This was an unannounced inspection which took place on 6 and 7 March 2017. We last inspected the service on 9 and 10 March 2015 when we rated the service as Good overall. Wellcroft is registered with the Care Quality Commission (CQC) to provide residential care and support for up to 42 people with a dementia. At the time of the inspection 37 people were using the service. The home provides permanent, short stay and day care services. Accommodation is provided over two floors in three self-contained living areas. The first floor can be accessed via a passenger lift. All bedrooms are single occupancy with nine having en-suite facilities. The home is set in landscaped gardens and is located in Gatley village Stockport. Wellcroft is one of eleven care homes owned by Borough Care Limited a not-for-profit registered charity.
At the last inspection, the service was rated Good and the registered manager told us of his plans to improve the service to make sure people on their dementia journey received high quality person centred care. Further information regarding our findings are detailed in the effective, responsive and well led domains of this report.
The service was rated as Outstanding in the Well-Led key question.
A registered manager was in place at the home. 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 registered manager showed passion and enthusiasm for promoting dementia care and had a very strong value base which was reflected throughout the service. The registered manager and deputy manager had spent two days with the dementia research team at Sterling University to gather further dementia initiatives to support, develop and improve their approach to meet the needs of people living with dementia at Wellcroft.
The registered manager told us that because the provider ran as a non for profit organisation and care workers were not paid as highly as similar care homes in the area, it was important when recruiting new care workers to make sure they were adaptable and were willing to go the extra mile to put people first. They told us that it was important for people who used the service to be cared for by care workers who shared the same vision and values as they did and that they only want the best care workers for the residents and want the residents to live happily at Wellcroft.
Since our last inspection in March 2015 the service was recognised locally as a ‘Stockport Star Award Winner’ and was voted the ‘Best Care Home in Stockport’ and a care worker was voted the ‘Best Care Assistant in Stockport’. They received an award in recognition of their ability to exceed their job role expectations and reflect an inherent sense of compassion towards people who used the service. The award was presented by Stockport Together, which is a partnership organisation across Stockport. In addition to this the registered manager was awarded the, “Most effective manager 2016” award and the housekeeping team had been awarded the, “Most effective team 2015” at the Borough Care company awards ceremony. This is an annual award designed to recognise Borough Care Ltd manager achievements based on specific results and behaviours.
Care workers we spoke with told us they had undergone a thorough recruitment process and employee induction. Training appropriate to the work care workers carried out was on going and always available to them. Care workers spoken with confirmed they had received safeguarding and whistle blowing training, and knew who to report concerns to if they suspected or witnessed abuse or poor practice. Some care workers were working towards a nationally recognised qualification in care such as a National Vocational Qualification (NVQ) in health and social care and the Care Certificate. This helped to make sure the care provided was safe and responsive to meet peoples identified needs. A care worker spoken with told us they have to be approachable and the training helped them to do this so they could improve people’s day to day living and deliver excellent care to people living with dementia.
People were supported by sufficient numbers of suitably trained care workers who often worked in excess of their paid hours. Care workers received regular supervision to help make sure they were carrying out their duties safely and effectively. We saw the overall care workers attitude and approach focused on positive interaction with people who used the service. They demonstrated a good understanding of people’s culture and history which helped them to engage people in meaningful reminiscence conversations about their childhood, family and work life.
Where people had difficulty communicating, we saw care workers were particularly patient listeners and showed understanding of people's individual communication styles. Care workers spoken with told us that It was about the person telling the care workers what to do, not the care workers telling the person.
We saw written evidence that people and their relatives were involved in the decision making process at the initial assessment stage and during reviews of their care needs. People were supported to have maximum choice and control of their lives and care workers supported them in the least restrictive way possible.
People who used the service and their relatives told us they were always included in making decisions about their care and support. This included where service improvements could be made to further enhance people’s experience of living at Wellcroft. For example a relative told us the registered manager was very forward thinking. They added that they were able to give their relative a bath once a week which was a great opportunity to talk with their relative. They told us it had makes such a difference for the person and themselves. People who used the service looked contented, relaxed and happy including visits to places of interest and local community involvement initiatives such as regular planned visits to a café which provided a service to people living with dementia. We saw all activities were geared towards individual people to meet their identified social and communication needs.
Comprehensive care records were in place which reflected peoples identified health care and support needs. Information about people’s dietary requirements, how people wanted to be supported, when support was required and how this was to be delivered were clearly detailed in the care records we examined.
There was a good system in place to make sure medicines were managed safely, monitored and reviewed frequently. Any specific requirements or risks in relation to people taking particular medicines such as anticoagulant medicines were clearly documented and records kept up to date.
Complaints, comments and compliments were encouraged by the registered manage and registered provider. Any feedback from people using the service or their relatives, were addressed by the registered manager initially. People spoken with knew how to make a complaint and felt confident to approach any member of the care workers team if they needed to.
The registered manager had systems in place to monitor the quality, including service user and relative surveys, to ascertain their views and opinions about their satisfaction of the service provided. Feedback received was noted and used to make improvements to the service and the care and support being provided.