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Inspection Summary


Overall summary & rating

Good

Updated 18 November 2017

William Wood House provides care and support to people living in specialist ‘extra care’ housing. Extra care housing consists of single household accommodation in a shared site or building. The accommodation is the occupant’s own home and is provided under a separate agreement. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service. The service does not provide nursing care. At the time of our inspection there were 30 people using the service. They lived in separate flats with shared areas including gardens and a large lounge and dining room.

The inspection took place on 12 and 14 September 2017 and was unannounced.

There was a registered manager in post. 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.

The manager was passionate and committed in their role. They worked well with their new area manager and they had put a detailed action plan in place which was improving the quality of support being provided, and addressing concerns in an open and effective manner. They prioritised risk well and continued to address poor practice despite the on-going staffing challenges.

The manager had focused on improving the safe administration of medicines over the last six months. Staff had been retrained, medicine care plans revised and other systems improved. However, during our inspection we became aware of a medicine error during which staff had not responded effectively and in a timely manner when a person’s medicines had run out. This example highlighted areas where the improvements put in place by the manager had not yet become firmly established.

The manager was also facing concerns around staffing levels. Where no staff were available, they had prioritised direct care to ensure people’s needs were met and were often providing care themselves. At our inspection we were told a new additional team leader role had been created and there was on-going recruitment to ensure the manager had a full staff team and could focus on running the service. Despite the pressure on staffing levels, recruitment processes remained robust. There was some reliance on agency staff, however systems to improve the induction for these staff had been revised to help them understand better the aims of the service and people’s needs.

Risk was well assessed and measures put in place to support people to stay safe. Staff knew what to do if they had concerns regarding people’s safety. People were supported to communicate their preferences and to remain as independent as possible. Staff had developed positive relationships with people and treated them with dignity.

Staff were experienced and confident in their role. They were well trained and supported, though the recent staffing pressures had led to a dip in morale. The needs of people at the service were becoming more complex, especially in the area of dementia. The manager was working well with professionals to support staff to develop skills and to adapt the support people received to ensure it continued to meet their changed needs.

Staff enabled people to access outside health and social care agencies where necessary and worked well with other professionals to promote people’s wellbeing. People choose what they ate and drank in line with their preferences.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005. While most people at the service had capacity to make choices about their care support, the manager knew of the need to consider any legal requirements where people’s capacity was becoming more variable. Staff respected people’s right to make their own decisions about their life

Inspection areas

Safe

Requires improvement

Updated 18 November 2017

The service was not always safe.

The improvements which had been introduced to ensure the safe administration of medicine had not yet been fully implemented.

The provider was resolving the concerns about staffing levels and availability. Staff were recruited and safely.

The service knew how to support people to minimise risk.

Effective

Good

Updated 18 November 2017

The service was effective.

Staff had varied opportunities to develop their skills, which included specialist guidance to ensure staff had knowledge about people’s individual needs.

People’s right to make their own choices about their life choices and the support they received was promoted by the manager.

People could choose how and where they wanted to eat. Staff supported them to maintain their wellbeing and access health and social care professionals.

Caring

Good

Updated 18 November 2017

The service was caring.

Staff developed positive relationships with people.

Care plans had been revised to promote choice and support.

Staff treated people with respect and dignity.

Responsive

Good

Updated 18 November 2017

The service was responsive.

Support was personalised and based on people’s individual preferences.

There was good communication with people when their needs changed.

There were a number of opportunities to raise concerns and complaints were investigated thoroughly.

Well-led

Good

Updated 18 November 2017

The service was well led.

The service was led by a manager who was passionate about implementing changes which improved the service.

The manager was visible and approachable.

Robust formal systems and procedures to check the quality of the service were in place.