This was an unannounced inspection which took place on 5 June 2018. This meant the staff and provider did not know we would be visiting.We inspected the service to follow up on the breaches and to carry out a comprehensive inspection.
At the last inspection in July 2017 the service was not meeting all of the legal requirements with regard to regulation 12, safe care and treatment, regulation 18, staff training and regulation 17, governance.
Following that inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions about is the service safe, is it effective and is it well-led to at least good.
At this inspection we found improvements had been made and the service was no longer in breach of regulations 12 and 18. Although further improvements were required as identified in the inspection report. A breach of regulation 17 was in place as further work was required in order to achieve compliance. The quality assurance processes although becoming more robust required further action in other aspects of care. You can see what action we told the provider to take at the back of the full version of the report.
Wheatfield Court is a care home. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Wheatfield Court accommodates a maximum of 60 people who require nursing care or personal care, some whom may live with dementia or a dementia related condition. This includes a separate ‘enhanced care facility’ unit run by the NHS which provides temporary care and rehabilitation to up to 20 people who have been recently discharged from hospital or care to prevent their admission to hospital. At the time of inspection 53 people were accommodated at Wheatfield Court.
A registered manager was in place. 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.
The provider undertook a range of audits to check on the quality of care provided. However, we considered some improvements were required with regard to record keeping, staff deployment, staff training and to ensure previous non-compliance was actioned in a timely way.
The environment was well-maintained and there was a good standard of hygiene. Improvements were required to ensure information was accessible to keep people involved and orientated.
Training provision had been improved for staff. However, we have made a recommendation that staff receive all available training, appropriate to their role to give them more insight into people’s specific care and treatment needs. Staff were supervised and supported.
People and staff told us they felt safe and there were enough staff on duty to provide safe care to people. Staff knew people’s care and support requirements. However, record keeping required some improvements to ensure it reflected the care provided by staff.
A complaints procedure was available. People told us they would feel confident to speak to staff about any concerns if they needed to. People had access to an advocate if required.
Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks. Staff knew the needs of the people they supported to provide individual care. Care was provided with kindness and people’s dignity was respected.
Some activities and entertainment were available to keep people engaged and stimulated. Staff did not always interact and talk with people.
People were protected as staff knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.
Staff had an understanding of the Mental Capacity Act 2005 and best interest decision making, when people were unable to make decisions themselves. 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 supported this practice.
People received an adequate and varied diet that suited their requirements. Systems were in place to ensure people’s health needs were met.
People had the opportunity to give their views about the service. There was regular consultation with people and family members and their views were used to improve the service. Communication was effective to ensure staff and relatives were kept up-to-date about any changes in people’s care and support needs and the running of the service.