28 August 2018
During a routine 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.