Wilford View Care Home

Wilford View Care Home is a purpose-built residential care home providing accommodation and

personal care for up to 83 people, including people living with dementia over three floors. At the time of the inspection 61 people were living at the service.

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

The risks to people's health and wellbeing were not always clearly documented, assessed or managed. People's records were not always detailed or up to date. People were at increased risk of harm because lessons were not always promptly learnt from incidents that occurred at the service.

There was enough staff to meet people’s needs. However, staff turnover, including management staff, was high. This prevented people and their relatives from building rapport with the staff. People and their relatives told us the support from the agency staff, “Was not the same,” as from the permanent, long standing members of staff. Some people and relatives said the agency staff did not know people well enough to provide good quality, person-centred care.

People were at increased risk of not having their medication administered correctly because their care plans were not always clear. The application of barrier creams to prevent skin from getting sore was often not documented.

People were at increased risk of catching and spreading infections, because staff did not always wear their PPE correctly.

People and their relatives were concerned about the management of the service. They noticed the lack of consistency and opportunities to express their feedback. The service was not led effectively because the systems and processes to monitor the service were not implemented or used efficiently. As a result, the quality of care was negatively impacted upon.

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

The last rating for this service was good (published 13 May 2021).

Why we inspected

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.

The inspection was prompted in part due to concerns received about a high level of safeguarding incidents at the service. As a result, we undertook a focused inspection to review the key questions of safe, caring and well-led only.

The information CQC received about the incidents indicated concerns about the management of risks to people’s health and wellbeing. This inspection examined those risks.

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 changed from good to 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 report.

You can see what action we have asked the provider to take at the end of this full report.

We requested the provider to immediately mitigate the urgent risks identified during the inspection and to provide us with an action plan on how other shortfalls will be addressed. The provider had taken agreed actions to mitigate the risks.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wilford View on our website at www.cqc.org.uk.

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 will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment and the 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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Wilford View Care Home is a purpose built residential care home providing accommodation and personal care for up to 83 people, including people living with dementia over three floors. At the time of the inspection 43 people were living at the service.

We found the following examples of good practice.

The provider followed the government guidelines to protect visitors from catching and spreading infection. For example, all visitors were supported to wear a face covering when visiting, and wash hands before and after mask use. Visitors, including health care professionals were asked to complete a lateral flow test (LFT) and health care professionals were asked to evidence their COVID-19 vaccination status before entering the home.

People were supported to use and access their environment safely. For example, people with symptoms of COVID-19 were supported to self-isolate in their bedrooms with access to en-suite bathrooms. Staff were observed wearing correct personal protective equipment (PPE). The provider used enhanced cleaning schedules to mitigate the risk of spreading infection in the areas of the home where it was not possible to implement social distancing or when people refused to self-isolate.

People were admitted into the service safely. The provider ensured people had been tested for COVID-19 before admitting them and supported them to isolate in their own rooms for 14 days after the admission, whenever possible.

People and staff had adequate access to the COVID-19 testing programme. Staff had a good understanding of COVID-19 symptoms that present in older people. The provider ensured the staff and people who presented with COVID- 19 symptoms, tested immediately.

The home looked clean and hygienic. There were cleaning schedules in place, including enhanced cleaning of high touch areas, such as light switches, handrails and door handles. All areas of the home were uncluttered so cleaning could take place effectively.

All staff completed infection prevention control training and the staff competency was regularly assessed by the in-house trainer.

The provider had an infection prevention and control policy in place and contacted their local health protection team in a timely way in the event of COVID- 19 outbreak.

During the active COVID-19 outbreak staff supported people to maintain contact with their loved ones via phone calls, video calls and window visits.

Wilford View Care Home is a new, purpose built residential care home providing accommodation and personal care for up to 83 people, including people living with dementia over three floors. At the time of the inspection 45 people were living at the service.

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

Medicines best practice guidance had not been consistently followed. This included dates not recorded when medicines were opened, and medicines stock levels did not tally with medication administration records. The provider's internal audits and checks had identified shortfalls with medicines management and were addressing this.

Risk management in relation to two people's needs found some inconsistencies, but overall guidance for staff was detailed and up to date.

Staffing levels were based on people's dependency needs. Staff deployment required further review to ensure people's safety.

Safe staff recruitment checks were completed before staff commenced. Staff received ongoing training and opportunities to review and discuss their training and development needs.

Incident analysis showed action had been taken to manage known risks and lessons were learnt to reduce incidents from reoccurring. Infection prevention and control practice followed best practice guidance. Staff were aware of their responsibilities to protect people from abuse and avoidable harm. Staff had received safeguarding training.

People were supported to achieve positive outcomes. Their individual needs were assessed and planned for. Recognised assessment tools were used to monitor people's health and well-being.

Health care needs were monitored and timely referrals were made to healthcare professionals when required and recommendations made were implemented. Processes were in place for information to be shared with external healthcare professionals in the ongoing care of a person. Staff were knowledgeable about people's health care needs and support.

People's nutritional needs and preferences were discussed with them. They received a well balanced diet offering frequent choices of food and drinks throughout the day.

The environment provided a pleasant spacious and light living experience, with a safe and comfortable garden space with a greenhouse and pet rabbit.

Where people lacked mental capacity to consent to their care, best interest decisions had been completed with the person's relative and or representative. Where people were deprived of their liberty care plans provided staff with guidance of support required.

Feedback from people and relatives about the approach of staff was good. Observations of staff practice during the inspection reflected that of comments received. Staff were kind, caring and compassionate. Independence was promoted and privacy and dignity respected.

A complaint policy and procedure were available and this was provided in easy read to support people's access to information. Complaints received had been investigated and responded to as per the provider's policy and procedure. Action had been taken to make improvements where required.

When people were approaching the end of their life, their wishes about care and support needs were discussed with them and or their relative. This enabled staff to provide dignified and person centred care.

The provider had robust systems and processes in place to assess, monitor and mitigate risks. Daily, weekly and monthly audits and checks were completed, and these were found to be up to date and detailed.

The provider and registered manager were meeting their registration regulatory responsibilities. The provider and registered manager had good oversight of the service and an action plan was in place to further drive forward improvements.

People, relative and staff were overall positive about the leadership of the service. Opportunities for people to share their experience of the service was provided. Effective internal communication systems were in place for staff to exchange information about people's care and support needs and the safe running of the service.

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 18 November 2019 and this is the first inspection.

Why we inspected

We were concerned about the number of falls people had experienced. As a result, we undertook a comprehensive inspection. We found action had been taken to manage and mitigate risks.

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 coronavirus and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.