Wentworth Lodge Residential Care Home Ltd

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

People were supported by safely recruited staff. There were enough staff available with the right skills to support people safely. Staff had been trained in understanding how to recognise abuse and report this to the appropriate body.

Risks to people’s safety were assessed and plans were put in place to minimise the risks, reviews and updates were done regularly. Staff understood how to support people with their medicines and people received these as prescribed.

People were supported by staff who had knowledge of infection prevention control guidance and followed this to keep themselves and people safe. People were supported to have visitors come to the home in a safe way. A learning culture was in place when things went wrong.

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.

The provider had systems in place to check the service people received and ensure actions were taken where improvements were needed. The provider followed the duty of candour guidance when things went wrong.

There were partnerships in place to offer people support to access their local community. The providers systems ensured people were supported using a person-centred approach. There were systems in place to seek feedback and people, relatives and staff felt listened to.

Rating at last inspection

The last rating for this service was good [16 July 2019].

Why we inspected

We received concerns in relation to the management of medicines. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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. 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 good. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wentworth Lodge Residential 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.

About the service:

Wentworth Lodge is a residential care home that was providing personal care for up to 44 people aged 65 and over. At the time of the inspection there were 43 people living in the home.

People’s experience of using this service:

People who lived at the home continued to receive good care and some aspects of the support they received to establish their own routines and their activities of interest were exceptionally well managed.

Staff knew people well and were motivated to provided support that met people’s needs and enabled them to take part in activities within the home and community in line with their wishes. People were supported with kindness and consideration. Staff knew how to keep people safe and had received training in safeguarding and how to reduce the risks of harm from occurring.

People received medications safely and risks to people had been assessed and managed to identify and reduce or address the impact of any known risks. People were supported to access healthcare services as needed and staff responded promptly to changes in people’s health. Other aspects of safety, including fire safety and issues of personal safety, were well managed in the home. Routine checks and audits were conducted to ensure that all aspects of the service were being delivered safely as planned.

Peoples rights were upheld and protected and people received kind support and assistance to have choice and control over their day to day lives. People’s preferences and experiences were known and staff provided personalised encouragement and enabled people to do as much as possible for themselves.

Effective monitoring systems were in place that checked if the home was well managed and delivered care that was supportive enabling people to have a good quality of life. People and staff were encouraged to provide feedback about the home and the management team were keen to consider and identify other improvements that could be made to support people and further improve their well-being.

The registered manager was aware of their responsibility to report events that occurred within the home to the CQC and other external agencies, complying with the regulations.

The home continued to meet the characteristics of a rating of good in all areas. More information about the inspection is in the full report.

Rating at last inspection:

The service was rated Good at the last inspection (report published in January 2016).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor the service through the information we receive.

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

The summary is based on our observations during the inspection, discussions with six people using the service, three visitors, seven members of staff and the manager. We also looked at four records relating to people's care and other records related to the running of the service.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe and secure.

The staff that we spoke to understood the procedures they needed to follow to ensure that people were safe. They were able to describe how they delivered care in a way that ensured risks were identified and responded to. The management were able to tell us different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.

We looked at how the home managed medication and found that improvements had been made. This meant that medication administration was safe and people were protected from the unsafe use of medication.

We found that equipment was well maintained and regularly serviced and all health and safety records were up to date. These checks meant that people were not placed at unnecessary risk

We inspected the staff rotas which showed that there was sufficient staff on duty to meet people's needs throughout the day. The staff rota reflected the number of staff we saw on duty. People received a consistent and safe level of support. A person told us that, 'The staff are lovely, they are there when you need them'. Some relatives told us, 'Normally seems to be plenty of staff around'.

Procedures for dealing with emergencies were in place and staff were able to describe these to us.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). This is legislation that makes provision relating to persons who lack capacity, and how decisions should be made in their best interests when they do so. At the time of our inspection no applications had been made. Although the management were able to describe the circumstances when an application should be made and knew how to submit one.

Is the service effective?

People all had an individual care plan which set out their care needs. People told us they received the care that they needed and some told us they had been involved in the assessment of their health and care needs, which in turn contributed to developing their care plan. Assessments included needs for any equipment, mobility aids and specialist dietary requirements. People had access to a range of health care professionals some of which visited the home. We saw that the manager made arrangements to ensure that healthcare appointments we made at times that were convenient for people.

This meant that people were sure that their individual care needs and wishes were known and planned for and that they had the equipment they needed to meet their individual needs.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff showed patience and gave encouragement when supporting people. People commented, 'The staff are very nice and they are clean and tidy, and the cook comes round to offer us a choice of meals'. A visitor said, 'Since I've been coming here the care (provided by staff) has improved immensely, X has really benefited from looked after and has put weight on'.

Staff were aware of people's preferences, interests, aspirations and diverse needs. Our observations of the care provided, discussions with people and records we looked at told us that individual wishes for care and support were taken into account and respected.

Is the service responsive?

We heard from some people that they were able to pursue individual activities. We also saw that there were some impromptu activities such as a sing a long during the inspection. We saw that staff recorded activities people participated in but visitors told us that they did not see many activities when they were there.

The manager told us how they planned to increase the hours of the home's activity co-ordinator and they had made activity boxes available for use with individual people, for example items relating to reminiscence. This showed that the manager was aware that this was an area that needed further development so as to improve stimulation for people.

People told us they were kept informed when their care needs changed. One relative had stated in a survey form returned to the home, 'The staff are very helpful and courteous, with smiling faces and information when you ask and talk to them'.

People knew how to make a complaint if they were unhappy. Two people said that they had made a complaint and both were satisfied with the outcomes. The manager told us that they took complaints seriously and looked into them quickly and we heard from some people that staff were responsive to matters they raised.

The registered manager told us the service worked well with other agencies and services to make sure people received their care in a joined up way. We heard from other agencies that they had found the service to be responsive to suggestions they had made to the manager.

Is the service well-led?

The home's owner was also the registered manager. Senior staff were trained appropriately to undertake the roles that they were delegated as part of the management team. This meant that senior staff had key areas of responsibility, for example care planning and medication which helped with management oversight.

The home had a system to assure the quality service they provided. The way the service was run had been regularly reviewed and people's views were sought. Prompt action had been taken to improve the service or put right any shortfalls they had found, or those we identified on the day of our inspection.

Information from the analysis of accidents and incidents had been used to identify changes and improvements to minimise the risk of them happening again.

People's personal care records, and other records kept in the home, were accurate and complete. We only found one risk assessment that was inaccurate and this was updated before we completed the inspection.

People received care that met their individual needs. We saw people being supported appropriately by staff throughout the day. One person said, 'The care is good here, I am really happy.'

Arrangements were in place to minimise risks around infection control. One relative said, 'The room is always clean and tidy.'

Systems were not always in place to ensure the safe handling of medicines. Records were not maintained appropriately to minimise the risks around medicines.

Staff were supported so they had the relevant skills, qualifications and experience to carry out their role. One staff member said, 'They really support me to get all the training I need.'

Systems were in place to monitor the quality of the service. Complaints and comments were taken seriously and action was taken to make improvements. One person told us, 'I have no complaints whatsoever.'

Records we looked at were fit for purpose, easily accessible and accurate.

We found that people were asked for their consent before care was delivered. One person told us, 'Yes, they always ask me.' We found that arrangements were in place for people who lacked capacity to make decisions.

We saw that people were well presented and wore clothes that reflected their own preferences, style, and gender. We found that people received care that met their needs. One person said, 'The staff are caring and look after us.' People had regular access to see other health professionals, when needed.

We found that arrangements were in place to ensure that people were safeguarded from harm.

We found that recruitment and section processes were consistent. Arrangements were in place to ensure that only staff suitable to work with vulnerable adults were employed.

People and relatives we spoke with knew how to complain. One person said, 'There is nothing to complain about here.' We found that people's comments and complaints were taken seriously.