Wollaton View Care Home

Wollaton View Care Home is a purpose-built care home providing accommodation for up to 46 people requiring nursing or personal care.

At the time of our inspection, 44 people were living at the service. The accommodation was established over two floors. The ground floor was allocated for people with longer term care needs. On the first floor was a short stay assessment and rehabilitation unit. The lower floor provided a communal lounge and dining space for people with access to a garden.

People’s experience of the service and what we found:

People were not kept safe from the risk of infection due to poor infection prevention and control practice within the service.

Staff did not always have sufficient guidance in care plans to support people with complex needs. People’s privacy and dignity was not always maintained.

Gaps in the skills and knowledge of staff left people at risk of not being supported effectively.

Medicines were not always safely stored and managed.

Audits were not always effective at creating improvements at the home.

People were protected from the risk of harm or abuse, by staff who understood their responsibility to ensure safeguarding standards were upheld.

There was a positive ethos at the service and people spoke highly of the care provided. Staff were kind and caring towards people.

Visiting professionals attended the home daily and reported good communication with the registered manager and staff team.

People felt safe at the service, and the registered manager had investigated any concerns and shared these with the local authority.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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

The last rating for this service was Good (published 9 November 2017.)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

The inspection was prompted in part by notification of an incident following which a person using the service was alleged to have been the victim of abuse. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk of harm to people. This inspection examined those risks.

You can see what action we have asked the provider to take at the end of this full report. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe and Well Led sections of this full report.

We undertook a focused inspection to review the key questions of safe, responsive and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Wollaton View Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to Regulation 9 (Person Centred Care), Regulation 12 (Safe care and treatment), Regulation 17 (Good Governance) and Regulation 18 (Staffing).

Please see the action we have told the provider to take at the end of this report.

Follow Up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Wollaton View Care Home is located in a residential area of Nottingham City and is registered to provide accommodation for up to 46 people who require personal care and support. At the time of inspection there were 23 people using the service with 17 people receiving rehabilitation support in short stay beds.

We found the following examples of good practice.

The provider had systems in place to effectively manage an outbreak of COVID-19. Staff were trained and followed safe infection prevention and control procedures, including the safe wearing and disposal of PPE and regularly cleansing their hands.

The provider had ensured a sufficient stock of personal protective equipment (PPE) was available to staff. PPE stations were placed outside rooms when people were isolating and provided at PPE stations across the service, to ensure staff had access to this when it was required.

The service was clean with frequent cleaning of high touch areas. Best practice guidance was being followed by staff and maintained across the service in relation to infection prevention and control.

Staff were participating in the testing and vaccination programme. People using the service and their relatives or essential care givers had been supported to participate in the COVID-19 testing and vaccination programme. People's individual risks in relation to COVID-19 had been assessed. Care plans had been updated to reflect any individual risks related to COVID-19 for people.

Wollaton View Care Home can accommodate up to 46 people. At the time of our inspection there were 38 people living at the service.

We found the following examples of good practice.

¿ Staff had received training in donning and doffing personal protective equipment (PPE), and we saw this was accessible throughout the home and staff used it in accordance with the most up to date guidance. Staff had received further training in Covid-19 and infection control.

¿ IPC (infection prevention and control) checks were carried out daily by a designated person to ensure that the service was always clean and that staff were wearing appropriate personal protective equipment (PPE).

¿ We saw the infection control policy and COVID-19 policy and both were kept up to date in line with current guidance. We reviewed audits which reflected actions had been taken to maintain the standards within the home.

¿ There were no visitors allowed in the home at the time of our inspection. Only essential medical professionals had entered the home during the outbreak. The registered manager told us that they were having a visiting pod built so that they could accommodate safe visiting after the outbreak.

¿ Window visits had been accommodated wherever possible so that people could see their families.

¿ There was a comprehensive and robust infection prevention and control audit in place which was carried out monthly along with the other regular checks throughout the home.

¿ The home was clean throughout and additional domestic staff had been utilised to ensure that the home was consistently clean and touch points regularly wiped. Clinical waste collection had been increased during the outbreak.

¿ Handovers for the staff team had been organised in the lounge area which is large enough for staff to be able to socially distance.

¿ We saw a COVID-19 risk assessment had been written which covered all areas to be considered. This included personal protective equipment and social distancing, handwashing and symptoms of the virus.

We carried out an unannounced inspection of the service on 27 September 2017. Wollaton View Care Home provides accommodation for a maximum of 46 people who require nursing or personal care. On the day of our inspection 19 people were using the service. This was the home’s first inspection since its registration on 5 December 2016.

A registered manager was present during the inspection. 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.

People’s safety was protected and the risk of harm reduced because staff could identify the potential signs of abuse and knew who to report any concerns to. Regular assessments of the risks to people’s safety were carried out, although plans to evacuate people in an emergency required more detail. Accidents and incidents were regularly reviewed, assessed and investigated by the registered manager. People were supported by an appropriate number of staff. People’s medicines were managed safely.

People were supported by staff who had completed an induction and training programme. Staff received supervision of their work and felt supported by the registered manager.

The principles of the Mental Capacity Act (2005) were followed when decisions were made about people’s care although assessments required more specific details about the decisions being made. Deprivation of Liberty Safeguards were in place and managed effectively. People spoke positively about the food provided at the home. People had access to external healthcare professionals when they needed to.

People were supported by staff who were kind, caring and compassionate and were knowledgeable about their needs. Staff responded quickly if people showed signs of distress. People were treated with dignity and respect, although private space was limited throughout the home. People’s diverse needs were respected. People were involved with decisions made about their care and were encouraged to lead as independent a life as possible. People were provided with information about how they could access independent advocates. People’s friends and relatives were able to visit whenever they wanted to.

People felt activities were provided too infrequently. A new activities coordinator had been recruited and was due to start working at the home. The home had not been appropriately adapted or decorated to support people living with dementia. People’s care records were detailed and provided appropriate guidance for staff to support people effectively, however daily records in relation to people’s fluid intake were not always completed appropriately. There were some gaps in people’s records in relation to the administration of topical medicines. People felt able to make a complaint and were confident it would be dealt with appropriately.

The home was well led by a dedicated, enthusiastic and caring registered manager. They were supported by an effective team of staff who carried out their roles with confidence and dedication. Representatives of the provider played an active role in driving improvements at the home.

People were encouraged to provide feedback about the quality of the service and this information was used to make improvements. Quality assurance processes were in place and these were effective. The registered manager had started to support people with becoming actively involved with their local community.