Archived: Wayside Residential Care Home

Updated 7 July 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.

This service was previously inspected in March 2016. At that time we found there were three breaches in regulations. This inspection took place on 18 and 19 April 2017 and was unannounced. Two adult social care inspectors carried out this inspection.

Prior to the inspection we looked at information we had about the service. This information included the statutory notifications that the provider had sent to CQC. A notification is information about important events which the service is required to send us by law.

During our visit we met and spent time with all eight people living in the home and we spoke individually with four. Some people we spoke with had dementia. We kept questions simple and enjoyed general conversations with them; we also acquired evidence from observations and listening to interactions with staff. We spent time with the providers, registered manager. We spoke with four staff and two relatives.

The service was being monitored and supported by various health and social care professionals following previous safeguarding concerns which were raised about people's well-being. We have referred to the intelligence reports we have received from those that visit the service and from multi-agency meetings we have attended.

We looked at four people's care records, together with other records relating to their care and the running of the service. This included staff employment records, policies and procedures, audits and quality assurance reports.

Updated 7 July 2017

This inspection took place on 18 and 19 April 2017 and was unannounced. This service was previously inspected in March 2016. At that time we found there were three breaches in regulations. Wayside provides accommodation for up to ten people. At the time of our visit there were eight people living at the service and one person was in hospital.

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. The registered manager was also the registered provider. For the purpose of the report we will refer to them as the provider/registered manager.

A significant number of improvements were required across the service. The provider/registered manager had failed to monitor the service effectively to ensure people were cared for by staff who had the right skills and knowledge. Lack of specific training meant staff did not understand or have the insight in order to enhance people's lives and to provide meaningful, person centred care.

Lack of specific risk assessments compromised safety and staff did not have clear guidance on how to manage some risks to people. Care plans did not contain enough detail to support people to receive individualised care. Care plans were missing people’s essential diagnosis and needs; this particularly included those people with dementia.

Understanding on the principles of the Mental Capacity Act (MCA) (2005) and Deprivation of Liberty Safeguards (DoLS) required improvements. The provider/registered manager and staff were not always aware of when they should be raising concerns with the local authority safeguarding team or notifying the CQC. People were supported by the recruitment policy and practices in the home. Staff confirmed they were supported by the provider/registered manager.

Additional training was required in order to equip staff with the right skills. This was particularly in relation to understanding MCA and DoLS, dementia and managing behaviours when people became anxious.

Although there was some evidence of seeking advice from health and social care professionals, for example GP’s and community nurses, further improvements were required. This particularly related to expertise from the community mental health team.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of this report.