Archived: Wild Acres Care Home

At the time of the inspection there was a registered manager in post. 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 completed thorough recruitment checks for potential members of staff. Maintenance and checks of the property and equipment were carried out promptly and within required timescales. Checks on fire alarms and emergency lighting had been completed in accordance with the provider’s policy and manufacturer’s instructions.

There was a system to ensure people received their medicines safely and appropriately. The quality of the service was monitored by the registered manager and the provider through gaining regular feedback from people and their representatives and auditing of the care provided. The provider had plans in place to deal with emergencies that may arise.

People who use the service were able to give their views about the quality of the care provided. Relatives, community professionals and local authority representatives told us they were very happy with the service they received from Wild Acres Care Home and felt that people were safe in the home. The service had systems in place to manage risks to both people and staff. Staff had good awareness of how to keep people safe by reporting concerns promptly through procedures they understood well. Information and guidance was available for them to use if they had any concerns.

People were treated with kindness, dignity and respect. They were involved in decisions about their care as far as they were able and relatives/representatives told us they had been asked for their views on the service for particular individuals. People’s care and support needs were reviewed regularly. The registered manager ensured that up to date information was communicated promptly to staff through a range of regular meetings and supervision.

Staff felt very well supported by the registered manager and deputy manager and said they were listened to if they raised concerns and any required action was taken without delay. We found an open and positive culture in the service and staff were comfortable to approach the registered manager or any member of the management team for advice and guidance.

Staff understood their responsibilities in relation to gaining consent before providing support and care. People’s right to make decisions was protected. New staff received an induction and training in core topics.

We observed how staff supported people, and looked at documents including care plans, training records and management reports. We considered how the service met key outcomes, including safeguarding people, providing for people's care and welfare, respecting and involving people in their care, supporting staff and assessing and monitoring the quality of care provision. We used the information we gathered to answer the five questions we always ask;

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

This is a summary of what we found.

Is the service caring?

We observed care workers were caring, respectful and patient with people. One person told us 'I can't fault them, the staff are excellent', and a relative said 'Staff are cheery, happy and content'.

We saw people's preferences and needs were understood, and staff took care to ensure these were met. They promoted people's independence and choice to help people maintain a sense of self worth. The local community was welcomed into the home to encourage social events and involvement with the service. Staff told us they felt the service was homely, and had a friendly family atmosphere.

Is the service responsive?

The service was responsive to people's needs. People were able to participate in activities within the home and in the local community. Staff arranged disabled access for external activities to ensure no one was excluded.

People's care and support needs were assessed prior to their admission to the service. Their needs were reviewed regularly to ensure that changes were appropriately supported. Care workers were aware of each person's needs and wishes, and ensured these were met.

People were aware of how to raise complaints. The complaints procedure was displayed in the reception area. We saw there was also an opportunity to raise concerns through resident meetings. Actions were taken to resolve issues satisfactorily for the complainant.

Is the service safe?

Two people told us they felt safe in the home. All staff we spoke with had a good understanding of signs of possible abuse, and the actions they should take to report concerns.

At the time of our inspection no one was under Deprivation of Liberty Safeguards (DoLS). The manager knew the procedure to apply for this if it was necessary. They were aware of recent legislative changes that may affect the need to make DoLS applications, and were preparing for this. Care workers were also informed of these changes and the potential impact from this.

Care workers were aware of risks to people's health and wellbeing, as these were documented in their care plans. Care workers were provided with training and guidance to ensure they supported people safely.

Is the service effective?

We found the service was effective in the care it provided. One relative told us 'X's health and wellbeing have improved a lot' since living at the service. People's care plans recorded any specialist support required, such as dietary needs, or pressure relief to maintain good skin condition. We saw care workers followed guidance to ensure people's health was promoted.

Staff were trained to ensure they could support people effectively and safely. Learning was evaluated, and additional support provided as necessary. One care worker told us 'The manager listens, and helps me to deal with issues'. The manager and other senior staff supported care workers to develop skills, knowledge and confidence to support people, through meetings, supervisions and evaluated observation.

Is the service well led?

The service was well led. When people's health or wellbeing changed, staff took appropriate actions to support the individual, for example through referral to the GP or district nurse. We spoke with a district nurse, who told us 'There is good communication' between the surgery and the service. They told us the service effectively managed and promoted people's health.

Staff listened to people's views, and sought feedback through regular resident meetings and an annual survey sent to residents and their relatives. We saw actions were taken to resolve issues identified. Staff chatted with people throughout the day to provide reassurance, and promptly responded to requests.

The provider and registered manager completed reviews, checks and audits to ensure care and support was delivered in accordance with the provider's policies and procedures. Where issues were identified, the registered manager monitored progress towards resolution, and took appropriate actions to learn from incidents to reduce the risk of repetition.

At our inspection on 11 October 2013 we found the provider had completed all required recruitment checks for staff employed by the service. We did not speak with people who use the service at this inspection, but we did discuss recruitment procedures with two members of staff and the registered manager.

Since our last inspection the manager had completed an audit of all the recruitment files of staff employed by the service. Gaps identified in employee's work histories had been investigated, and explanations recorded. All other recruitment checks required by the regulation were documented.

We saw people's care needs were assessed on arrival, and reviewed monthly by staff. One relative said "staff get on top of any illness immediately and deal with it so that it doesn't take a hold.' We saw evidence of changes to people's care plans that reflected current health issues.

We saw care workers asked people for their consent before providing treatment or care. Care plans contained signed 'consent to care' forms. People confirmed staff listened to their responses, and acted accordingly.

We looked at the systems put in place by the manager to ensure people were not at risk of inappropriate care or treatment. We saw that peoples' comments were sought, and actions were put in place to address concerns raised.

People were protected from the risks of unsafe or inappropriate care because accurate records were maintained.

The provider did not ensure all appropriate checks were undertaken before staff began work. The recruitment process was not effective. There was a risk people would not have their health and welfare needs met by staff of good character.