Warley House

Warley House accommodates up to 39 older people, including those who may be living with dementia, across one adapted property. Communal accommodation is provided in a variety of lounge and dining areas and bedroom accommodation is provided in single rooms, some with en-suite facilities. The home is situated in a residential area on a main road and close to local amenities and bus routes into the centre of Scunthorpe. At the time of this inspection a service was being provided to twelve people.

At the last inspection in January 2017 the service met The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, but it was rated ‘Requires Improvement’. This was because there were issues with promoting respect, dignity and independence and effective audits, for which we issued recommendations.

This comprehensive inspection of Warley House took place on 5 February 2018 and was unannounced. We saw that improvements had been made in the activities offered to people and that medicine and environmental audits of the service were carried out more regularly. We found the overall rating for this service to be ‘Good’. The rating is based on an aggregation of the ratings awarded for all 5 key questions.

The registered provider was required to have a registered manager in post. On the day of the inspection we found that the registered manager had been in post for the past seven years. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 this inspection we found that the provider had addressed the recommendations with regard to promoting respect, privacy and independence and using audits more effectively to identify shortfalls in service delivery.

There were systems to safeguard people from harm and risks were reduced. The premises were safely maintained. Staffing levels and recruitment practices were safe and protected people. The management of medication was safely carried out.

People were supported by qualified and competent staff that received regular supervision. People’s mental capacity was assessed and their rights protected. The registered manager worked with other professionals and families to ensure decisions were made in people’s best interests where they lacked capacity. People’s nutrition and hydration were monitored. The premises were suitable for those living with dementia.

People received compassionate care from kind staff. People were supplied with the information they needed, involved in all aspects of their care and their consent was sought.

Person-centred care plans reflected people’s needs well and were regularly reviewed. People were supported to maintain friend and family connections and networks. An effective complaint procedure meant that complaints were investigated without bias.

The service was well-led. The culture and the management style of the service were positive. Satisfaction surveys and meetings aided the quality audit system so that improvements in service delivery were made. The registered manager maintained a status quo, but had not been proactive in seeking current best practice to enhance the service delivery in general and in looking to the future.

The recording systems used in the service protected people’s privacy and confidentiality as records were well maintained and securely held on the premises.

Warley House is a registered care home providing personal care and accommodation for up to 39 older people, some of whom may be living with dementia. The home is close to a bus route and is situated on a housing estate, some distance from the town centre of Scunthorpe and its amenities. There is an enclosed garden at the rear of the property. The home consists of a two-storey building; the first floor was accessible by a passenger lift and stairs. At the time of our inspection there were 17 people using the service.

We undertook this unannounced inspection over two days, on the 9 and 10 January 2017. The service was last inspected in November 2014, when we identified a breach of Regulation 18 of Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds with Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because there were concerns that people had not always consented and been fully consulted in decisions about how their care and support was carried out. Following the inspection in November 2014 we received an action plan from the registered provider that detailed how improvements would be made to the service.

At this inspection we found improvements had been made to address the above breaches of regulation. We found assessments had been carried out to ensure where people were unable to make informed decisions, best interests meetings were held, that involved people and those with an interest in their care and support. Care staff had undertaken training on the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and people were supported to have choice and control over their lives by care staff that supported them in the least restrictive way possible.

A registered manager was in post at the time of this inspection. 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.

Recruitment checks were carried out to ensure care staff were safe to work with people who used the service. Safeguarding training had been provided to enable care staff to recognise and report potential signs of abuse. Care staff were supported and confident the registered manager would take appropriate action to follow up concerns when this was required. Risks to people were monitored with action taken, to ensure these were appropriately managed. People’s medicines were administered in a safe way, by care staff who had received training on this aspect of their role. Whilst dependency levels of people were not always carried out in a timely way, the registered manager took steps to ensure sufficient numbers of care staff were available to meet people’s needs.

Care staff were provided with a range of training and development to help them progress their careers and carry out their roles. People received a choice of nourishing home cooked meals and were consulted about their care and support. Community based health care professionals had good working relationships with the service.

Whilst opportunities for meaningful social interaction were sometimes limited and the registered manager had plans to develop these for people, we noticed some aspects of people’s dignity could be better supported. A complaint’s policy was in place and people were able to raise concerns and have these investigated and resolved wherever possible.

Management checks were carried out to enable the quality of the service to be assured, however action was not always taken in a timely way to make changes and improvements when this was required.

We observed that people looked comfortable, well cared for and that staff interacted with them in a friendly and compassionate manner. People told us that staff supported them well and answered their call bells promptly. People said that staff listened to them and obtained medical assistance where this was needed. They told us that staff were, 'Lovely' and 'Kind.'

We observed staff interacted with people in an open and friendly way. People told us they trusted the staff and felt comfortable with them.

Policies and procedures were available for checking staff were safe to work with people who used the service. The files of the two most recently recruited members of staff contained evidence a range of appropriate checks had been carried out as part of their recruitment process.

Systems were in place to enable the health, welfare and safety of people who used the service to be monitored by the provider. We saw evidence of regular visits from the people that own the home, together with action plans to address shortfalls identified, following a range of audits that were carried out of the service.