Wilton Lodge - Care Home

Updated 17 February 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 3 February 2022 and was unannounced.

Updated 17 February 2022

At the last inspection of Wilton Lodge – Care Home in October 2016 the service did not meet all of the regulations we assessed under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At that inspection the service was rated ‘Requires Improvement’. This was because the provider was in breach of regulation 12: Safe care and treatment, on three occasions. This was with regard to safe management of medicines, health care and collaborative working with healthcare professionals. We also found that audits were not as effective as they could be and so we made a recommendation about identifying all shortfalls.

At that inspection we asked the provider to take action to make improvements to the management of medicines, meeting health care needs and working in collaboration with other health and social care professionals. They sent us an action plan saying when the improvements would be made.

This comprehensive inspection of Wilton Lodge – Care Home took place on 13 and 14 November 2017 and was unannounced. We found the overall rating for this service to be ‘Good’. The rating is based on an aggregation of the ratings awarded for all 5 key questions. Action had been taken and there were significant improvements in the meeting of regulations since we visited in 2016.

Wilton Lodge is registered to provide personal care and accommodation for up to 48 older people, including those who may be living with dementia related conditions. Communal accommodation is provided in a variety of lounge and dining areas and bedroom accommodation is provided in single rooms, some with en-suite facilities. The home is situated in a residential area on a main road and close to local amenities and bus routes into the centre of the City of Kingston-Upon-Hull. At the time of this inspection the service was being provided to 47 people.

The registered provider was required to have a registered manager in post. On the day of the inspection we found that the registered manager had been in post for the last one and a half years. 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 2008 and associated Regulations about how the service is run.

At this inspection we found the provider now met the regulation on safe care and treatment with regard to safe management of medicines. Procedures had been tightened up and practice was now much safer. We found that the management of medication was safely carried out. Other risks were also assessed and managed for people individually and on a group basis so that people avoided injury wherever possible.

People were protected from the risk of harm because systems were in place to detect, monitor and report potential or actual safeguarding concerns. Staff were appropriately trained in safeguarding adults from abuse and understood their responsibilities in respect of managing potential and actual safeguarding concerns.

The premises were safely maintained and there was evidence in the form of maintenance certificates, contracts and records to show this. Accidents and incidents were appropriately managed, risk assessed and mitigated. Equipment was safely used in the service.

Recruitment policies, procedures and practices were carefully followed to ensure staff were ‘suitable’ to care for and support vulnerable people. Staffing numbers were sufficient to meet people’s needs.

People were protected from the risks of infection and disease because good infection control management systems and practices were in place.

At this inspection we found the provider now met the regulation on safe care and treatment with regard to supporting people’s health care and working collaboratively with other health and social care professionals. People’s medical conditions and health care needs were appropriately met.

Staff encouraged people to make choices and decisions wherever possible in order to exercise control over their lives.

People were cared for and supported by qualified and competent staff who were themselves regularly supervised and received annual appraisals of their personal performance. Staff respected the diversity that people presented and met their individual needs.

People’s nutrition and hydration needs were met to support their health and wellbeing.

The premises were suitable for providing care to older people and measures had been taken when developing the service to include features which ensured the environment was ‘friendly towards’ those people living with dementia.

People’s mental capacity was appropriately assessed and their rights were protected. Everyone that worked in the service had knowledge and understanding of their roles and responsibilities in respect of the Mental Capacity Act (MCA) 2005 and they understood the importance of people being supported to make decisions for themselves. The registered manager followed the ‘best interests’ route where people lacked capacity to make their own decisions.

Consent for all things to take place was respected so that staff always sought people’s cooperation and agreement before completing any support tasks.

People received compassionate care from kind staff that knew about people’s needs and preferences. People were involved in all aspects of their care and their rights were respected. The management team set good examples to the staff team with regard to attitude and approach, which meant staff had good role models to follow.

People’s wellbeing, privacy, dignity and independence were monitored and respected. This ensured people were respected, that they felt satisfied and were enabled to make choices regarding their lives.

We saw that people were supported according to their person-centred care plans, which reflected their needs well and which were regularly reviewed. There were opportunities to engage in some pastimes and activities if people wished. People maintained family connections and support networks and their communication needs were assessed and met.

We found that there was an effective complaint procedure in place and people’s complaints were investigated without bias.

The service sensitively managed people’s needs with regard to end of life preferences, wishes and care.

The provider now met the recommendation we had made at the last inspection to ensure quality assurance systems were effective. Audits, satisfaction surveys, meetings, handovers and the provider’s own internal quality monitoring tools ensured there was effective monitoring of service delivery.

The registered manager understood their responsibilities with regard to good governance and practiced a management style that was open, inclusive and approachable.

The registered manager strove for continuous learning around best practice, updated their learning and practice at every opportunity and searched for innovative ways to deliver the service. The service fostered good partnerships with other agencies and organisations.