Archived: Wallfield House Care Home

The service did not have a registered manager as this is not required as they are the sole provider. 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.

On our previous inspection we identified concerns that people were not always protected from harm as suitable equipment had not been provided. On this inspection we saw equipment was now available for people who needed this and risks of falls had been reduced. Other people were still at risk as incidents had not always been investigated and action had not been taken to ensure people had not injured themselves. Where concerns about potential harm had been identified, this had not been reported to the local authority under agreed safeguarding procedures to protect people from potential further harm.

On our previous inspection we identified that some people may not have capacity to make some important decisions although an assessment to determine this, had not been completed. On this inspection we saw these assessments had not been completed and some decisions may have been made by other people. There was no evidence to show that people may not be able to make these decisions for themselves. Quality assurance systems were in place but these had not been used to bring about improvements following our last inspection and further concerns had been identified.

People had mixed views about the opportunities they had to engage in activities that interested them. Some activities were organised including, an entertainer, visits by local school children and pets, but opportunities to go out were limited and some people felt they would like more activities to be organised. People knew how to raise a concern but were not always confident they would always be listened to or action would be taken.

People were able to make choices about the food and drink they wanted and a choice or food was available. Where people needed support to eat or needed a specialist diet, this was provided and referrals had been made to healthcare professionals in a timely manner to maintain people’s health and wellbeing. Medicines were managed safely and in accordance with good practice.

Systems were in place to ensure checks were completed prior to new staff starting to work in the home. Staff received training and support to develop and enhance their skills to meet the needs of people. People’s care was reviewed with them and care plans had been developed to ensure they included information about how people wanted to be supported. Risk assessments were in place to promote people’s safety and reduce identified risks.

We saw that people were responded to in a kind and friendly manner by the care staff on duty and care staff knew people well and engaged in conversation about their interests and family. People were consulted about the quality of the service through surveys and encouraged to maintain good relationships with people.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

The service did not have a registered manager as this is not required as they are the sole provider. 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.

Risks to people had been assessed although not all risks had been managed to prevent further injuries. The provider had identified that different equipment was needed to reduce further injury and this had not been provided. Domestic furniture was being used to restrict people from falling from their bed although this had not been assessed as being suitable and safe to use.

People consented to their support and were able to make choices about their care. Applications to restrict some people of their liberty had been made. These people may have capacity to make decisions about how they wanted to be supported and any restrictions that may be placed upon them for their safety.

Where people needed a blended diet, this was blended together which did not allow people to continue to taste the different food ingredients within the meal. People’s health and wellbeing was monitored and the support of healthcare professionals was sought whenever specialist advice was required. People were asked what they would like to be prepared and could eat and drink food they liked; the dining area offered people a pleasant dining experience. People could choose to have a glass of wine or a drink of alcohol with their meal and there was a range of condiments offered to people.

Staff understood their role when taking action to protect people from the risk of abuse and knew how to act. There was a sufficient number of suitably recruited staff to provide support to people. People benefitted from receiving care from staff who had training to enhance their skills and knowledge. Staff received supervision and on-going support to check they were competent and had an opportunity to discuss further developments. People received their prescribed medicines to keep them well as there were processes in place to ensure medicines were administered, recorded and stored correctly.

People contributed to the development of their support plan and were able to include family members. People’s care was reviewed with them to ensure they were happy with how they were supported and that it reflected any changing need.

People had opportunities to spend time together and be involved in individual or group activities. Family and friends were welcome to the home and people were able to visit and see people in private.

People were treated politely by kind and considerate staff who knew them well and ensured that they were supported to maintain their dignity and respected their right to privacy. People were consulted about the quality of the service and felt that staff listened to their views. People knew how to raise any concerns and were confident these would be addressed. The quality of the service was assessed and reviewed to ensure people remained safe and areas for improvement could be identified.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.