Archived: Weald Hall Residential Home

Updated 30 November 2018

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

This inspection took place on 28 August 2018 and was unannounced.

The inspection team consisted of two inspectors and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we reviewed information we held about the service. This included previous inspection reports, any complaints and notifications. A notification is information about important events which the service is required to send us by law. Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This helped us with the planning of the inspection. We contacted the local authority and two visiting healthcare professionals for feedback on the care provided.

We used a number of different methods to help us understand the views and experiences of people, as not all were able to tell us about their experiences as they were living with dementia. During the inspection we spent time with people who lived at the service and observed the care and support provided. We spent time in the lounge, dining room and people's own rooms when we were invited to do so. We took time to observe how people and staff interacted. We used the Short Observational Framework for Inspection (SOFI) during the lunchtime experience. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spoke with 20 people individually or in a group setting. We also spoke with four relatives. We spoke with the registered manager and their personal assistant, the deputy manager, a senior care staff, a chef/member of care staff, two agency care staff and the activities coordinator. We looked around the service in general including the communal areas, and a sample of people’s bedrooms, and the garden. We observed the lunchtime experience for people, observed the administration of medicines, the care and support provided in the communal areas, and activity sessions run during the day. We looked at menus and records of meals provided, medicines administration records, the compliments and complaints log, incident and accidents records, records for the maintenance and testing of the building and equipment, policies and procedures, meeting minutes, staff training records and four staff recruitment records. We also looked at five care plans and supporting risk assessments along with other relevant documentation to support our findings. We ‘pathway tracked’ people living at Weald Hall Residential Home. This is when we looked at their care documentation in depth and obtained their views on how they found living in the service. It is an important part of our inspection, as it allowed us to capture information about a selected group of people receiving care. We also looked at the provider’s own improvement plan and quality assurance audits.

This was the first inspection of Weald Hall Residential Home under a new registration due to changes to the details of the provider’s registration, however Weald Hall was not a new service.

Updated 30 November 2018

This inspection took place on 28 August 2018 and was unannounced. Weald Hall Residential Home is a ‘care home’ and provides accommodation for up to 26 older people who may be living with dementia. People in care homes receive accommodation and personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. There were 24 people living at the service on the day of our inspection.

This was the first inspection of Weald Hall Residential Home under a new registration due to changes to the details of the provider’s registration. However, Weald Hall Residential Home was not a new service. It was still owned and managed by the provider as at our previous inspection. We last inspected the service in May 2017 and rated it as Requires Improvement: One breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was identified. We issued a requirement notice relating to Good Governance. We found improvements had been made, but there were still areas in need of improvement.

There was a registered manager for the service. 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. There was a clear management structure with identified leadership roles. The registered manager was supported by a deputy manager and senior care staff. Staff spoke of good support. A member of staff told us, “We are a strong team, (Registered manager’s name) has been a really good leader.”

The registered manager acknowledged there had been a period when some of the quality assurance systems had fallen behind or not occurred. There had been a recent vacancy and change in deputy manager had led to some delay in the provision of staff training updates, supervision and appraisal. However, this had been identified and work completed to address this. Care and support was provided to some people living with a high risk of falls. Individual falls risk assessments had been completed. Staff described robust measures in place to manage the risk of falls. However, some documentation failed to reflect the measures in place. Supporting guidance as to the frequency these reviews should be completed had not been followed. Although there were robust recruitment checks to be followed when recruiting new staff, for one of the four recruitment files we looked a criminal records check had not been received prior to staff commencing work in the service. These were areas in need of improvement.

Staffing levels were sufficient to meet people’s care and support needs. Senior staff regularly worked in the service and people’s dependency was monitored. This was to highlight the level of staffing needed to ensure people’s care and support needs were met. Senior staff acknowledged there had been difficulty in recruiting new staff, but there had been ongoing recruitment to address this.

Staff told us they were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. Staff told us that communication throughout the service was good and included comprehensive handovers at the beginning of each shift. They felt they knew people’s care and support needs and were kept informed of any changes. They confirmed that they felt valued and supported by the senior staff, who they described as very approachable. They told us the team worked well together.

People and their relatives told us they felt people were safe. They felt it was somewhere where they could raise concerns and they would be listened to. Policies and procedures were in place to safeguard people. Staff were aware of what actions they needed to take in the event of a safeguarding concern being raised. The building and equipment had been subject to regular maintenance checks. Medicines were stored correctly and there were systems to manage medicine safely. Audits were completed to ensure people had received their medicines as prescribed.

People's individual care and support needs were assessed before they moved into the service. Where possible people had been involved in making decisions about their care and treatment and they had felt listened to. Personalisation and person-centred care focused on people having choice and control in their life, and was at the forefront of the care delivered. People’s care and support plans and risk assessments were reviewed regularly to ensure people’s care and support needs had been identified for care staff to follow. People told us the food was good and plentiful. They had been supported to access a varied menu and maintain a healthy diet to meet their individual dietary needs. People’s healthcare needs were monitored and they had access to health care professionals when they needed to.

Consent was sought from people about the care that was delivered. Senior staff had a good understanding of the Mental Capacity Act 2005 (MCA) and The Deprivation of Liberty Safeguards (DoLS). All staff understood about people’s capacity to consent to care and were observed to ask for people’s consent before they provided any care and support.

People were treated with respect and dignity by the staff. They were spoken with and supported in a sensitive, respectful and professional manner. When asked what people liked about living at Weald Hall Residential Home one person told us, “It’s nice and peaceful here.” Another person said, “The people who look after us can’t do enough.” People had a range of social activities they could attend. One relative told us, “They care, they don’t just leave him in a chair.”

There was a positive culture in the service. The registered manager had a good oversight of the service and knew where changes and improvements were needed. People and their representatives were asked regularly to complete a satisfaction questionnaire. There were systems in place to record any compliments, concerns or complaints received. People and their relatives told us they would be comfortable in raising any concerns if they needed to.