Archived: Wickham Hall Also known as Wigan Council Extra Care

Updated 29 July 2016

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 7, 11 and 12 April 2016 and was unannounced. The inspection team consisted of two adult social inspectors and a pharmacist specialist advisor. At the previous inspection on 13 November 2013 the service was found to be meeting all regulations inspected, when it was part of a merged service called Reablement-Extra Care. The service then re-registered as a result of a redesign of services within the local authority. At this inspection we found no breaches of regulations. At the time of the inspection there were 37 people receiving a service at Wickham Hall, 29 people at Elliot Gardens and 30 people at Elmridge Court.

We looked at eight care files, nine staff personnel files and spoke with five people who used the service, two relatives, four staff members, two team leaders, two housing scheme managers and the lead provider manager at Wigan council. We also visited the Wigan Council human resources team to check staff recruitment information. We did not ask the provider to complete a Provider Information Return prior to the date of the inspection because the service was in the process of

re-registering with CQC. Prior to the inspection we reviewed information we held about the home in the form of notifications received from the service such as accidents and incidents. We also contacted Wigan Local Authority Quality Assurance Team, who regularly monitored the service

Updated 29 July 2016

The Wigan Extra Care Service is registered to provide personal care to people living in purpose-built (or purpose adapted) single household accommodation that is owned or occupied under an agreement with a housing association provider that gives exclusive possession of a home with its own front door. At each location we visited people were supported with their personal care needs to enable them to live in their own homes and promote their independence, whilst living in an environment that offered companionship, an active social lifestyle, security and privacy. People were able to socialise and make new friends in communal lounges, whilst still enjoying privacy in their own apartments, which were managed by the housing provider.

The establishments were located within walking distance from local amenities, such as shops, pubs and cafes, GP and dental surgeries, pharmacies and banks. Extra Care housing is similar to sheltered housing but with additional care and support provided to scheme residents to meet their individual needs.

At the time of the inspection there was no registered manager in post, but one person was in the process of registering with CQC. 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 using the Extra Care service told us they felt safe. People and their relatives told us that they were involved in the planning of their care and they consented to their care and treatment. Records confirmed that people had consented to their care and had been involved in the assessment of their needs. People we spoke with told us that staff were caring and compassionate toward them. People we spoke with told us they were supported by care staff they knew and were confident in the way the service was managed.

The registered provider (Wigan Council) had internal policies and procedures to provide guidance to staff on 'safeguarding vulnerable adults' and 'speaking out at work' (whistle blowing).

Discussion with staff and examination of training records confirmed that staff had access to safeguarding training.

Staff worked within the principles of the MCA and demonstrated a satisfactory understanding of the different types of abuse.

A suitable disciplinary policy was in place and we saw evidence in staff personnel files of the disciplinary policy being appropriately followed.

Staff were recruited safely and there were Disclosure and Barring Service (DBS) checks undertaken for staff in the files we looked at. Staff were subject to a formal induction plan which referenced different tasks to be completed in the first days/weeks/months of employment.

We looked at staff rotas and found that staffing levels were sufficient across the three locations to safely meet the needs of people who used the service. However some staff (including the team leaders and scheme managers) said that the recent reduction to two team leaders (from three) was having a negative impact on staff support and had led to an increased workload.

We saw copies of accident and incident forms had been completed correctly at each location and staff were aware of how to complete these forms.

We looked at how the service managed the administration of medicines across the three locations and looked at medication administration records (MARs) for people who used the service. Policies and procedures were in place covering all aspects of medicines management including the ordering, receipt, storage, administration and disposal of medicines. Regular audits (monthly) were carried out on the storage and recording of the administration of medicines on dedicated paperwork. Staff who administered medicines had completed a NVQ level 2 medicines training package through Wigan council. Each location had an up to date staff training matrix that identified training achieved and required.

The three establishments were adequately maintained and we saw evidence recorded for the servicing and maintenance of equipment used to ensure it was safe to use. The housing scheme managers were responsible for building checks and health and safety within each establishment. There was a business continuity plan in place for each establishment, which covered areas such as loss of staffing or severe weather conditions.

Each establishment had a supervision policy. However at all establishments the team leaders told us that supervisions had not occurred in line with the schedule identified in the supervision policy which stated these should be every six weeks.

The service was working within the principles of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS).

Menus were on display at each location, specialist diets were catered for and kitchen staff were employed by the housing provider. Nutritional risk assessments were in place in people’s care plans where required.

The three premises were clean throughout and free from any malodours. Corridors and communal rooms were free from clutter and well organised.

Although there were some staff vacancies, staff turnover at the three locations was very low and this enabled familiarity and the development of close working relationships with people who used the service.

We found the service aimed to embed equality and human rights though good person-centred care planning.

The registered provider (Wigan council) had a complaints policy to provide guidance to staff and people using the service and / or their representatives.

Some of the care plans we looked at did not always reflect people’s current needs and contained limited detail. Some risk assessments had also not been regularly reviewed and did not always consider all potential risks.

There was not a registered manager in post but one person was in the process of becoming registered with CQC.

Care staff told us the registered manager was approachable, accessible and felt they were listened to which they said supported both them and the people they provided care for.

The service worked in partnership with other organisations to ensure that appropriate care and support was provided to people in relation to their changing needs.

A team leader showed us a pro-forma that was used for gaining feedback from people through satisfaction surveys and said this had recently lapsed but was due to be re-introduced.

A scheme manager said there used to be regular joint team meetings with council staff to discuss every person who used the service, but these had recently fallen behind.

Within the Extra Care service, team meetings were usually bi-monthly, but the last recorded meeting we saw at one location was in September 2015.

Each location had a business continuity plan in place which covered areas such as loss of staff, loss of electronic care planning information, adverse weather conditions and fire evacuation. This was being updated at the time of the inspection.