Archived: Wellfield House

Wellfield House is a care home registered to provide personal care and accommodation to up to 21 people. The home specialises in the care of older people living with dementia. At the time of the inspection 19 people lived at Wellfield House.

People’s experience of using this service:

People who lived at Wellfield House were supported by sufficient numbers of staff who were well trained and knew how to support older people. We observed people’s requests for support being responded to promptly.

The quality of interaction between staff and people was good. The environment was comfortable and safe. There was good communication between staff and people making it easier for people to understand what was being asked of them.

People were active and took part in hobbies and interests that staff had identified with them. There were events and interesting activities each day and one to one support for people who needed this.

People were consulted on menus and staff supported people to eat and drink where appropriate. Staff cooked people meals from scratch so that people could enjoy good home cooked food. Although pureed foods were not presented well.

We recommend the provider reviews how they present pureed and soft foods in line with published best practice and guidance.

People had good access to healthcare and other professionals. People knew how to complain. Incidents and accidents were minimal and if they occurred staff took appropriate actions.

People and their families were not fully involved with planning care. A relative told us, “I am kept up to date if things change.” Another relative said, “I have not seen a care plan, but staff do tell us what’s going on”.

Rating at last inspection:

At the last inspection the service was rated as Good (November 2016).

Why we inspected:

This inspection was a scheduled inspection based on the previous rating

Follow up:

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

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

The home does not provide nursing care and people who require nursing assistance were supported regularly by the community nursing team.

There is 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 registered manager was open and approachable and supported people and staff well. At this inspection we found the registered provider had improved their support for the home by providing regular contact and supervision for the manager. The provider arranged for their in-house trainer to provide training to staff in the home.

The manager had robust systems in the home to monitor the quality of the service offered to

people.

The quantity and range of social activities available in the home had been developed since the last inspection. An activities co-ordinator had been appointed and people were offered a range of in-house activities. Some people were also able to enjoy trips to local places of interest. The registered manager told us they continued to encourage people to give ideas for the

activities they would like to have arranged.

People told us staff were kind and caring and always respected their privacy and dignity. Several people commented on how helpful staff were. One person said “Staff are more than kind. They wait on me hand, foot and finger.” Another person said “Staff are very kind and polite. Everyone.” “With some you do not even have to ask. They know us and what we need.”

A relative wrote “I was so pleased to see where (relatives name) lived and how well they were taken care of.”

People felt well looked after and said the home arranged for them to see healthcare professionals according to their individual needs. A visiting nurse practitioner s informed us the

staff monitored people’s health and always asked for advice if they had any concerns. They said “I have no concerns about the home. They are responsive. They take action and listen to any advice given”

Care was responsive to people’s needs and personalised to their wishes and preferences. People were able to make choices about all aspects of their day to day lives. Staff knew the importance of learning about people’s preferred ways of daily living and supporting them to continue to be independent when possible. One person said” “I do what I like. I go where I like. Tomorrow I am going out for the day. All day. But the next day I will be a bit tired. So I will take it easy. Please myself. Everyday.”

Staff were aware of how to assist people to make decisions if they lacked the mental capacity to make decisions for themselves.People were involved in discussions about the care and support they received and were made aware of any risks. The staff responded to changes in people’s needs and adjusted care accordingly.

People enjoyed the food in the home. They had a choice of food and staff catered for people with specific dietary needs and preferences when required. Food was plentiful and the size of people’s meals varied according to their appetite and preferences.

Staff had access to on-going training in health and safety and the specific needs of the people who lived at the home. This made sure staff had the skills and knowledge to safely and effectively support people.

There was a robust recruitment procedure which minimised the risks of abuse to people. Staff had received training in recognising and reporting abuse and were confident that any concerns would be fully investigated to make sure people were protected.

People knew how to make a complaint and everyone told us they would be comfortable to do so. All were confident they would be listened to and action would be taken to address any shortfalls. One person said “The manager listens to us; we can catch her most days. You just mention something and they take it on board.”

Below is a summary of what we found. The summary describes what people using the service, their relatives and staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found;

Is the service safe?

People had been cared for in an environment that was clean, safe and hygienic. Equipment was well maintained and regularly checked. We observed people being well cared for and treated with respect and dignity. Staff personnel records contained appropriate documentation detailing applications, references, disclosure and barring service reports and on going training that had been completed.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.

People told us 'I can say they look after me 100%, hand, foot and finger and they are so respectful' and 'Things are fine here we are treated with respect and kindness'. A visiting relative told us 'The care here is absolutely super, I cannot fault it and it's totally reassuring' 'You can come and go as you please and I think that's telling, it always smells so wonderful, like a home'

Is the service effective?

People told us they were very happy with the care they received and felt their needs had been met. We observed people being treated in a respectful, kind and supportive way. There was an unhurried atmosphere and we observed people being supported to maintain maximum independence.

All the staff we spoke with told us they had received appropriate training to do their job and felt well supported by the manager and colleagues. One member of staff told us 'I absolutely love it here, everyone is so nice and friendly' and 'People are looked after well, staff are very polite and kind to residents'

Records confirmed that care plans were updated with new information and action taken following incidents to prevent recurrence.

Person centred care plans identified individual preferences and dislikes.

Is the service caring?

We observed people being supported by kind and attentive staff. We saw that care workers were patient and gave encouragement when supporting people. We observed people doing things at their own pace and were not rushed or hurried.

We saw that staff and people interacted in a positive way and heard lots of laughter from people during the day when talking and interacting with staff. One person told us 'It's so nice when you get up and feel low to have some company who cheer you up'

Is the service responsive?

People's needs had been assessed before they moved into the home. Some people were able to tell us the name of their key worker and told us that they signed their care plans on a monthly basis and had been involved in developing them.

Some people we spoke to felt there could be more in the way of activities especially in the afternoons. One person told us 'The care is alright but there could be more stimulus, it can get boring' The manager had recently started placing the planned activity schedule in people's rooms on a monthly basis so they were aware of the activities available.

Is the service well-led?

Wellfield House has a registered manager who is registered with the Care Quality Commission.

Staff had a good understanding of the ethos of the home, one member of staff told us 'We try to make it as homely as we can'

The manager aims to hold residents meetings on a three monthly basis and we saw evidence of how residents suggestions had been acted upon.

Resident and family member surveys are conducted annually. All staff received supervision with the manager on a three monthly basis. Staff meetings are held three monthly. The registered manager is in the process of developing staff appraisals and surveys for staff and visiting professionals.

Staff told us they were clear about their roles and responsibilities and received good support from the manager. Staff also told us that they felt they worked well as a team and that communication was very good.

Some people who lived at the home were unable to fully express their views verbally. We saw that people were well dressed and well presented which demonstrated that staff took time to assist people with personal care. We saw staff assisting people in a kind and caring way.

There were some organised activities in the home to provide social and mental stimulation for people. A fortnightly activity programme was displayed in the entrance hall. It was not clearly visible and therefore most people we spoke with were unaware of any planned activities. People we spoke with said that the activities in the home were poor.

There were policies and procedures in place for the safe handling and administration of medicines. There was appropriate storage available for medication.

All areas of the building we viewed were clean, well decorated and maintained. This meant that people lived in a pleasant and safe environment.

The recruitment procedure minimised the risks of abuse to people who lived at the home by making sure that all staff were thoroughly checked before beginning work.

The manager had basic systems in place to monitor the quality of the service offered to people and to ensure that practices within the home were safe.