Wells House Nursing Home

Updated 7 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered persons continued to meet 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.

We used information the registered persons sent us in the Provider Information Return. This is information we require registered persons to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also examined other information we held about the service. This included notifications of incidents that the registered persons had sent us since our last inspection. These are events that happened in the service that the registered persons are required to tell us about. We also invited feedback from the commissioning bodies who contributed to purchasing some of the care provided in the service. We did this so that they could tell us their views about how well the service was meeting people’s needs and wishes.

We visited the service on 4 July 2018 and the inspection was unannounced. The inspection team consisted of a single inspector.

During the inspection we spoke with seven people who lived in the service and with two relatives. We also spoke with three care staff, a senior member of care staff, two nurses, the activities coordinator, the chef, a housekeeper and the maintenance manager. In addition to this, we met with the deputy manager, registered manager and Care Quality Director. We observed care that was provided in communal areas and looked at the care records for five people who lived in the service. We also looked at records that related to how the service was managed including staffing, training and quality assurance.

After the inspection visit we spoke by telephone with two relatives.

Updated 7 August 2018

We inspected the service on 4 July 2018. The inspection was unannounced. Wells House Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.

Wells House Nursing Home is registered to provide accommodation, nursing and personal care for 21 older people. There were 18 people living in the service at the time of our inspection visit.

The service was run by a company who was the registered provider. During the inspection visit the company was represented by one their senior managers who was the Care Quality Director. There was 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. In this report when we speak about both the company and the registered manager we refer to them as being, ‘the registered persons’.

At the last comprehensive inspection on 26 and 27 April 2017 the overall rating of the service was, ‘Requires Improvement’. We found a breach of regulations because sufficient numbers of suitably qualified care staff had not always been deployed in the service.

We told the registered persons to send us an action plan stating what improvements they intended to make to address our concerns. After the inspection the registered persons told us that they had made the necessary improvements.

At the present inspection we found that sufficient progress had been achieved to meet the breach of regulations. This was because enough nurses and care staff had been deployed to enable people to promptly be given all of the assistance they needed and wanted to receive.

Our other findings were as follows: People were safeguarded from situations in which they may experience abuse including financial mistreatment. People had been helped to avoid preventable accidents while their freedom was respected. Medicines were managed safely and background checks had been completed before new care staff had been appointed. Suitable arrangements were in place to prevent and control infection. Lessons had been learned when things had gone wrong.

Care was delivered in a way that promoted positive outcomes for people and care staff had the knowledge and skills they needed to provide support in line with legislation and guidance. This included respecting people’s citizenship rights under the Equality Act 2010. People were supported to eat and drink enough to have a balanced diet to promote their good health. Suitable steps had been taken to ensure that people received coordinated care when they used or moved between different services. People had been supported to access any healthcare services they needed. The accommodation was designed, adapted and decorated to meet people’s needs and expectations.

People were supported to have maximum choice and control of their lives. In addition, the registered persons had taken the necessary steps to ensure that people only received lawful care that was the least restrictive possible.

People were treated with kindness and they had been given emotional support when needed. They had also been helped to express their views and be actively involved in making decisions about their care as far as possible. This included them having access to lay advocates if necessary. Confidential information was kept private.

People received person-centred care that promoted their independence. This included them having access to information that was presented to them in an accessible way. People were given opportunities to pursue their hobbies and interests. The registered manager and care staff recognised the importance of promoting equality and diversity. This included appropriately supporting people if they adopted gay, lesbian, bisexual, transgender and intersex life-course identities. Suitable arrangements were in place to resolve complaints in order to improve the quality of care. People were supported at the end of their life to have a comfortable, dignified and pain-free death.

There was a registered manager who had promoted a person-centred culture in the service and had made the arrangements necessary to ensure that regulatory requirements were met. People who lived in the service and members of staff were actively engaged in developing the service. There were systems and procedures to enable the service to learn, improve and assure its sustainability. The registered persons were actively working in partnership with other agencies to support the development of joined-up care.