Wray Park Care Home is a residential care home for up to 24 older people. This includes people who are living with the experience of dementia. At the time of our visit 13 people lived here.
Care and support are provided on three levels which includes rooms partially below ground at the base of the house. Communal areas include a large lounge and separate dining area.
The inspection took place on 16 September 2015 and was unannounced. At our previous inspection in October 2013 we had not identified any concerns at the home.
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.
Overall there was generally positive feedback about the home and caring nature of staff from people and their relatives. One person said, “They treat me well.” A relative said, “The staff are very friendly and sympathetic.” However people told us that sometimes their privacy was not respected, or that they could not always understand what staff said.
People were not always safe at Wray Park Care Home. There were insufficient staffing levels deployed to meet the needs and preferences of the people that live here. People who wanted to be up and about in the morning had to wait as staff were not available to help them. Staff were not always available when people at risk of falls were moving around, or when people asked for help. The rota that recorded the number of staff required to support people did not match with the actual staff deployed on the day of our inspection. Less staff were deployed than was recorded. During the course of the inspection additional staff came to the home from the provider’s other services. Not all staff understood their duty should they suspect abuse was taking place. The provider had not ensured that potential safeguarding incidents had been referred to the local authority for review.
Where people did not have the capacity to understand or consent to a decision the provider had not followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had not been completed. People told us that staff did ask their permission before they provided care.
Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.
Quality assurance records were not kept up to date to show that the provider had checked on important aspects of the management of the home. Records for checks on health and safety, infection control, and internal medicines audits were all out of date. Accident and incident records were kept, but were not analysed and used to improve the care provided to people. Records of people’s involvement in their care planning was not clear.
People had enough to eat and drink, and received support from staff where a need had been identified. Specialist diets to meet medical or religious or cultural needs were provided. Some people commented negatively on the quality of the food. Pureed food had been blended together so people would not be able to taste the individual elements of the dish. People and staff told us that they had little input into the menu planning.
The staff were generally kind and caring and treated people with dignity and respect, but areas for improvement were identified. People’s personal care needs were not always noticed by staff, people’s privacy in their rooms was not always respected, and language used in some care plans was inappropriate and not respectful. Some good interactions were seen, such as holding people’s hands when sitting and talking with them.
Care plans were based around the individual preferences of people as well as their medical needs. They gave a good level of detail for staff to reference if they needed to know what support was required. People’s involvement in the review and generation of these plans had not been recorded. People did not always receive the care and support as detailed in their care plans, as staff were not always available to support them when they needed it.
People did not always have the opportunity to be involved in how the home was managed. People told us that residents meetings had not taken place for some time. The registered manager had arranged for a residents and relatives meeting in the autumn to address this.
The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff received training to support the individual needs of people in a safe way, however records showed that staff were out of date in key areas such as first aid moving and handling, and dementia care.
People received their medicines when they needed them. Staff managed the medicines in a safe way and were trained in the safe administration of medicines. People were supported to maintain good health as they have access to relevant healthcare professionals when they needed them.
People had access to activities that met their needs. Group activities were available to people during the week. Individualised activity plans were being further developed with people by the activities coordinator. Good use of technology was made to encourage people living with the experience of dementia to become involved in activities. The staff knew the people they cared for as individuals.
People knew how to make a complaint. Documents recorded that complaints had been responded to in accordance with the provider’s policy.
We identified five breaches of the regulations. You can see what action we told the provider to take at the back of the full version of this report.