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Archived: Wells Place Care Home Requires improvement

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 18 March 2016

We carried out an unannounced comprehensive inspection of this service on 23 and 25 June 2015. Breaches of legal requirements were found in relation to person centred care, safe care and treatment, good governance and staffing. As a response to this, the provider wrote to us to say what they would do to meet legal requirements in relation to these breaches. We undertook this focused inspection on the 17 and 18 December 2015 to check they had met the legal requirements. Whilst the provider has made some improvements, we found they had not fully met their own action plan. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Wells Place Care Home’ on our website at www.cqc.org.uk

Wells Place Care Home is registered to provide accommodation and nursing care for up to 42 older people, some of whom are living with dementia. Accommodation is arranged over three floors, with access to the lower and upper floors via stairs or a passenger lift. 38 people were using the service at the time of our inspection.

At the time of this focussed inspection a registered manager was not in place. An operations support manager for the provider was temporarily fulfilling the role as manager of the home. 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 living at Wells Place Care Home had needs relating to living with dementia, mobility and general health. We were not assured that staff had the skills and knowledge to meet these needs. Staff had not received all the training they needed to deliver care safely and effectively. There were inconsistencies in staff’s experience of training, supervision and support. We found that care practices were not effectively monitored to identify shortfalls in staff performance.

People who used the service and their relatives were complimentary about the conduct of staff and improved staffing levels. However, because improvements were needed in staffing skills and knowledge in supporting people with dementia, people were not always provided with meaningful activities to meet their needs and reduce social isolation. Areas in the home were not suitably designed for people living with dementia.

The service had taken action to review records about people’s care and this was still in progress at the time of our inspection. Care plans for people reflected their identified needs and the associated risks. Further work was required to embed and sustain the practice of effective care planning.

We saw new aspects of quality assurance and there were some systems in place to look at the quality of the service. However, the service required sustained and effective leadership to maintain this and provide guidance and stability to staff.

Following our inspection the provider informed us they had placed a voluntary embargo on new admissions to the home. In addition, the local authority safeguarding team and commissioners had begun action to review people’s care.

At this inspection we found continued breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014. We also identified a new breach in relation to managing complaints. You can see the action we have told the provider to take at the end of the report. We will carry out another comprehensive inspection to check on all outstanding legal breaches.

Inspection areas

Safe

Requires improvement

Updated 18 March 2016

We found that action had been taken to improve the safety of this service.

Care records had been updated to include accurate information about risks to people’s safety and welfare, and how those risks were to be managed. This included care plans for people at risk of development of pressure sores.

We could not improve the rating for this question from requires improvement because to do so requires consistent good practice over time. We will check this during our next planned comprehensive inspection.

Effective

Requires improvement

Updated 18 March 2016

The service was not effective. The provider had not fully complied with a requirement notice in relation to staff training and supervision.

People were at risk of receiving inappropriate care because staff training was not well managed and systems were not used effectively to formally monitor their practice and development needs.

Caring

Good

Updated 25 August 2015

The service was caring.

People and relatives told us staff were caring and we observed kind and sensitive interactions between staff and people in the service.

Privacy and dignity was respected and people were supported to maintain relationships with those that were important to them.

People were able to make choices about their end of life care and relatives were also involved in this process.

Responsive

Requires improvement

Updated 18 March 2016

The service was not responsive.

Steps were being taken to ensure that each person's care plan was up date and reflected the needs of the person and their interests and preferences.

The provider did not have effective processes in place for dealing with complaints.

The environment did not fully meet the needs of people who used the service living with dementia.

Well-led

Requires improvement

Updated 18 March 2016

The service was not well-led.

People did not benefit from a well run service as the home had lacked sustained and effective leadership. The provider was aware that the home was not operating as they wanted it to but improvements were planned, including the recruitment of a new manager.

New systems and processes to check the quality of care had been introduced. However these had not been effectively established to ensure consistent and sustainable good governance at the home.

The provider asked people, their relatives and other professionals what they thought of the service through meetings and questionnaires.

We could not improve the rating for this question from requires improvement because to do so requires consistent good practice over time. We will check this during our next planned comprehensive inspection.