Wainford House Residential Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating changed to Inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

The service was in breach of legal regulation in relation to Person-centred care.

This service scored 33 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them.

There was no evidence in care plans that demonstrated people, or their relatives had been supported to be involved in discussions about their care and support. Relatives we spoke with as part of the inspection process confirmed that they had not been asked to be involved in discussions about service users care planning. A relative said, “Staff at the Wainford have kept me and my sister informed on the few occasions that [relative’s] health has deteriorated. Other than that, there has been no other communication unless we have been proactive in contacting staff.” This meant that care and support had not been developed collaboratively with people and their families.

A relative also told us, “[Relative] is often without one or both of her hearing aids. They often seem dirty and not working needing the battery replaced.” Failure to ensure hearing aids were used and working effectively could impede people’s communication leading to them becoming isolated.

The provider did not plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Staff had access to best practice tools such as those used to monitor people’s weight or skin integrity. However, there were areas where records were not kept up to date which meant these tools were not always being used effectively to plan peoples care. For example, for 1 person the Waterlow tool had been used to assess their risk of pressure ulcers. In a section of the care plan their risk had been recorded as low risk but in another part of the care plan it had been recorded as being high. This inconsistency meant staff did not have clear or reliable information to follow, placing the person at risk of receiving care that was inappropriate to their actual needs and increasing the likelihood of avoidable harm.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

We received mixed feedback from staff as to whether they were kept up to date with people’s changing needs, for example in hand over meetings between shifts. A member of staff said, “I sometimes don’t get informed of what has happened at all and have to find out myself.” However, another member of staff said, “If a person’s care needs change, we are informed promptly.”

The service was not proactive in working with other services when multidisciplinary involvement was required, and any actions to be followed up on as needed. For example, we observed a person repeatedly coughing during their meal which could indicate they were having swallowing difficulties. Their care plan recorded they had been referred to the Speech and Language Team (SALT), but the date of the referral was not recorded. The care plan did not demonstrate if a further referral had been made regarding this ongoing coughing concern and there was no outcome for the previous referral.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Care plans did not demonstrate that people had been involved in monitoring and reviewing their own health and wellbeing needs. This included being involved with regular monitoring and reviewing with the service or being supported to be as involved as possible in regular health checks with other healthcare professionals. For example, a person told us that their relative needed a dental x-ray, but this had not been facilitated. They said, “I have repeatedly asked the manager to arrange this and offered to pay for a taxi to get [relative] there. Unfortunately, this must have been 2 years ago now and nothing.”

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

There was a lack of monitoring regarding people’s care and support needs. For example, we observed a person struggling to stand with staff support. Their care plan recorded they could mobilise a few steps and transfer into a wheelchair with the aid of a walking frame and support from 1 or 2 care staff but there was no information regarding difficulty standing. There were no details of how staff should assist the person to stand. There was no record of a referral to the occupational health service for an assessment for equipment to support the person with standing.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

During our inspection visits we observed staff providing support to people without obtaining their consent. For example, moving a person in their wheelchair without asking them if they wanted to be moved to a new location and staff putting protective aprons on people without asking their consent.

Relatives told us that the service was aware when they held a power of attorney for the person living in the service. However, a relative gave us an example of where action had been taken without consulting them.