You are here

Wansbeck Care Home Requires improvement

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 22 November 2018

Wansbeck Care Home 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. Wansbeck Care Home can accommodate up to 40 people. At the time of the inspection there were 39 people living at the service, some of whom were living with a dementia.

We undertook an unannounced focused inspection on 3 September 2018. This meant that the provider did not know we would be visiting. We made a further three announced visits to the home on 7, 12 and 19 September 2018 to complete the inspection. The inspection was prompted following concerns received by the Care Quality Commission (CQC) regarding the management of medicines and concerns relating to pressure care for people. The team inspected the service against two of the five key questions we ask about services: is the service safe and well-led. Issues were identified during the inspection which resulted in the process converting to a comprehensive inspection where all five key areas were examined.

The last comprehensive inspection for the service was carried out in November 2017. At that time the overall rating for the home was good.

At this inspection we found care plans for people were inconsistent in the level of detail recorded and contained contradictory information about the needs of people. This resulted in care plans being confusing and difficult to read. Care staff knew people well and had in-depth knowledge of people’s needs but this was not always reflected in the documentation we reviewed.

There were short falls and omissions with the management of risk. In some instances, risk assessments had been re-written over making them difficult to understand. Some risk assessments were not always detailed for known risks such as pressure care.

Consent to care and treatment was not always sought in line with the Mental Capacity Act 2005 (MCA). The best interest’s decision-making process had been followed for people who lacked capacity to make certain decisions themselves. However, the provider did not have copies of Lasting Power of Attorney (LPA) documentation and could therefore not confirm if relevant people were legally able to act on behalf of people.

Audits were not detailed or robust and had failed to identify the issues found during this inspection. Quality assurance systems had not been effectively implemented to assess, monitor and improve quality at the service.

We saw positive interactions between staff and people. Most people spoke very positively about staff and thought they were kind and caring. There were limited meaningful activities available for people on the days the activity co-ordinator did not work.

Parts of the home were dirty and infection control procedures were not robust.

We received mixed feedback from staff regarding staffing levels and some staff told us they had too much to do and did not have time to spend with people. Safe recruitment procedures were in place however, omissions were noted. Selected training courses the provider had deemed mandatory were not up to date. Some staff told us they did not have time to complete all their work and were behind with paperwork.

The administration of medicines was not consistently safe.

People told us they felt safe. Safeguarding procedures were in place and staff told us about what they would do if they suspected or had concerns about harm being caused to people. However, we found that these procedures were not always followed.

The overall rating for this service has deteriorated from good to requires improvement.

During this inspection, we identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also identified a breach of the Care Quality Commission Registration Regulations 2009. Notifications of other incidents. You can see what action we have told the provi

Inspection areas

Safe

Requires improvement

Updated 22 November 2018

The service was not always safe.

The management and administration of medicines was not consistently safe.

Systems, processes and practices for keeping people safe did not always protect people from abuse.

Infection control procedures were in place, however, these were not robust and we found areas of the home were dirty.

Safe recruitment procedures were in place although they were not always fully followed.

Effective

Requires improvement

Updated 22 November 2018

The service was not always effective.

Copies of Lasting Power of Attorney (LPA) paperwork were not available, therefore the provider could not confirm if relevant people were able to legally act on behalf of people.

There were gaps in training the provider had deemed to be mandatory and induction paperwork was not always available for staff.

Some care records for people lacked detail and contained contradictory information.

Preadmission assessments were completed for people.

Caring

Requires improvement

Updated 22 November 2018

The service was not always caring.

People's dignity was not always promoted by staff.

We observed practice where staff treated people with dignity and respect but we received mixed feedback from people about their exchanges with staff. Staff told us of ways they worked to protect people's privacy and dignity.

People's relatives were able to visit when they wished and were made to feel welcome.

Responsive

Requires improvement

Updated 22 November 2018

The service was not always responsive.

Some plans did not have sufficient information to ensure people’s care was provided in a person centred way.

Complaints had not been consistently recorded, investigated and responded to appropriately.

In the absence of the activity coordinator there was a lack of meaningful activities for people.

Well-led

Requires improvement

Updated 22 November 2018

The service was not well-led.

Although audits were carried out monthly, they were not robust and failed to identify the failures we found during this inspection.

There was a registered manager in post although they were not present during our inspection. The regional manager and deputy manager were present throughout the inspection and were supporting the home both prior to and following the inspection.

Multiple breaches of regulations were identified during our inspection.