Wells Lodge Nursing Home

Updated 20 June 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 person 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 person 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 person had sent us since our last inspection. These are events that happened in the service that the registered person is 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 16 May 2018 and the inspection was unannounced. The inspection team consisted of a single inspector.

During the inspection visit we spoke with 10 people who lived in the service and with four relatives. We also spoke with a nurse, four care staff, a housekeeper and the activities coordinator. In addition, we met with the manager, the care quality director and the managing director of the company who ran the service. The care quality director was responsible for supervising the manager and for checking that the service was being run in line with the company’s quality standards. We observed care that was provided in communal areas and looked at the care records for five people. We also looked at records that related to how the service was managed including staffing, training and quality assurance.

In addition, we 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 speak with us.

After the inspection visit we spoke by telephone with a further three relatives.

Updated 20 June 2018

We inspected the service on 16 May 2018. The inspection was unannounced. Wells Lodge 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 (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Wells Lodge Nursing Home is registered to provide accommodation, nursing and personal care for 22 older people. There were 22 people living in the service at the time of our inspection visit.

The service was run by a company who was the registered provider. There was no registered manager in post. 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. However, there was a manager who was in charge of the day to day running of the service and who had applied to be registered with CQC. In this report we refer to the company as being, ‘the registered person’. When we speak about the person who was in day to day charge of the service we refer to them as being, ‘the manager’.

At the last comprehensive inspection on 24 and 25 January 2017 the overall rating of the service was, ‘Requires Improvement’. We found that there were two breaches of the regulations. This was because there were shortfalls in the arrangements that had been made to provide people with person-centred care. In particular, suitable provision had not been made to fully support people who had special communication needs to express their wishes about all parts of the care they received. We also found that robust arrangements had not been made to complete background checks in relation to new nurses and care staff.

We told the registered person to take action to make improvements to address both of our concerns. After the inspection the registered person told us that they had made the necessary improvements.

At the present inspection we found that suitable provision had been made to provide people with person-centred care and to complete background checks in relation to new nurses and care staff.

Our other findings were as follows. People had been safeguarded from situations in which they might experience abuse. People received safe care and treatment. Medicines were managed in the right way and there were enough nurses and care staff on duty. Suitable provision had been made to prevent and control infection. Lessons had been learned when things had gone wrong.

People received care that achieved effective outcomes in line with national guidance. This included providing people with the reassurance they needed if they became distressed. Nurses and care staff knew how to care for people in the right way and had received training and guidance. People were helped to eat and drink enough to maintain a balanced diet. Appropriate arrangements had been made to help people receive coordinated care when they moved between different services. People had been supported to access healthcare services when necessary. Suitable arrangements had been made to obtain people’s consent to the care and treatment they received. The accommodation was adapted, designed and decorated to meet people’s needs and expectations.

People were treated with kindness and compassion in a way that respected their dignity. People were given emotional support when it was needed and they had been supported to 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 responsive care that met their needs for practical assistance and which took into account their special communication needs. People had been offered sufficient opportunities to pursue their hobbies and interests and to engage in social activities. Suitable arrangements were in place to promote equality and diversity including supporting people if they chose lesbian, gay, bisexual or transgender life-course identities. There were suitable arrangements for managing complaints and provision had been made to support people at the end of their life to have a comfortable, dignified and pain-free death.

There was no registered manager in post. However, the person in day to day charge of the service had promoted an open and inclusive culture and there were suitable management arrangements 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 person and manager were actively working in partnership with other agencies to support the development of joined-up care.