Wayside Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Staff and managers knew how to identify harm and abuse however further work was required to ensure staff had access to detailed policies that would provide them with the correct guidance. Risks had not always been identified or appropriately mitigated but the provider was working on improving any shortfalls in documentation. The provider had systems in places to manage risks to the quality of the service and protect people from the risk of abuse and neglect. However, the systems were not always implemented effectively and as a result, not all risks were assessed adequately. Following our feedback, the provider took immediate action to mitigate the risks we were concerned about.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Feedback we received from people and their relatives was mixed, but in general people felt safe living at Wayside Care Home. One relative told us, “Well it’s very good, we are very pleased with Wayside, we live away and when I asked if [person living at the home] would like to move nearer, they refused and are happy, so I am sure they are safe there”. Another relative told us, “We had some issues around 6 months ago with the call bell not being answered, their bedroom not being cleaned and a member of staff was rough, but it’s cleaner now. I keep an eye on the place as they don’t always follow directions”. A third relative said, “There is a lot of different staff, I think they have a high turnover, and a lot don’t speak English, which doesn’t help. There have been issues with missed medicines and I do worry about [person living at the home] safety and I think they worry a little too”.

There was a safeguarding policy in place, however this needed further detail to provide staff with clear guidance on recognising abuse and how to raise a concern. 68% of Staff had up to date safeguarding adults training to ensure they understood the importance of protecting people from all types of abuse.

We found the home to be clean and free of malodour. We observed staff supporting people individually in shared parts of the house. People were observed being supported with meals and drinks generally in line with guidance. During lunch we saw a person was communicating distress. Staff supported this person in a calm and positive way. We received mixed feedback from relatives about whether people were involved in planning the delivery of their care and support. 2 relatives told us they hadn’t been invited to be involved in care planning and were not aware of the contents of their loved one’s care plans. One relative told us, “There is a high turnover of staff but the nurses are very good, [person living at the home] gets all their medication and sees the Doctor, that’s very important as they have seizures. Staff they do ring me and let me know what’s going on.” Another relative said, "[Person living at the home] is in better health than they have ever been. It has improved a lot since they first moved in.” A further relative said, “[Person living at the home] is supported by staff to take their medicines but staff ring me if [Person living at the home] refuses. I understand they can’t force [Person living at the home] to take their medicines but despite this refusal, they have improved so much since they moved into the home.”

The manager told us they were working on developing risk assessments further, however at the time of our visit there were several missing or incomplete risk assessments in place. These included risk assessments of health conditions, eating and drinking, and mobility. The manager took steps to address these during and shortly following our visit. However, the practice of identifying and mitigating risks had not always been effective.

During our time on site, we reviewed the steps the provider had taken to ensure the environment was safe. The provider told us they had implemented checks and audits to ensure the environment was safe. The manager and provider shared with us a service improvement plan they were working through to ensure the décor was updated.

Systems were in place to ensure suitable checks and maintenance were carried out on equipment and the environment. Any environmental risks were assessed and monitored. For example, all lifting equipment including the passenger lift were serviced regularly and had safety checks completed. Daily checks were completed to identify any new risks or maintenance issues. Routine checks were completed to support the health and safety of people. A relative told us, “I do see more staff about recently than there has been. The home is clean enough, just worn and old”.

We received mixed feedback regarding staffing levels and support people received from staff. One person said, “All the staff are lovely, carers are lovely, the Cook is lovely and looks after me. I like them [staff] all.” A relative told us, “The staff are very good, very attentive. It’s the staff that matter really and they are very good. They let us know if there are any problems. [Person living at the home] is very with it and can tell us what is going on but they are happy here”. A second relative said, “The place is just depressing. I think the staff are generally kind but the lack of English doesn’t help.”

Staff told us many of them had worked at the service for a long time and were welcoming of the provider recruiting more permanent staff to boost the staffing pool. Staff told us they would prefer more staff on each shift so they could move their focus from task centred care, to being able to spend more personalised time with individuals. Staff were hopeful the changes made so far would be embedded and sustained with a supportive management team now in place to help support them.

On the day of the assessment visit we observed positive interactions between staff and people. We observed staff supporting people to move around the service. They were patient and good humoured in their approach. At lunchtime we noted staff were interactive and supportive towards people. However, we noted people did not receive their morning medicines in a timely manner and the nursing staff had to request additional support from the clinical lead who was working from home. Staff informed us having 1 nurse on each shift was having an impact on people receiving care and medicines. We raised this with the provider who advised us they will be increasing the number of nurses on each shift as the occupancy at the home increases.

Overall, staff received training appropriate and relevant to their role, this included training in areas such as learning disability and autism and mental health. There were systems in place to check the competency of staff to deliver particular tasks.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us they were supported to take their medicines as prescribed by staff who were trained. One relative said, “[Person living at the home] gets all their medication and sees the doctor, that’s very important due to seizures. They do ring me and let me know what’s going on.” Another relative said, “[Person living at the home] has not had their medicines on a couple of occasions recently but the manager did ring me and say this was because of an emergency.” A third relative said “[Person living at the home] can sometimes refuse medicines and they [staff] do ring me if this happens so I can help”.

Staff informed us they received training and were competency assessed to handle medicines safely. Staff we spoke with told us they felt supported by the manager and provider but had not received any formal supervision, or an appraisal recently. Supervision and feedback enables staff to learn and improve on the care they deliver. We raised the lack of this support with the provider who told us this will be addressed once the new clinical lead has completed their training to deliver this work. Staff also raised with us the impact they feel having one qualified nurse on each shift is having on people receiving their medicines and nursing care in a timely manner. The provider told us the nursing staff ratio would be increased once the occupancy levels of the home increased. The provider also informed us they had arranged for an additional nurse to be on shift during planned periods such as GP rounds etc.

The provider did not have robust processes in place for managing people’s medicines safely. We found there was no protocol in place to ensure people who required time sensitive medicines received them at the correct times. People’s medicines records and care plans were not always accurate and contained misleading information which may pose a serious risk to the safe administration of medicines. This meant there was a risk staff may not know which medicines to give correctly. We reviewed a recent audit the manager had completed and found some information was incorrect or missing. For example, the manager had not identified when and by whom actions would be completed. Additionally, the audit suggested checks of controlled drugs were taking place weekly. However, the nursing staff confirmed these checks are completed twice a day. We raised our concerns with the provider who took action to implement a more thorough and accurate medicine audit going forwards.