Wellfield

We found the following examples of good practice.

Staff wore appropriate personal protective equipment (PPE) to ensure people were protected as much as possible from the risk of cross infection. There was a large quantity of PPE in stock. PPE and hand sanitising gel was located throughout the home. Staff had received training in infection control and how to put on and take off PPE safely. Cleaning was being managed throughout the home by a dedicated housekeeping team and the registered manager liaised with them daily.

There were clear processes in place for visitors to the service. They were screened for vaccination status (where they were not exempt) and for COVID- 19 symptoms. In addition, a negative lateral flow devise test was required on arrival and they were required to wear appropriate PPE.

The provider was facilitating visits in line with the Government guidance and understood how important this was to people living at the home and their families. During times when visiting had been restricted, due to local and Government guidance or outbreak, the provider had supported people to stay in contact with family and friends through regular video calls and telephone calls.

Staff and people living at the home were being tested regularly, and appropriate action had been taken if anyone contracted the virus including staff who were supported to self-isolate. Staffing was being effectively managed where shift cover was required.

The registered manager said that they were well supported in their role to be resilient and managing IPC risks effectively.

Wellfield is a residential care home that at the time of inspection was providing accommodation and personal care to 22 people aged 65 and over. The service can support up to 29 people. Accommodation is provided in one double bedroom and the remainder in single bedrooms over two floors. Most of the rooms have bathroom facilities. The home is located in Accrington in Lancashire.

People’s experience of using this service and what we found

People told us they were well cared for and felt safe in the home. The also told us staff treated them with dignity and were respectful. Our observations supported these views. Staff had been safely recruited.

People received their medicines as prescribed, and were happy with the support they received. Care plans contained information on people’s health and communication needs as well as their family background, religious needs and social interests. The provider had systems to assess and monitor people’s health and nutritional needs.

Staff encouraged people to be as independent as possible. People felt listened to and confident to raise any issues. We saw that where concerns had been raised, the registered manager had acted to resolve the matters. Activities were available for people to participate in if they wished.

The home had received one complaint since the last inspection. This had been handled appropriately. We noted minor issues within the home were dealt with prior to becoming complaints.

There were systems to ensure staff documented any accidents or incidents which had taken place and there was learning from these incidents. Staff had completed safeguarding training and knew the correct action to take to protect people from the risk of abuse.

Staff told us they felt well supported and received regular supervision during which they were able to discuss their professional development.The registered manager had systems to assess and monitor the quality of the service.

Professional visitors spoke highly of the home and how the staff supported people with a variety of conditions. They were complimentary around how well the registered manager and staff worked with health care professionals to achieve effective outcomes.

The interior of the home was clean and free from malodour. The environment was safe and equipment had been regularly serviced and checked to ensure it was safe to use.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 3 December 2018).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Wellfield is a 'care home' which is registered to provide care and accommodation for up to 29 older people. People in care homes receive accommodation and nursing care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection. Nursing care is not provided at Wellfield. At the time of our inspection 24 people were using the service.

There was a registered manager who was also the provider. A registered manager is a person who has registered with the CQC 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.

At the last inspection on 9 and 10 August 2017 the service was rated 'Good'. However, we found the provider was in breach of one regulation of the Health and Social Care Act (Regulated Activities) Regulations 2014. This related to a lack of robust complaints management processes. Following the inspection, the provider sent us an action plan outlining the progress to be made. At this inspection we found sufficient action had been taken to make improvements.

At this inspection we found there was one breach of regulations under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The breach related to insufficient processes for monitoring and improving the safety and quality of the service.

We have also made recommendations on staff recruitment procedures, medicine management processes and person centred care. We also found some further improvements were needed with risks to health and wellbeing, monitoring staff deployment, the catering arrangements and the suitability of bathing facilities.

The service had a management and leadership team to direct and support the day to day running of the service. However, we found there were shortfalls in the auditing/monitoring systems and making plans for improvement in a timely way.

We found staff recruitment did not include all the required character checks for the protection of people who used the service.

Arrangements were in place to promote the safety of the premises, this included maintenance, servicing and checking systems. However, during the inspection we identified some areas were in need of attention.

There were enough staff available to provide basic care and support; people who used the service and staff had some concerns about the numbers of staff, however additional staff were being recruited.

People told us they felt safe at the service. Staff were aware of the signs and indicators of abuse and they knew what to if they had any concerns. Staff spoken with were aware of safeguarding and protection matters.

There were some safe processes in place to support people with their medicines, but we found improvements were needed.

Arrangements were in place to gather information on people’s backgrounds, their needs, abilities and preferences before they used the service.

People made positive comments about the care and support they received from staff. They said their privacy and dignity was respected. We observed respectful and friendly interactions between people who used the service and staff.

Visiting arrangements were flexible, relatives and friends were made welcome at the service.

People said they were satisfied with the variety and quality of the meals provided at the service. However, we found there was scope for making improvements with the catering arrangements.

People were supported with their healthcare needs. Changes in people's health and well-being were monitored and responded to. Where necessary, people received appropriate medical attention.

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 at the service supported this practice.

People spoken with had an awareness of the service's complaints procedure and processes. They indicated they would be confident in raising concerns. Processes were in place to receive and manage complaints.

There were adaptations and equipment to assist people with mobility and independence. There was a suitable standard of décor and furnishings to provide for people's comfort and wellbeing. We advised the suitability of bathing facilities be reviewed and planned for.

There were opportunities for people to engage in a range of group and individual activities.

There were arrangements for staff training, supervision and development. Some staff training was overdue; however, the registered manager was dealing with this matter.

The service had a registered manager who was also the provider. 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.

We found the provider had safeguarding adult’s procedures in place and staff had a clear understanding of these procedures. Staff had access to a whistle-blowing procedure and said they would use it if they needed to. Appropriate recruitment checks were carried out before staff started working at the home and there were enough staff to meet people’s needs. Risks to people using the service were assessed, reviewed and managed appropriately. People received their medicines as prescribed by health care professionals.

All staff had completed mandatory training in line with the provider’s policy; they were receiving regular formal supervision and, where appropriate, an annual appraisal of their work performance. The registered manager and staff understood the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and acted in accordance with this legislation. People were being supported to have a balanced diet and they had access to health care professionals when they needed them.

Staff had a good understanding of people’s care and support needs. They knew people well and had developed positive caring relationships with them. The environment was designed and adapted to meet people’s individual needs. People using the service and their relatives, where appropriate, had been consulted about their care and support needs. They were also provided with appropriate information about the home in the form of a service user guide. People’s privacy and dignity were respected.

People’s care plans and risk assessments provided guidance for staff on how to support them with their needs. Where people’s needs had changed, their care records were being updated to reflect the changes. There was a wide range of appropriate activities available for people to enjoy. People and their relatives knew about the home’s complaints procedure and said they were confident their complaints would be investigated and action taken if necessary. However, the service was not recording some issues that amounted to complaints and as such improvements are required in this area.

There were appropriate arrangements in place for monitoring the quality of the service that people received. The provider took into account the views of people using the service and relatives through meetings and surveys. The registered manager carried out unannounced visits to the home to make sure people where receiving appropriate care and support. Staff said they enjoyed working at the home and they received good support from the registered manager and senior staff.

We found that the home was clean, tidy and free from offensive odours. Members of staff had received training for the prevention and control of infection.

Members of told us they received the training and support they needed in order to provide safe and appropriate care for people using the service.

We found improvements to the system for monitoring the quality of the service provided had been made. The manager regularly checked most aspects of the care and facilities provided at the home.

We saw that improvements to care planning had been made. All sections of people's care plans were accessible to all care workers.

We saw that people lived in clean and comfortable surroundings. People were encouraged to make their rooms more homely with personal items such as photographs, ornaments and pictures for the wall.

We noted that recruitment procedures were thorough and members of staff received the training they needed in order to provide safe and appropriate care for people using the service.

We found that some improvements to the monitoring of the quality of the service had been made. However, the system did not cover all aspects of the care and facilities provided at the home.

We saw that people's individual care plans lacked clear guidance for staff to follow in order to ensure that identified risks were effectively managed. Care records stored electronically were inaccessible to care workers.