Archived: Wordsworth House Care Home

Wordsworth House Care Home is a care home without nursing registered to provide accommodation and personal care for up to 51 older people. At the time of our inspection 41 people were living in the home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

People’s experience of using this service:

People told us they felt safe, they were relaxed and familiar with the staff and each other. People were cared for by a consistent staff team who had received appropriate training to carry out their roles. Staff spoke knowledgably about the systems in place to safeguard people from potential abuse.

The service was working within the principles of the Mental Capacity Act 2005. However, we have made a recommendation regarding the management of people’s Deprivation of Liberty Safeguards conditions.

People’s dietary needs and preferences were assessed and where needed, people received support to eat and drink. Meal times were an important social event in the day for those who chose to eat together. People enjoyed their meals, one person told us, “The food here is really good.”

People’s medicines were managed safely, stored securely and administered by trained staff. People received assistance to take their medicines as prescribed and were supported to access health care services.

People received care from staff that knew them well and treated them with kindness, compassion, respect and dignity. People received care that was tailored to their individual needs and maintained their independence as much as possible. Care plans were comprehensive, person centred, respectful, and reviewed regularly to ensure they reflected people’s needs.

Staff received regular supervision and annual appraisals to ensure they were fully supported in their role. There was a robust training programme that staff felt was effective and well delivered.

The service had a full and varied activity programme for people to enjoy if they wished. Activities included outings to places of interest, towns as well as indoor activities and supporting people to take part in activities on a one to one basis to prevent social isolation.

People and their relatives knew how to complain and were confident their views would be heard.

No people were receiving end of life care at the time of our inspection visit. Staff spoke knowledgably about end of life care and were proud of the care they provided to people at this time of their lives.

There was a system of audits and spot checks in place to ensure the service received ongoing monitoring to review the quality of the service provided.

People, relatives, staff and health professionals expressed confidence in the management team and felt the service had a clear management structure and an open and supportive culture.

More information is in our detailed findings below.

Rating at last inspection:

The previous inspection was comprehensive. The overall rating was Good (report published in November 2016).

Why we inspected:

This was a planned inspection based on the rating from the last inspection. The service remained rated Good overall.

Follow up:

We will monitor information received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.

This inspection took place on 29 September 2016. It was carried out by one inspector.

Wordsworth House provides residential care for up to 51 older people. There were 38 people living in the home at the time of our visit, some of whom were living with dementia. The home is a detached three storey property There was an on-going improvement plan to refurbish the building. During our inspection new carpets were being laid and we saw some bath and toilet facilities had been replaced.

There was a registered manager who told us the home was a family run business which was integral to the ethos of the home. 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.

People told us they felt safe living in the home. Staff were aware of what constitutes abuse and the actions they would take if they suspected if someone was being abused. Staff were able to explain how to escalate any concerns about poor practice. The registered manager demonstrated they had learnt from a safeguarding incident and had reviewed procedures to ensure appropriate actions were followed.

People were supported by enough staff who had been recruited safely. Relevant checks were undertaken before people started work. For example references were obtained and checks were made with the Disclosure and Baring Service to ensure that staff were safe to work with vulnerable adults. Staff told us they were busy but did not feel rushed and felt they had enough time to spend with people. The registered manager told us they monitored staffing levels to ensure people’s needs were met. They informed us they would not exceed 40 people on the existing staff numbers.

People had opportunity to be involved in activities that interested them. The activity coordinator told us people were asked about their interests on admission and each month people were consulted again as part of planning the next month’s activity calendar. They gave us examples of activities which had been planned based on people’s suggestions, such as a trip to a local military museum and baking.

People’s risks were assessed and plans developed to ensure that they received care which minimised the risks of them coming to harm. For example one person had risks associated with their behaviour; the home had involved healthcare professionals in planning how to manage the person’s risks so that they could be supported in the least restrictive way.

Medicines were managed safely. Medicine Administration Records (MAR) were signed to indicate that people had received the correct medicine. Medicines were kept securely and staff who were responsible for administering medicine had undergone training and were aware of actions to take if an error occurred.

There were quality monitoring systems in place which included regular checks of medicines, accidents and incidents, handwashing and mattresses. Any improvements needed were highlighted and there was a process for ensuring actions were recorded and checks made to ensure they were completed. Management also carried out spot checks.

People had access to healthcare when they needed it; peoples care records demonstrated contact with a variety of healthcare professionals.

People had personalised care plans which were took account of their likes, dislikes and preferences. They included detailed guidance on the care and support people needed. They were kept up to date and reviewed as required and staff were knowledgeable about peoples care needs. People were asked if they would like to develop a life story as part of their care plan.

People were supported by staff who received appropriate training to enable them to carry out their job roles. They told us they were supported by management and received regular supervision and an annual appraisal.

Staff were patient and caring towards people. We observed positive interactions and staff were knowledgeable about people’s interests and preferences.

We found that the flooring in the garden room was stained and broken. We found carpet in the communal rooms and corridors of the home were stained and torn in places. The provider had a plan in place to improve the environment which included the flooring.

Improvements had been made to staffing in the home. Staff knew their role and responsibilities.

People's personal records were not accurate, which could lead to people not receiving the care they needed.

People's needs were assessed and care was planned and delivered to meet their assessed needs. One person told us, 'They look after me very well.' We saw that people's care records contained sufficient information and were accurately completed.

Medicines were safely managed. One person told us 'The staff give me my tablets. They come at a regular time and they offer me pain killers if I need them.' We saw that medicines were accurately recorded and stored securely.

There were not always sufficient numbers of staff on duty. One person told us, 'The staff are so busy. Occasionally you can see the staff for a chat but they are busy helping people.' Staff did not consider there were sufficient numbers of staff.

People told us that staff met their needs competently. One person told us, 'The staff are skilled, although they do not have to do much for me.'