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Signature at Wimbledon Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 8 December 2018

This responsive inspection took place on 5 November 2018 and was unannounced.

Signature of Wimbledon is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Signature of Wimbledon is a large purpose-built building split over three floors, in the London Borough of Wimbledon, for up to 79 older people. At the time of the inspection there were 43 people using the service.

The service was previously known as Kingsmere Retirement Home, registered to provider Avery Homes (Wimbledon) Limited. This provider organisation was acquired by Signature and Kingsmere Retirement Home became Signature of Wimbledon in May 2018. The service was previously inspected in February 2018 and rated ‘good’ overall, however we rated the key question ‘is this service effective?’ as ‘requires improvement’ as staff were not always supported through appropriate training and supervision.

At the time of this inspection, in November 2018, there was not a registered manager in post. The manager had applied to the Commission to become registered. 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 were not protected against identified risks, as risk management plans were not always in place and staff did not always have up to date guidance to mitigate those risks. Incidents and accidents that took place at Signature of Wimbledon were not always clearly documented, reviewed and audited in such a way as to ensure lessons were learnt. We shared our concerns with the manager who sent us an updated action plan and copy of a completed risk management plan.

People’s medicines were not always managed in line with good practice as PRN (as and when) medicines protocols were not always in place and dosages of medicines were not always recorded. The newly appointed manager had identified issues around safe medicines management and was implementing new systems to ensure improvements were made.

People received care and support from staff that had undergone robust pre-employment checks to ensure their suitability for the role. Staffing levels did not always afford staff ample time to develop meaningful relationships with people.

People were protected against the risk of abuse as staff knew how to identify, report and escalate suspected abuse. Staff confirmed they would be confident in whistleblowing should the manager not address suspected abuse in a timely manner.

The provider had adequate systems and processes in place to minimise the risk of cross contamination through effective infection control management.

Audits carried out by the service did not always identify issues in a timely manner and action taken to address these did not always take place swiftly. We raised our concerns with the manager who sent us an action plan to address our concerns.

People were not always aware of the management structure within the service and felt communication could be improved. People’s views were sought, through regular house and relative meetings and comments boxes.

The manager sought partnership working with other healthcare professionals to drive improvements.

Inspection areas

Safe

Requires improvement

Updated 8 December 2018

The service was not as safe as it could be. Risk management plans were not always in place to give staff guidance and keep people safe.

Incidents and accident forms were not always fully completed. Management did not always sign off the forms, meaning it is unclear if lessons were learnt.

People were protected against the risk of abuse as staff knew how to identify, report and escalate suspected abuse.

Medicines management was not in line with good practice. The manager was implementing strategies to improve the medicines management.

Although staffing levels were at safe, staff appeared hurried and unable to spend quality time with people to develop meaningful relationships.

The provider had adequate systems and processes in place to minimise the risk of cross contamination.

Effective

Requires improvement

Updated 19 April 2018

The service was not always effective.

Staff were not always supported through regular supervision and some staff required updates in their training. The home’s environment was not dementia friendly.

People were supported to maintain a healthy, balanced diet and see healthcare professionals when required.

Staff were clear on the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards.

Caring

Good

Updated 19 April 2018

The service was caring.

People were treated with kindness and their privacy and dignity were respected.

People were involved in decisions about their care and support.

Responsive

Good

Updated 19 April 2018

The service was responsive.

People received care suited to their needs, at the time that they needed it.

People were supported to maintain relationships with people that mattered to them. People were well supported with their end of life preferences.

The provider had an appropriate complaints and compliments system in place.

Well-led

Requires improvement

Updated 8 December 2018

The service was not as well-led as it could be. Audits did not always identify issues to ensure action was taken in a timely manner.

People were not always aware of the management structure within the service.

People’s views were sought through comments boxes, regular meetings and discussions.

The manager sought partnership working to improve the provision of the service.