The inspection took place on 7 and 13 February 2016 and was unannounced. At our last inspection on 26 February 2015, the service was found to be meeting the required standards in the areas we looked at. Wilton lodge had been rated as good in all five domains. However at this inspection we found the service had deteriorated. The manager had recognised the need for improvements and was committed to improving the service. Wilton Lodge Residential Home provides accommodation and personal care for up to 36 older people, some of whom have dementia. It does not provide nursing care. At the time of our inspection 34 people were staying at the home. There was no registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run. However the manager has started the registration process and this had been received at the time of the inspection.
Trained staff helped people to take their medicines at the right time. We found that prescribed creams were not always documented when applied and that the guidance for medicines given when required (PRN) was not detailed enough. Safe medicines practices were not always followed by staff when administering people`s medicines.
Accidents and incidents were documented but not always investigated to identify trends and patterns and to ensure people were kept safe.
Safe and effective recruitment practices were followed to help ensure that all staff were suitably qualified and experienced. However we found that written and verbal communication skills some staff had needed improvement.
Care was not always provided in a way that promoted people’s dignity and respected their privacy.
Staff obtained people’s consent before providing personal care and support, they developed positive and caring relationships with the people they cared for and knew them well. However we found that the Mental Capacity Act principles were not always followed.
Complaints were recorded and responded to in line with the service’s policy. People, relatives and staff were complimentary about the manager and how the home was run. However we found that audits did not identify shortfalls or areas of concern and had not led to the necessary improvements being made.
People were not always supported to pursue social interests and take part in meaningful activities relevant to their needs, both at the home and in the wider community.
People felt safe, happy and well looked after at the home. Staff had received training in how to safeguard people from abuse and knew how to report concerns, both internally and externally.
People received personalised care and support which took account of their preferences. Staff were knowledgeable about people’s background histories, preferences, routines and personal circumstances, however the environment was not designed to promote the wellbeing of people living with dementia.
Plans and guidance had been drawn up to help staff deal with unforeseen events and emergencies. The environment and equipment used were regularly checked and well maintained to keep people safe.
People and relatives were positive about the skills, experience and abilities of staff who worked at the home. They received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.
People were supported to access health and social care professionals when necessary. They were provided with a healthy balanced diet that met their individual needs.
People were involved in the planning, delivery and reviews of the care and support provided. The confidentiality of information held about their medical and personal histories was securely maintained throughout the home.
Complaints were recorded and responded to in line with the service policy. People, relatives and staff were complimentary about the manager and how the home was run and operated. However we found that audits had no systems in place to ensure areas identified were improved.