Wellhead Lane

We found the following examples of good practice.

Risk assessments were in place and were reviewed regularly. This gave staff management plans to work safely during COVID-19 which followed up to date guidance. People had their own risk assessments which covered their individual needs and risks of catching COVID-19. Measures were in place to support people to carry out their chosen activities as safely as possible.

People were testing for COVID-19 regularly and staff were checking their temperatures daily to help identify any symptoms of COVID-19. Staff were also testing as per the government guidance. The registered manager had provided staff with training on how to test for COVID-19 and had checked their competence to test safely.

Staff had been provided with training and updated guidance throughout the pandemic. Staff told us they felt safe working at the service and well supported. We observed staff wearing appropriate personal protective equipment (PPE) and were told there was plenty of stock available.

All visitors had to provide a negative Lateral flow test (LFT) prior to being able to enter the service. Appropriate PPE had to be worn at all times and staff checked visitors’ temperatures. Professionals had to provide proof of COVID-19 vaccination status before being allowed indoors. There were posters visible giving guidance on a range of COVID-19 measures such as wearing masks.

The home was clean and being cleaned throughout the day by staff. Records were being kept of the cleaning carried out and monitored by the registered manager. Surfaces and high contact areas were cleaned frequently.

People had been supported to keep in touch with families and visiting was being supported. People had also been able to visit their families in their homes and some had been able to go on family holidays with risk management in place.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Wellhead Lane accommodates up to five people in one adapted building. At the time of our inspection there were four people living in the home. This inspection took place on the 9th January 2018 and was announced, which meant the provider had 24 hours' notice that we would be visiting. This is because the home is small and we wanted to make sure the registered manager, or someone acting on their behalf, would be available to support our inspection.

A registered manager was 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.’

People were supported to make decisions. Staff showed a sound knowledge of the Mental Capacity Act (2005), however assessments were not always recorded appropriately.

Detailed information and person centred assessments were available but this information had not been fully incorporated into a current care plan document.

The home was supporting people with medicines in a safe manner. Where people were able, they self-administered their medicines with supervision and support from the staff. A PRN (as required) protocol was in place but needed to be added to the medicines record.

Risk assessments were in place. People were encouraged and supported to take risks safely and guidance on how the staff were to support the person were present. Bath temperatures were estimated using touch and not by using a thermometer.

People said they felt safe living at Wellhead Lane. There were systems in place to protect people from harm and staff had a sound knowledge of safeguarding processes.

People were supported to gain access to a wide circle of healthcare professionals.

People received care and support in a timely manner from sufficient members of staff who were skilled to meet their individual needs. The staff team was stable and people said they had the care they needed, when they needed it.

People’s dietary requirements were catered for and people were offered choices.

Interactions between staff and people were caring and compassionate, people spoke positively about staff and were comfortable in their presence. Staff knowledge around privacy and dignity was observed.

People had the opportunity to take part in activities of their choosing, no complaints have been received and informal concerns were logged and acted upon.

The registered manager is very visible within the service and staff and people spoke very positively about her. Communication between the staff team is good and quality assurance systems were in place.

People’s relatives spoke positively of the service, the staff and the care and support their loved one was receiving. One family member said, “what a wonderful place Wellhead Lane is, [my relative] has experienced a couple of supported living environments, this being leagues ahead of all of them."

A registered manager was employed by the service. 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.

People’s needs were assessed and care plans developed to identify the care and support people required. Relatives said they were involved in planning their family member’s care and were happy to express their views or raise concerns. Some of the wording used to describe how to support people in the care plans was inappropriate and the registered manager assured us this would be addressed and rectified. There was no evidence of staff talking in this way to people during our inspection.

There were systems in place to protect people from the risk of abuse and potential harm. Staff were aware of their responsibility to report any concerns they had about people’s safety and welfare.

There were enough staff deployed to fully meet people’s health and social care needs. The registered manager and provider had systems in place to ensure safe recruitment practices were followed.

The service was supporting people with medicines in a safe manner, and helping people to access healthcare services to maintain and support good health, however the medicines policy in place contained no guidance on PRN medicines (as required). We saw for one person who was receiving a homely remedy that no protocol had been put in place to guide staff when this should be offered and the processes around this.

People’s relatives spoke positively of the care their loved ones received and praised the staff for their compassion and commitment. One comment from a relative was “They are very good, very caring and loving; they understand X and are consistent”.

The registered manager had systems in place to monitor the quality of service provided. One notification concerning police involvement had not been received by CQC. We raised this with the manager and it was actioned during our inspection and has since been received by CQC.