30 May 2017
During a routine inspection
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.
People, relatives and staff spoke highly of the service. One relative told us, "I think it’s friendly and the staff are so brilliant. They’re calm, patient, good humoured and dedicated.” Another relative told us, “I like the fact that she has a lovely room with all her things in. I like the fact that we are always welcomed with a smile.” Whilst the feedback from people was positive, we found areas of practice that were not consistently well-led.
The provider had failed to maintain accurate, complete and contemporaneous records. People’s individual care plans failed to consistently reflect the level of support and intervention needed to meet their needs in a safe and consistent manner. Incidents and accidents were not consistently audited for emerging trends, themes or patterns. An overarching governance system was not in place and shortfalls found on the inspection and had not been identified by the provider or registered manager.
Care and support was provided to people living with dementia, however, improvements were required to make the environment dementia friendly. We have made a recommendation about sourcing input from a national source on dementia friendly environments.
People told us they felt safe living at Weald Hall Residential Home. One person told us, “Yes I do because I have a lot of friends here, I like the company.” The provider employed two dedicated activity coordinators and people had access to a range of group activities. Where people preferred to spend time in their bedroom, documentation failed to address the risk of social isolation. We have made a recommendation about social activities and minimising the risk of loneliness.
People we spoke with were complimentary about the caring nature of staff. People told us care staff were kind and compassionate. People were treated with respect when they received care. One person told us, “The staff are very caring and very gentle.”
Medicines were managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately. Systems were in place to enable people to self-medicate their medicines.
The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate application to restrict people's freedom had been submitted. People were being supported to make decisions in their best interests. The manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).
Safeguarding adult's procedures were robust and staff understood how to safeguard the people they supported from abuse. There was a whistle-blowing procedure available and staff said they would use it if they needed to. People were protected, as far as possible, by a safe recruitment system. Staffing levels were sufficient and met people’s individual care needs.
People had access to relevant healthcare professionals to maintain good health. Records confirmed that external healthcare professionals had been consulted to ensure that people were supported to receive effective care. People received good health care to maintain their health and well-being.
Arrangements for the appraisal and support of staff were in place. Staff told us they felt supported and recognised the part that a yearly appraisal made. One staff member told us, “The manager is very supporting and I can go to her with any concerns.” Staff spoke highly of the training provided and felt it equipped them to provide safe, effective and responsive dementia care.
During our inspection we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered providers to take at the back of the full version of the report.