not always receive prompt or appropriate responses to their requests.

People’s care plans did not consistently reflect people’s holistic needs. Changes to people’s needs were not updated promptly in their records. People did not have meaningful end of life care plans in place that detailed their preferences for their care at this time.

Not all people received the support they needed to stay cognitively and physically active. There was a programme of activities available; but there was no evidence to show people with more complex needs, who would not benefit from these, had been consulted about how staff could tailor support to their individual needs.

The provider had not ensured the quality of the service was monitored effectively. Concerns found during the inspection had not all been identified through the provider’s governance processes.

People felt cared for and valued the relationships they had developed with staff. Relatives told us staff were professional, welcoming and kind. People’s care plans described how staff could help people develop or maintain their independence. People and relatives told us staff respected people’s privacy and dignity.

No people, staff or relatives raised concerns about ill treatment of people or staff. People and relatives told us they would feel confident raising concerns or a complaint. Staff understood how to report safeguarding concerns. Staff told us they felt supported and received sufficient training. People and relatives gave positive feedback about the staff team.

Rating at last inspection

The last rating for this service was Good (published 23 June 2017). The rating for ‘well led’ was required improvement as there was no registered manager in post.

At this inspection a manager was in the process of registering with the commission.

Why we inspected

The inspection was prompted in part due to concerns received about a culture of bullying at the service and that people and staff were threatened by the senior management. We also received concerns about the environment, medicines management, recruitment and a lack of person-centred care. A decision was made for us to inspect and examine those risks.

People and staff did not raise any concerns about the culture of the service. We have found evidence that the provider needs to make improvements in other areas. Please see the safe, effective, responsive and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to how risks to people are managed, staff recruitment, people’s mental capacity, person centred care and governa

Inspection areas

Safe

Requires improvement

Updated 23 October 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 23 October 2019

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 23 October 2019

The service was caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 23 October 2019

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 23 October 2019

The service was not always well-led.

Details are in our well-Led findings below.