Wainford House Residential Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last inspection we rated this key question Inadequate. At this inspection the rating changed to Requires improvement. This meant people’s needs were not always met.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives were involved in planning their care, and care plans included information about people’s needs, interests and preferences. However, this information was not always used effectively to provide meaningful activities that reflected people’s individual interests and choices.

Some people told us they felt bored or had limited opportunities to go out. Activity records frequently described people watching television, spending time in communal areas or having informal social contact, but did not always demonstrate how these activities reflected their individual interests. Records also showed some people had limited or no recorded opportunities to spend time outdoors.

Opportunities for meaningful activity and social engagement sometimes depended on staff availability, and people who spent more time in their bedrooms or were unable to participate in group activities did not always have access to sufficiently personalised alternatives. This increased the risk of people experiencing boredom, social isolation and reduced opportunities to pursue their interests and maintain their wellbeing.

The manager had plans to develop links with faith groups and a gardening group from the local community. However, these had not started at the time of our inspection, so we could not assess their impact on people.

People generally received consistent care and support with their day-to-day and healthcare needs. Records showed staff supported people with personal care, continence, mobility, eating and drinking and pressure care. Staff sought support from GPs, district nurses and other healthcare professionals when people’s health needs changed.

Relatives told us they were kept informed about people’s care and some received regular care plan updates, which provided opportunities to comment on changes. However, activities and opportunities for social engagement sometimes depended on staff availability. This demonstrated that staffing arrangements did not always support continuity of people’s planned care and activities.

The provider had taken some steps to make information accessible, including using pictures within menus. However, they had not assessed whether the information provided was effective in meeting people’s individual communication needs. The activities programme also used small print, and the provider could not demonstrate how they had established whether people, including those living with dementia, could easily access and understand the information available to them.

This meant the provider could not be assured that information was presented in a way that enabled each person to understand the choices available to them and make informed decisions independently. Following our feedback, the manager said they would review the information provided to people in line with best practice.

People and their relatives were involved in decisions about their care and were encouraged to share their views about the service. Relatives spoke positively about communication and described an open approach from the management team. Some relatives received regular care plan updates and were given opportunities to comment on changes. Relatives also gave examples of concerns being responded to promptly, including issues relating to people’s personal care and belongings.

Records did not always demonstrate that actions arising from feedback had been completed or that their effectiveness had been reviewed. This meant the provider could not always demonstrate how people’s views had been used to consistently drive improvements in their care and experience of the service.

We observed staff offering people choices about their meals, drinks, personal care and daily routines and respecting their decisions. The provider also sought feedback through surveys and shared information about changes made in response.

People were supported to access healthcare services when they needed them. Staff worked with GPs, district nurses and other healthcare professionals to support continuity of care, and records showed referrals were made when people’s health needs required further assessment or treatment.

Where people experienced difficulties attending external appointments, staff worked with healthcare professionals to explore alternative arrangements, including support being provided at the home where appropriate. This helped reduce barriers to accessing healthcare and supported people to receive timely care and treatment that reflected their individual needs.

The provider adapted people’s care when their health needs or risks changed. Care plans were updated and staff had access to specialist guidance, training and equipment to support people’s changing needs.

However, activities were not always adapted to reflect people’s individual interests, abilities and support needs. This was particularly relevant for people living with dementia and those receiving care in bed, who had fewer opportunities to participate in meaningful activity and social interaction. This increased the risk of people experiencing boredom, isolation and reduced wellbeing.

People’s wishes and preferences for future and end-of-life care were not always clearly recorded. Some people had end-of-life care plans and do not attempt cardiopulmonary resuscitation (DNACPR) decisions in place. However, other records lacked detail about people’s wishes and preferences. Management audits had identified incomplete plans, but there were not always clear timescales or evidence that identified actions had been completed.

We also found some medicines prescribed for end-of-life care had expired. The provider replaced these during the inspection. Although this addressed the immediate concern, the gaps in advance care planning meant the provider could not consistently demonstrate that people’s wishes were known and that appropriate arrangements were in place to provide care in accordance with their preferences as they approached the end of their life.