Archived: Wayside Residential Care 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. 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.

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 is also the joint registered provider and owner of the service.

People were “very happy” living at Wayside and we received positive comments about their views and experiences during our visits. Despite the areas for improvement, people were “very satisfied” and “staff always did the best they could”. Comments included, “The registered manager and staff work very hard and never let me down”, “It’s quiet and peaceful, I am so happy” and “The owners are impressive”.

Despite the views of people and their relatives, improvements were required in a number of areas.

People were not protected from the risk of cross infection. This was because appropriate guidance had not been followed. People were not cared for in a clean, hygienic environment.

Although staff had access to a variety of training topics, we could not be satisfied that the training was always effective. Staff did not always have the knowledge and skills they needed to carry out their roles effectively.

Monitoring the quality of the service was not always effective. People who used the service, staff and visitors were not always protected against the risks of unsafe or unsuitable premises.

Staff were knowledgeable in safeguarding procedures and how to identify and report abuse. People were supported by the recruitment policy and practices to help ensure that staff were suitable. The registered manager and staff were able to demonstrate there were sufficient numbers of staff with a combined skill mix on each shift. Staff confirmed they were supported by the provider and the registered manager at all times.

People were helped to exercise choices and control over their lives wherever possible. Where people lacked capacity to make decisions Mental Capacity Act (MCA) 2005 best interest decisions had been made. The Deprivation of Liberty Safeguards (DoLS) were understood by staff and appropriately implemented to ensure that people who could not make decisions for themselves were protected.

People received a varied nutritious diet, suited to individual preferences and requirements. Mealtimes were flexible and taken in a setting where people chose. Staff took prompt action when people required access to community services and expert treatment or advice.

People enjoyed receiving visitors and had made “friends” with people they lived with. They were relaxed in each other’s company. Staff had a good awareness of individuals' needs and treated people kindly. References were made by relatives and staff about the “family atmosphere and homely feel”. Staff were knowledgeable about everyone they supported and it was clear they had built up relationships based on trust and respect for each other.

People moved into the service only when a full assessment had been completed and the registered manager was sure they could fully meet a person’s needs. People’s needs were assessed, monitored and evaluated. This ensured information and care records were up to date and reflected the support people wanted and required.

The service was important to the provider and registered manager and they wanted the best for people. There was an emphasis on teamwork amongst all staff at all levels.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

People living at Wayside all had a diagnosis of a dementia. Clear information was in place about people's abilities to make decisions. Information had been recorded to show if people were able or not to give consent for the support and treatment affecting their health and care.

People's special dietary needs were being met and had been recorded within care plans and risk assessments.

Four staff members told us there was suficient staff on duty to enable them to spend individual time with people living at the home and to complete their daily tasks. We looked at four peoples care files and saw the level of staffing at the home was dependent upon people's assessed needs.

We found that people and staff felt confident about taking any suggestions or concerns to the provider. A relative of one person told us that, "I find the manager and staff approachable, they are caring and kind and know my mother well'.

Records were kept secure, they could be located promptly when needed and were stored in a lockable room.

Some people were spending time in the lounge before their midday meal while others had chosen to stay in their rooms. People spoken with made comments such as 'Staff are nice, we have a laugh.' They confirmed that they liked the food offered and that they had regular visitors. Staff demonstrated that they had developed good relationships with people and were knowledgeable about their individual care needs including the need to maintain and enable their independence.

We looked at people's care files and saw that people's care and support was planned and delivered in a way that was intended to ensure their safety and welfare.

We looked at records to ensure that people's safety was being maintained. Health and safety and management audits had been carried out regularly to help monitor the quality of the service.