Archived: Waypoints Verwood

Updated 2 November 2018

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.

This inspection took place on 18 September 2018 and was unannounced. The inspection continued on 19 September 2018 and was announced. The inspection was carried out by two inspectors, accompanied by a specialist advisor with nursing experience and an Expert by Experience on the first day. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The second day of the inspection was carried out by two inspectors.

Before the inspection we reviewed all the information we held about the service. This included notifications the home had sent us. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive. We contacted the local authority quality assurance team and safeguarding team to obtain their views about the service.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with three people who used the service and met with five relatives and a health care professional. We received feedback from two health care professionals via the telephone.

We spoke with the director of operations and acting head of care. We met with nine care staff and the quality assurance monitoring officer. We reviewed six people’s care files, five medicine administration records (MAR), policies, risk assessments, health and safety records, incident reporting, consent to care and treatment and quality audits. We looked at three staff files, the recruitment process, complaints, and training and supervision records.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experiences of people who could not talk with us. We also walked around the building and observed care practice and interactions between care staff and people.

Updated 2 November 2018

The inspection took place on 18 September and was unannounced. The inspection continued on 19 September 2018 and was announced.

The service is registered to provide accommodation and residential and nursing care for up to 42 older people. At the time of our inspection the service was providing residential care to 24 people most of whom were living with a dementia.

Waypoints Verwood is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. People were supported in a large purpose built home which was separated into four separate units spread over two floors. Each unit had a lounge area and there were two large communal lounge and dining areas on the ground floor. Access to the first floor was via lift or three staircases and there were accessible outside areas to the rear of the home and two first floor enclosed terraces.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

At the last inspection in November 2017, we asked the provider to take action to make improvements in a number of areas. These included; staffing levels, risk management, fire safety measures, medicines and incident reporting. Further improvements were also needed around Deprivation of Liberty Safeguards, involving people and relatives in decisions and handling and responding to complaints. These actions had been completed.

We found that improvements were still required in monitoring and improving the service. People’s topical cream Medicine Administration Record sheets and repositioning records had not been completed accurately and were out of date. Quality monitoring systems were not fully effective or robust as they did not monitor whether tasks or actions had been completed. This meant that the service had not identified these recording errors.

The home had not had a registered manager in post since August 2018. 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 acting head of care had been offered the head of care role and a new home manager had recently been recruited and was due to start in October 2018. The director of operations was basing themselves at the home in the interim period so that they could provide additional management support to staff and people at the service.

People were at risk of avoidable skin damage because pressure-relieving air-mattresses were set incorrectly Staff were checking that mattresses were set but had not ensured that these were at the correct weight for people. Although this had not resulted in any pressure areas, it meant that people were not always supported with safe pressure care and were therefore at increased risk of developing sore skin.

Staff understood how to recognise signs of abuse and the actions needed if abuse was suspected. There were enough staff to provide safe care and recruitment checks had ensured they were suitable to work with vulnerable adults. People had person centred risk assessments which identified that individual risks they faced and provided actions for staff to safely manage these. The service was responsive when things went wrong and reviewed practices in a timely manner. Medicines were administered and managed safely by trained staff.

People and families had been involved in assessments care needs and had their choices and wishes respected including access to healthcare when required. Their care was provided by staff who had received an induction and on-going training that enabled them to carry out their role effectively. People had their eating and drinking needs understood and met. Opportunities to work in partnership with other organisations took place to ensure positive outcomes for people using the service. Consent to care was sought in line with the principals of the decision making. However, there was not sufficient oversight of people who had Deprivation of Liberty Safeguard authorisations in place, or any conditions which were attached to these.

People, professionals and their families described the staff as caring, kind and friendly and the atmosphere of the home as homely. People were able to express their views about their care and felt in control of their day to day lives. People had their dignity, privacy and independence respected.

People had their care needs met by staff who were knowledgeable about how they could communicate their needs, their life histories and the people important to them. A complaints process was in place and people felt they would be listened to and actions taken if they raised concerns. People’s end of life wishes were known including their individual spiritual and cultural wishes. People had opportunities to take part in activities and outings which met the interests and preferences.

People, relatives and professionals told us that they had experienced improvements in the home since the last inspection. Leadership was visible and promoted teamwork. Staff spoke positively about the management and had a clear understanding of their roles and responsibilities. The service understood their legal responsibilities for reporting and sharing information with other services.

During our inspection we found a continued breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered providers to take at the back of the full version of the report.