This unannounced inspection was undertaken on 11 January 2017 by one adult social care and one pharmacy inspector. The service was last inspected on 1 September 2015, when it was found to be compliant with the regulations that we looked at and an overall quality rating of ‘requires improvement’ was awarded. Wrawby Hall is registered with the Care Quality Commission (CQC) to provide accommodation for up to 34 older people who may be living with dementia. Accommodation is provided over two floors. Secure gardens are provided at the rear of the property and a car park is available at the front. The service is situated off the main road that runs through Wrawby. People have access to local amenities. There were 30 people living at the service on the day of our inspection.
This service has a registered manager 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
We found there were some minor shortfalls in the operation of systems at the service which were addressed by the medicine fridge being reallocated to make sure staff monitored the temperature of this effectively. We made a recommendation about the medicine shortfalls that we found.
We observed the staffing levels on the day were adequate to meet people’s needs. We received some feedback from visitors and a member of staff felt staffing levels at peak times could be improved. This was discussed with the registered provider and a director who informed us they would increase the staffing levels on an afternoon by having ancillary staff or bank staff on duty. The management team assured us staffing levels provided at the service would be kept under review.
Staff received training about protecting people from harm and abuse. Safeguarding issues were reported report to the local authority and Care Quality Commission.
Staff received training, supervision and appraisals which helped to support them and develop their skills.
Health care professionals told us staff contacted them and followed their guidance appropriately to maintain people’s wellbeing.
People’s nutritional needs were assessed and monitored and their preferences and special dietary needs were catered for. Staff encouraged and assisted people to eat and drink. Advice was gained, as necessary from GP’s and dieticians to ensure people’s nutritional needs were met.
Staff supported people to make decisions for themselves. People chose how and where to spend their time. Staff reworded questions to help people living with dementia understand what was being said.
Activities were provided and visiting was encouraged at any time. People visiting the service were made welcome.
A programme of redecoration and refurbishment had taken place and further improvements were scheduled. Pictorial signage was present to help people living with dementia find the bathrooms and toilets. Bedroom doors were numbered and named and some people had pictures present to help them find their bedroom. General maintenance occurred and service contracts were in place.
There was a complaints procedure in place. This was explained to people living with dementia or to their relatives so they could raise issues if they wished. People living at the service, their relatives and staff were asked for their views. Feedback received was acted upon. This helped the management team to maintain or improve the service provided.
The registered manager and senior staff undertook a variety of audits to monitor the quality of the service. The minor issues we found with the medicine systems had not been identified by the auditing process and the staffing levels provided were to remain under review. We were sent an action plan which told us what action had been taken to make sure the issues we found during our inspection would not occur again.