Walton Park Care Home

Walton Park Care Home is a residential care home providing accommodation and personal care support to up to 35 people. The home provides support to older people living with physical and health related support needs, some of whom also live with dementia. At the time of our inspection there were 23 people using the service.

People’s experience of using this service and what we found

There were multiple changes in the management team in the home and a new home manager had started not long before the inspection. Governance and oversight processes in place had overall improved but were not yet fully embedded and effective. Although improvements had been made to the care people were receiving, the home and its culture, not all actions had been completed yet and some audits were not yet fully effective in identifying issues promptly.

People and their relatives told us the home was safe. Staff were recruited safely, there was enough staff to meet people’s needs and consistency of the staff team had improved since the last inspection. People were safely supported around their medicines, individual risks and infection prevention and control.

Staff knew people’s needs and risks and any individual changes were discussed with people, their representatives and healthcare professionals to find best ways to support them safely. People had individual care plans in place and staff were trained to provide the care they needed. People received personalised care and support and had regular opportunities to express their wishes.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to host visitors and the offer of things to do and home events was being reviewed and improved at the time of the inspection. The home environment continued to improve with an extensive refurbishment work underway.

People and their relatives told us staff were caring, compassionate and respectful. Staff felt supported by the home management and listened to. The home worked with other health and social care professionals.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 28 February 2023).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended the provider to review the way they had recorded MCA and 'best interest decisions' to ensure the records clearly indicated how the MCA Code of Practice had been followed. At this inspection we found the provider had made improvements.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Sherwood House is a residential care home providing accommodation and personal care to up to 35 people. The service provides support to older people who live with physical and health related support needs, some of who also live with dementia. At the time of our inspection there were 30 people using the service. The home was recently refurbished and people lived in two parts of the building, called Claremont and Sundown suites with further refurbishment works being completed.

People’s experience of using this service and what we found

The governance and management systems in the home were still not fully effective in identifying and addressing shortfalls in a timely way which put people at risk. People’s records were not always robust enough and up to date around their changing needs and risks, including specific health risks. Although staff in general knew how to support people safely, they did not always have appropriate specialist training and detailed guidance to ensure people received safe care at all times.

The provider’s audits and checks did not always identify or address effectively concerns around staff deployment, medicines administration records or people’s care records. The provider did not effectively address the recommendation we made in relation to people’s mental capacity records at the last two consecutive inspections.

The provider was responsive to our feedback and took action to address it following the inspection. They provided evidence of progress with the actions and continued to support the home’s management team. The provider’s oversight of the service had improved significantly since the last inspection and completion of some actions was delayed due to challenges related to management changes.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to eat and drink well, to keep safe and received care meeting their needs. Where needed, staff supported people with their medicines safely. People told us they liked the home and felt safe with staff. When people raised concerns, staff acted on them and knew how to report these concerns externally.

New staff were recruited safely. Staff told us the atmosphere and communication in the home had improved. Staff now felt supported and encouraged to raise any concerns and ideas. There were regular meetings, checks and audits held in the home to identify improvements needed. We saw evidence of some actions being completed. For example, the home environment, cleanliness, maintenance and fire safety had improved.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 6 July 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

At our last inspection we recommended that the provider reviewed the national guidance on environment supporting people living with dementia and made further improvements to the home to support people. We found some improvements were made to the home environment for people living with dementia.

We also recommended that the provider reviewed the way they record mental capacity assessments and 'best interest decisions' to ensure the records clearly indicate how the MCA Code of Practice was followed. At this inspection not enough improvement had been made to meet this recommendation. At this inspection, we took into consideration the limited length of time and changes in management team since the last inspection and provider's response. We repeated the latter recommendation at this inspection for the provider to still address.

The last rating for this service was requires improvement (published 6 July 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last 3 consecutive inspections.

Why we inspected

We carried out an unannounced focused inspection of this service on 10 March 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve staffing and governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remained requires improvement. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sherwood House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to staffing and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Sherwood House is a residential care home providing accommodation and personal care support to up to 35 older people. People received support around physical and health related care needs, some of who also lived with dementia. At the time of the inspection, 26 people lived and received care in the home.

People’s experience of using this service and what we found

There were some improvements made to the standard of care people received since the last inspection, but they were not yet fully embedded into the practice. The governance systems in the home and the management oversight of the quality and safety were still not robust enough and effective in addressing shortfalls and protecting people.

People were not always supported by a sufficient number of care staff. Staff were not allocated and deployed effectively during the day. This impacted on staff’s ability to deliver good and safe care in a timely way. One person said, “They definitely need more staff, yesterday there was hardly anyone on duty. There’s so much to do here; they need more people to do it.”

Staff did not always receive support and training to enable them to provide people with high standard of care, although people found staff to be caring.

Opportunities to learn lessons and to improve people’s care were still being missed. There was a lack of robust analysis of incidents and accidents in the home. The registered manager did not always have a good oversight of the actions required to safeguard people from avoidable harm.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We recommended the provider improves their records around mental capacity and best interests’ decisions when people lacked capacity to make specific choices for themselves.

People told us staff knew them well and they liked their home and felt safe with staff. The cleanliness and infection prevention and control in the home had improved since our last inspection. We made a recommendation the provider reviews the national guidance on dementia friendly environments and makes further improvements to the home whilst the wider refurbishment works are underway.

People received safe support with their medicines. Staff respected people’s preferences and independence and people were involved in assessments of their needs and their care. Where needed, staff enabled people to access healthcare services. People received support to eat and drink well and commented they enjoyed the food served in the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 22 December 2021).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found some improvements had been made and the provider was no longer in breach of regulation 12 (Safe care and treatment). However, not enough improvements had been made around staffing and good governance and the provider remained in breach of regulations 18 (Staffing) and 17 (Good governance).

At our last inspection we recommended that the provider reviewed the national guidance on environment supporting people living with dementia and made further improvements to the home to support people. We also recommended that the provider reviewed the way they record mental capacity assessments and 'best interest decisions' to ensure the records clearly indicate how the MCA Code of Practice was followed. At this inspection we found not enough improvements had been made to meet those recommendations. At this inspection, we took into consideration the limited length of time since the last inspection and provider’s response. We repeated these recommendations at this inspection for the provider to still address.

The last rating for this service was requires improvement (published 22 December 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We carried out an unannounced focused inspection of this service on 09 November 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve staffing, safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe, effective and well-led which contain those requirements.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sherwood House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified continued breaches in relation to staffing and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Sherwood House is a residential care home providing personal care to up to 35 older people, some living with dementia. The service supported 29 people at the time of the inspection.

People’s experience of using this service and what we found

People did not always have robust and consistent individual risk management plans, although staff knew them well and were generally aware of how to provide safe support. The management team did not always recognise how they could proactively support people to minimise risks to their health and wellbeing, for example by learning from incidents and accidents.

Staff were not always able to provide timely, safe and person-centred care to people around their physical or emotional needs. This could cause a risk to people when they got upset or tried to mobilise unsupported. The registered manager made some recent improvements to how the medicines were managed, but the systems and processes in the home were not always safe, putting people at risk of not getting their medicines as prescribed.

The staff team followed good infection prevention and control in their day to day practice, but due to lack of regular housekeeping the cleanliness and tidiness of the home deteriorated. Staff were not always provided with training to ensure they had all skills and knowledge required to support people safely. However, most staff told us they felt supported in their roles, competent and listened to by the management.

The quality and safety monitoring systems in the home did not always effectively identify and address risks and improvements needed. However, the registered manager was progressing with some identified improvement actions and was responsive to our feedback.

People were supported to eat and drink when needed and their individual needs and preferences were addressed in their care plans. Staff contacted healthcare professionals when people required their input to remain healthy and well.

People felt safe in the home and were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 12 Feb 2020).

Why we inspected

We received concerns in relation to management of medicines, staffing, cleanliness and the management of the home. As a result, we undertook a focused inspection to review the key questions of Safe, Effective and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvement. Please see the Safe, Effective and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sherwood House on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to staffing, safe care and treatment and good governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Sherwood House is a residential care home providing personal care to 33 people at the time of

the inspection. Some of the people are living with dementia. The service can support up to 35 people.

People's experience of using this service

People told us they were happy living at Sherwood. People experienced good care because the service was well-led and organised. People often referred to staff as being like family members and told us they felt safe because of the quality of care they experienced. The provider took great care when recruiting new staff to ensure they shared and practiced the values of the service. Staff understood their responsibilities to keep people safe from harm.

Potential risks to people had been assessed and measures were put in place to mitigate these. If accidents or incidents occurred, staff took action to reduce the risk of similar incidents happening again. Medicines were managed safely and staff maintained appropriate standards of hygiene and infection control. Staff supported people to maintain good health and worked effectively with any professionals involved in their care.

People were provided with a variety of opportunities to participate in activities and events hosted by the home. People also went for trips out into the community, this included trips to do shopping or to visit coffee shops and a local school.

People told us they enjoyed the food provided in the home. We observed people had choice of meals and staff took time to explain to them the different types of food available. People had access to fresh drinks and snacks when they wanted them.

People were supported by staff who had the right skills and knowledge to provide care that met their assessed needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and relatives told us that staff were kind and caring and they were very satisfied with the quality of care and support. Staff respected people, treated them with dignity and involved them in decisions about their care. People experienced continuity of care because they were supported by caring staff who understood their needs. This also meant people experienced care and support responsive to their needs. People were supported by staff who promoted their independence as much as possible.

The service was well-led by a management team who worked closely together to ensure people were at the heart of everything they did. The registered manager actively ensured people were well looked after, motivated and provided with high levels of care and support.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (July 2017)

Why we inspected

This was a planned inspection based on our inspection process.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Sherwood House is a residential care home providing support for up to 35 older people. At the time of our inspection there were 22 people at the home, some of whom were living with dementia. The home had recently changed to a new provider at the time of inspection.

At our last inspection we found breaches of regulation. At this inspection we found actions had been taken to ensure the regulations had been met and the service had improved.

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.

People were kept safe by robust risk assessments that identified any risks they faced and measures to keep them safe. Staff understood how to promote people’s independence whilst managing risks. Where accidents or incidents occurred, actions were taken to prevent them reoccurring. Plans were in place to keep people safe in the event of an emergency.

Where people had health conditions, plans were in place to ensure that their healthcare needs were met. Staff worked alongside healthcare professionals to meet their needs. Staff had received training to ensure they could carry out their roles effectively. People’s medicines were managed and administered safely. We did note that in some cases where people were administered creams and ointments, these were not recorded. The provider took action to rectify this following the inspection.

People had access to a range of activities that were suited to their needs. Staff supported people to make their own choices about their care. Staff interacted with people in a way that showed kindness and compassion. People were involved in the running of the home through regular meetings. A complaints policy was in place and people were aware of how to raise a complaint if they were not happy.

Staff felt supported by the registered manager. Regular staff meetings took place that provided opportunities for staff to make suggestions. Staff had regular one to one supervisions and appraisals, to encourage personal development. There were sufficient numbers of staff to meet people’s needs and the provider had carried out checks to ensure that staff were appropriate for their roles. Staff understood their roles in safeguarding people from abuse.

The provider kept up to date records. People’s care plans were person centred and contained important information about them. Staff knew the people that they were supporting and they promoted people’s privacy and dignity when providing care. People’s rights were protected because staff worked in accordance with the Mental Capacity Act (2005). The registered manager understood their responsibilities and notified CQC of important events and incidents.

People were offered choices of food each day and their dietary needs were met. People were regularly asked for their feedback on food and other aspects of their care. Audits were in place to measure and assure the quality of the care that people received.