Archived: Wentworth Croft Residential and Nursing Home

Updated 11 December 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 11 October 2016 and was unannounced. The inspection was completed by an inspection manager, a pharmacist inspector, four inspectors and an expert-by-experience. An expert-by-experience is a person who has personal experience of caring for someone who uses this type of care service. Their area of expertise was older people and people living with dementia.

Before the inspection, we asked the provider to complete and return 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 any improvements they plan to make. The provider completed and returned the PIR form to us and we used this information as part of our inspection planning.

We looked at other information that we held about the service including information received and notifications. Notifications are information on important events that happen in the service that the provider is required to notify us about by law.

On the day of our visit, we observed how the staff interacted with people who lived in the service. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with seven people who lived at the service and seven of their relatives (one by telephone). We also spoke with the home manager; clinical services manager; three unit managers; an interim unit manager; a deputy unit manager; one nurse; three senior care staff; eight care staff; two activities co-ordinators; a house keeper; and a hostess. We received feedback about the quality of the service provided from a representative of the local authority. The provider had an action/sustainability plan in place for the service following a multi-agency large scale enquiry and we used this to inform part of our inspection planning.

As part of this inspection we looked at 10 people’s care records and three staff records. We looked at other documentation such as quality monitoring information, complaints and compliments, staffing rotas, medication administration records, staff and relatives meeting minutes and feedback on the service.

Updated 11 December 2016

This unannounced inspection was carried out on 11 October 2016.

Wentworth Croft Residential and Nursing Home provides accommodation for up to 156 mainly older people who require nursing and/or personal care. The service offers accommodation over one floor within four separate houses. Woolsack House provides personal care, Hayward House provides dementia care, Harvester House provides dementia care and nursing, and Yeoman House provides nursing care. Each house has single occupancy bedrooms with ensuite facilities and there are internal and external communal areas, including lounges, dining areas, a pamper room, cinema room, and gardens for people and their visitors to use. There were 69 people using the service at the time of our inspection.

During this inspection there was no registered manager in place. A manager was working at the home and they had started to apply to become the registered manager. A registered manager is a person who has registered with the Care Quality Commission (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 comprehensive inspection on 12 April 2016 this service was placed into special measures by the Care Quality Commission (CQC). Breaches of seven legal requirements were found and the service was rated overall as ‘inadequate.’ After the comprehensive inspection, the provider wrote to us to say what they would do to meet the legal requirements in relation to; safe staffing levels; safe medicines management; robust safety checks on all new staff; safe moving and handling techniques to be used on people; improvements in staff training and staff support; people’s nutrition and hydration needs being meet and robust quality monitoring, good governance and management of the service.

During this inspection we found that there was sufficient improvement to take the service out of special measures. We found that the provider had made the necessary improvements to demonstrate that the majority of the legal requirements were now compliant. However, we noted that some improvements were still needed. We found that there were still concerns around the safe management of people’s prescribed medicines. This was because we could not be assured that people were receiving their medicines safely. Detailed records as guidance for staff on when to administer people’s ‘as required’ medicines were not always kept.

Safety checks were carried out on all new staff to make sure that they were deemed safe to work with people who lived in the service.

There was a sufficient number of staff to provide people with safe assistance and care.

People had care and support plans in place to give guidance to staff on the assistance a person required. Records included how people wished to be supported, and what was important to them. People's care records had been reviewed and they or their appropriate relatives had been involved in this process.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. Where people had been assessed as lacking capacity, decisions were made in their best interest and this was clearly recorded in their care and support plans. Applications had been made to the local authorising agencies to lawfully restrict people’s liberty where appropriate.

Staff understood their roles and responsibilities to report any concerns of poor care practices and harm.

Staff had received training to develop their skills and knowledge to support people’s individual care and health needs in an effective way. Staff received regular supervision and appraisals.

The majority of people’s nutrition and hydration needs were met.

There was a system in place to receive and manage and resolve people’s complaints.

Improvements had been made to the provider’s and managerial oversight of the service. Quality monitoring systems were in place and improvements identified and completed or were on-going. However, improvement for the safe management of people’s medicines had not been identified by the provider’s audits.

People and their relatives provided feedback on the quality of the service so that the provider could see what was going well and what required improvement.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.