Walberton Place Care Home

Walberton Place Care Home is a residential care home providing personal care to people aged 65 and over. The service can support up to 80 people, there were 78 people living at Walberton Place Care Home at the time of inspection. The service supports people who may be living with dementia or need support with their physical health. Walberton Place Care Home is a large purpose-built building over two floors. Each floor has separate facilities such as dining areas, lounges and places to socialise. The first floor is a specialist unit for people living with dementia. The building is surrounded by gardens and has an internal, enclosed courtyard garden.

People’s experience of the service and what we found:

Risks to people were not consistently assessed and managed. Risk assessments and care plans did not always contain the information staff needed to provide safe and effective care and staff did not always know how to support people’s needs.

People were not always receiving their medicines safely and according to prescriber’s instructions. People were not consistently safeguarded from improper treatment. Infection prevention and control procedures were not reviewed and updated, and staff were not provided with clear guidance and support. Governance and management systems were not effective in identifying these shortfalls.

Staff did not always have the skills they needed to support people’s needs. Systems for monitoring care and support were not effective in driving improvements. There was poor leadership and ineffective oversight of quality and safety. There had been a failure to make and sustain improvements over time.

People and their relatives described staff as being kind and caring. There were safe systems in place for the recruitment of staff

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.

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 10 June 2023). At this inspection enough improvement had not been made and the provider was still in breach of regulations. This service has been rated requires improvement for the last four consecutive inspections and the service is now rated inadequate.

Why we inspected

The inspection was prompted in part due to concerns received about risk management and leadership. A decision was made for us to inspect and examine those risks.

The inspection was prompted in part by notification of an incident following which a person using the service died. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk of hydration and nutrition. This inspection examined those risks.

You can see what action we have asked the provider to take at the end of this full report. Please see the safe and well led sections of this full report. We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Walberton Place Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to management of risks, safeguarding, staffing and the management and governance of the service. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow Up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions, it will no longer be in special measures.

Walberton Place Care Home is a residential care home providing personal care to people aged 65 and over. The service can support up to 80 people, there were 62 people living at Walberton Place Care Home at the time of inspection. The service supports people who may be living with dementia or need support with their physical health. Walberton Place Care Home is a large purpose-built building over two floors. Each floor has separate facilities such as dining areas, lounges and places to socialise. The first floor is a specialist unit for people living with dementia. The building is surrounded by gardens and has an internal, enclosed courtyard garden.

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

Risks to people were not consistently assessed and managed. Some people who were living with dementia needed support when expressing feelings of distress or agitation. Staff did not have clear guidance about the level of risk and strategies to provide care safely. This had a negative impact on the safety and quality of life for some people who were living with dementia. The provider’s systems for monitoring quality had not identified shortfalls in risk management.

There were safe systems in place for managing and administering medicines. Staff knew when and how to report any safeguarding concerns. Environmental risks and infection prevention and control procedures were well managed. There were enough staff to care for people and they told us they felt safe living at the home. A person said, “The staff are so friendly, but they don’t push themselves on you. We know they’re there for us if we need them.”

People were supported by kind and caring staff who knew them well. People told us they were happy living at the home. A person commented, “It’s very good. I’ve got no complaints at all. I would certainly recommend it here.” 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.

Staff were recruited safely and there were effective systems in place to provide staff with the training and support they needed. A staff member told us, “I've had every training that you could possible imagine.”

People were supported to have enough to eat and drink and staff worked effectively with other services to ensure people’s health needs were met.

The service engaged constructively with people, their relatives and staff to involve them in developments at the home. There was a positive culture and staff worked collaboratively with other services to improve people’s experiences.

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 requires improvement (published 26 October 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last 2 consecutive inspections. At our last inspection we made recommendations about staff training and support for staff health and wellbeing. At this inspection we found the provider had acted on these recommendations and had made improvements.

Why we inspected

The inspection was prompted in part due to concerns received about staffing and risk management. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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, based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe 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 Walberton Place Care Home on our website at www.cqc.org.uk.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

Walberton Place Care Home is a residential care home providing personal care to people aged 65 and over. The service can support up to 80 people, there were 64 people living at Walberton Place Care Home at the time of inspection. The service supports people who may be living with dementia or need support with their physical health.

Walberton Place Care Home is a large purpose-built building over two floors. Each floor has separate facilities such as dining areas, lounges and places to socialise. The first floor is a specialist unit for people living with dementia. The building is surrounded by gardens and has an internal, enclosed courtyard garden.

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

We have made recommendations about staff training and support for staff health and wellbeing. Please see the safe and effective sections of the report.

Recent improvements had been made to how people’s needs and risks were initially assessed and responded to over time. The changes need time to embed for the Care Quality Commission (CQC) to be assured new systems are effective in supporting people’s health risks.

People and their relatives felt they were safe. Staff understood how to identify and raise concerns to protect people from the risk of abuse. Some staff were not up to date with refresher training for safety related topics, the manager was finding ways to improve this.

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 felt comfortable and happy in the home’s setting, meals and drinks met people’s needs and preferences.

People received support from kind and caring staff. Staff were motivated to provide respectful and attentive care, which ensured people’s dignity was upheld.

People enjoyed a range of activities and opportunities to follow their specific interests. People and relatives found the atmosphere homely and friendly. People felt comfortable sharing their views about the service to staff and managers, and they felt listened to.

Improvements were being made to how the quality of the service was being audited and how information was being analysed in order to improve outcomes for people.

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 19 July 2021), and there were breaches of regulation. 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 regulations. However, the service remains rated requires improvement.

Why we inspected

The inspection was prompted in part due to concerns received about how people’s risk of falls was being managed. A decision was made for us to inspect and examine those risks. We also followed up on action we had told the provider to take at the last inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

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 Walberton Place Care Home on our website at www.cqc.org.uk.

Follow up

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

We found the following examples of good practice.

The manager had sought advice and guidance from local health organisations when experiencing a recent COVID-19 outbreak at the home. Increased testing, infection prevention and control measures and zoning of areas of the home had been put in place.

Staff and managers were observed to wear personal protective equipment (PPE) appropriately. Staff uniforms were laundered onsite and there were places for staff to change clothing and PPE.

There was a schedule of cleaning and deep cleaning around the home and in communal areas. There were numerous areas for people to meet with space for social distancing, activity and privacy. We observed the home to be clean and well maintained.

There was regular testing in place for people and staff, government guidelines were being followed for this and test results were being monitored by the manager to ensure a swift response.

Walberton Place Care Home is a residential care home providing personal care to people aged 65 and over. The service can support up to 80 people, there were 64 people living at Walberton Place Care Home at the time of inspection. The service supports people who may be living with dementia or need support with their physical health.

Walberton Place Care Home is a large purpose-built building over two floors. Each floor has separate facilities such as dining areas, lounges and places to socialise. The first floor is a specialist unit for people living with dementia. The building is surrounded by gardens and has an internal, enclosed courtyard garden.

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

People told us there were not enough staff to complete necessary care in a timely way. This meant people had to wait for support with drinks, getting to the toilet and moving around. People said they felt frustrated when staff were too busy to respond to call bells. We saw staff rotas did not always have enough staff to match the planned schedule.

Information in care plans about people's assessed risks and needs was not always accurate and people had not contributed to their assessments. This meant that staff did not always know what people's needs and risks were and how to support people. Care plans were not always person centred as they did not accurately reflect people's individual needs and preferences for care.

People did not always experience a service which responded to their changing risks and needs. One example of this was that people had not been referred to the falls prevention service in line with the service's policy. Some people had experienced repeated falls, records of these had been kept but people were not offered specialist assessments to reduce risks and improve outcomes.

People did not always experience a service which responded to their changing risks and needs in a timely way. One example of this was that some people had not experienced a timely referral to the falls prevention service in line with the service's policy. Two people had experienced repeated falls, records of these had been kept but they were not offered a timely referral to reduce risks and improve outcomes.

People were not always supported to have maximum choice and control of their lives and staff were not always given information about people’s agreed best interests. Some people were thought by managers to lack mental capacity to make decisions about their medicine, however, this had not been assessed with them. Staff supported people with their medication needs but there were no records to show people's wishes and preferences about medication. Managers took steps to address this during our visit.

People told us staff and managers were kind and friendly, they told us they enjoyed the meals and social group activities were varied. People were supported to join a wide range of social groups and exercise sessions. We saw these activities taking place through the day.

People told us they felt safe from abuse and protected from the risks of COVID-19. The service had good measures in place to manage infection prevention and control, for example, there were robust cleaning schedules and waste disposal measures. Visitor arrangements followed government guidelines, all visitors were supported to complete COVID-19 tests and personal protective equipment, handwashing facilities and hand gel were available. A visiting room had been created and there was a booking system to ensure the room could be cleaned thoroughly between visits.

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

This service was registered with us on 01 October 2019 and this is the first inspection.

Why we inspected

This was a planned comprehensive 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 found no evidence during this inspection that people were at risk of harm from this concern.

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 have identified breaches in relation to safe care and treatment, person centred care, 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 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.