Wishmoor Rest Home

Wishmoor Rest Home is a residential care home for 28 people living with dementia. At the time of our inspection 25 people were using the service.

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

The provider had systems and processes in place to protect people from the risk of abuse. Staff had received training and shared good knowledge of how to raise concerns. People and relatives told us they felt safe and would be listened to if they raised concerns. The provider had risk assessments in place to help reduce risk and keep people safe.

People were supported by kind, caring staff who knew them well. Staff had completed an induction process, shadowing and had their competency assessed before commencing their roles. Staff received the relevant training to meet people’s care needs. Staff were recruited safely into the service and some staff had taken roles as dignity champions.

Medicines were managed safely. Accidents and incidents were monitored, with lessons learned and action taken to mitigate risks to people.

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.

People's privacy, dignity and independence was respected. People were able to personalise their rooms and had additional communication aids to support their decision making.

The provider offered a range of activities, both internally and externally which people enjoyed. Visitors and relatives were welcomed into the home to take part in activities and share their loved one’s experiences.

The provider had a consistent management team and governance systems were in place to provide regular oversight of the service. Internal audits were completed by the provider, registered manager and deputy manager.

Effective systems were in place to gather feedback from people, relatives, staff and professionals which was used to drive improvements and positive outcomes.

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 18 October 2018].

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Wishmoor Rest Home is a residential care home for 25 people with dementia. At the time of our inspection 25 people were living at the home.

Rating at last inspection

At our last inspection on 11 January 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good.

People continued to receive care in ways which helped them to remain as safe as possible. Staff understood risks to people’s safety and supported people receive their prescribed medicines safely. There was enough staff to provide support to people to meet their needs.

Staff received training which matched the needs of people who lived at the home, so they would develop the skills and knowledge to care for them. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People were supported by staff if they needed help making key decisions about their life. People were cared for so they had enough to eat and drink and their food preferences were met. Staff supported people to see health professionals so they would remain well.

People enjoyed spending time with the staff that cared for them and were treated with dignity and respect. Staff spoke warmly about the people they cared for and encouraged them to make their own day to day decisions and maintain their independence. People were treated with respect and dignity.

People care was planned in ways which reflected their preferences and wishes. Relatives’ and health and social care professionals’ views and suggestions were considered when people’s care was planned. People, relatives and staff were confident if any complaints were made these would be addressed. Systems were in place to manage complaints.

People were encouraged to stay active. The provider had a comprehensive activities and entertainment programme for people to join in and enjoy.

People, their relatives and staff were encouraged to make suggestions to develop the care they received further through open communication with the senior management team. The manager and provider regularly checked the quality of the care people received. Where actions were identified these were undertaken to improve people’s care further.

Wishmoor Rest Home is registered to provide accommodation for 25 people who require personal care. On the day of our visit there were 22 people using the service.

Below is a summary of what we found. The summary describes what people using the service and staff told us, what we observed and the records we looked at. We used the evidence we collected during our inspection to answer five questions.

Is the service safe?

People told us that they felt safe. One person told us, 'I feel safe and protected'. Individual risk assessments were well completed and actions to minimise the risks identified were reflected in care plans. Service wide risk assessments, together with the actions to reduce those risks, were reviewed regularly.

The provider had a Mental Capacity Act 2005 policy but this was not fully applied in practice. We have asked the provider to take action to improve this.

The provider had systems and processes in place to ensure that medicines were obtained, administered and disposed of safely. This ensured that people were protected from the risks associated with the unsafe use and management of medicines.

The provider had effective recruitment and selection policies and procedures that were applied in practice.

Is the service effective?

People we spoke with told us that they had consented for the care that was detailed in their care plan. This was documented in their care records. Staff asked for people's consent before they carried out any personal care.

People's needs were assessed and care plans developed. Care plans reflected both the needs and wishes of people. Staff had a good knowledge of people's care needs

Policies and procedures were appropriate, up to date, and reflected current research and guidance.

Is the service caring?

People told us that the staff were kind and friendly. One person told us, 'The staff are all very kind and caring'. The relative of one person told us, 'The staff take very good care of (name).' We observed staff treating people in a friendly and caring way. People told us that the staff had time to spend talking with them. We saw that there was time scheduled within the day for activities. However, not all the people we spoke with were aware of what activities were available.

Is the service responsive?

People who used the service and staff were clear about the complaints process. People told us they were confident that any issue raised, or complaint made, would be thoroughly investigated and acted upon.

People told us that they were not aware of being asked to complete satisfaction surveys. The registered manager told us that surveys had been sent to people but they had not received any responses. The provider agreed to look at further ways in which feedback from the people who use the service and their families could be gained.

Is the service well-led?

Staff we spoke with told us they felt well supported by their manager. Staff said they were able to raise issues with their manager at any time and were confident they would be acted upon. Staff had opportunities to raise and discuss issues at staff meetings and at supervision sessions.

A range of audits were undertaken and the results used to improve the service. Action plans clearly identified who was responsible for implementing any change required.

Lessons learnt from complaints and incidents were analysed, shared with staff, and actions agreed and monitored.

People expressed their views on how they wanted to maintain their independence. Care workers we spoke with told us how they supported people in their choice and how they promoted people's privacy and dignity.

People were complimentary about the care and support they received. One person told us: 'I like it here, I was lucky to come here'. Another person said: 'It's nice here, it feels relaxed'.

People were supported and cared for in an environment that was safe, secure and clean.

People who used the service were supported by care workers who were suitably trained and qualified to meet people's needs.

The provider made sure they carried out regular supervisions and encouraged care workers to participate in team meetings and supervisions.

The provider had some systems in place to regularly assess and monitor the quality of service that people received, however on occasions did not complete follow up action to minimise the risks.

We last inspected the service on 19 April 2012 and found that care workers were not adequately trained and care plans had not been updated to reflect people's current needs. During this inspection we found some improvements had been made.