Background to this inspection
Updated
14 February 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection was unannounced and took place on 28 November, 11 December 2018 and 10 January 2019. The team consisted of two inspectors and one expert by experience on day one. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Days two and three were completed by one inspector.
We did not ask the provider to complete a Provider Information Return (PIR). This is a form the provider completes to give some key information about the service, what the service does well and improvements they plan to make.
We checked the information we held about the service and the provider including statutory notifications. This is information about important events which the provider is required to send us. We reviewed information about the service provided from the local authority contracts team.
During the inspection, we used several different methods to help us understand the experiences of people who lived in the home. We spoke with seven people who lived at the home, a visiting relative and a healthcare professional. We spoke with the registered manager, assistant manager of care, and five members of staff, including care staff, kitchen and activity staff.
We looked at the care records and associated risk assessment for three people, three staff recruitment files, staff rotas, training and supervision records, minutes from meetings, medicines administration records, service certificates and quality assurance records. We also observed staff interaction with people who lived at the home throughout our inspection.
Updated
14 February 2019
This inspection was unannounced and took place on 28 November, 11 December 2018 and 10 January 2019.
The Weir is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
The service provides accommodation and personal care for a maximum of 31 older people, some of whom may be living with dementia. It is located in the town of Hessle, in the East Riding of Yorkshire. At the time of our inspection there were 24 people using the service.
The service had a manager who was registered during this inspection, on 4 January 2019. 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.
At our last inspection, in November 2017, we found there were five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service was rated 'Requires Improvement.' Following the inspection, we asked the provider to complete an action plan to show us what they would do and when by to improve the key questions to at least 'Good'. The provider sent us their action plan and we reviewed this as part of this inspection.
This inspection took place to follow up on our previous findings. We found a number of significant improvements had taken place. The provider had taken action and implemented sufficient improvements to their systems, processes and practice which meant they were now compliant with the regulations. The overall rating has improved to ‘Good.’
People using the service said they felt safe and that staff treated them well. There were policies and procedures in place to guide staff in how to keep people safe from abuse and harm. Staff we spoke with understood how to safeguard the people they supported. Medicines were administered as prescribed.
During this inspection, we observed the atmosphere in the home was calm and staff were not rushed when responding to people's needs. We were satisfied that there were enough staff on duty. Appropriate recruitment checks had taken place before new staff started work.
The cleanliness of the home was meeting expected standards. Infection control practices had been reviewed and improved. The home was clean and in the main free from unpleasant odours. Improvements had been made to the design and decoration of the premises to meet people’s needs.
People were supported with their health and wellbeing. Drinks were provided throughout the day and a picture menu was provided to support people with a choice of food. People received additional support from diet and nutrition specialists where this was required.
Staff were provided with the training to ensure they had the skills and knowledge to meet people’s needs. Since the last inspection the registered manager had created a training plan to ensure regular training and development was available to staff. Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have choice about how they lived their lives.
Care planning documentation had been improved and contained information for staff to follow around people’s care, support and treatment. People's needs were assessed on a regular basis and care plans were updated to reflect any changes. Risks to people had been appropriately assessed.
We saw great improvement had been made to the activities that were on offer to people. Staff had a good understanding of promoting and respecting people's privacy, dignity and independence. Staff were visible in the communal areas of the home and promptly attended to people's needs.
There was a formal complaints system in place to manage complaints if or when they were received.
Relatives told us there were no restrictions on the times they could visit their loved ones, and that they were always welcomed by staff.
The registered manager had made improvements to the overall leadership of the home and both people using the service and the staff team told us there were opportunities to raise concerns and issues which were listened to.
The provider had reviewed the systems used to assess and monitor the safety and quality of the service, and we saw these were now more robust. The registered manager had provided consistency for staff and had clearly worked hard, alongside the staff team, at making a number of improvements within the service. They encouraged good communication and provided guidance to staff on improving and maintaining standards. Staff felt supported and valued.
The registered manager worked together with other organisations to ensure people's wellbeing. They were pro-active and committed to continuous development which had led to improvement in the managerial oversight of the service.