Archived: Wadeville

Updated 30 July 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of an inspector, a specialist advisor and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Wadeville is a ‘care home’. 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before the inspection we reviewed the information we held about the service. This included the provider’s action plan and details about notifications the provider must tell us about, such as any safeguarding alerts that had been raised. We spoke with the local authority safeguarding and commissioning teams about the service.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection

We spoke with four people using the service. Most people could not express their views verbally about the care and support provided, so 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 talk with us.

We reviewed a range of records. This included five people's care records and medication records for eleven people. We looked at two staff files in relation to recruitment and a variety of records relating to the management of the service, including policies and procedures.

Following the inspection, the Expert by Experience spoke with three relatives of people using the service and the inspector spoke with one relative. We also spoke with an activities coordinator, a team leader and five support workers.

After the inspection

We continued to seek clarification from the registered manager to validate the evidence found.

Updated 30 July 2021

About the service

Wadeville is a care home providing care and support to people living with learning disabilities, mental health and physical disabilities across two joined houses. The service was registered to provide support for up to 13 people, there were 11 people using the service at the time of our inspection.

People’s experience of using this service and what we found

Relatives told us they felt their loved ones were safe and happy at the home. The provider had taken action to address the issues we found at the last inspection. Work had been done to improve the cleanliness security and upkeep of the building.

However, we found a small number of fire safety and environmental risks which were acted on promptly following the inspection. The provider had not identified some areas of staff training to meet the specific needs of people using the service. Records did not consistently evidence relatives’ involvement in people’s care where this was appropriate.

Staff understood their roles in safeguarding people from harm. Other risks to people had been assessed and staff knew how to manage these risks safely. There was a process to identify learning from accidents, incidents and safeguarding concerns.

There were safe recruitment practices that followed legal requirements. Medicines were safely stored and administered. The service had policies and procedures to respond effectively to Covid-19. The home was clean and free from odours. Staff mostly followed appropriate infection control practices to prevent or minimise the spread of infection.

People's nutritional needs were assessed and met. Staff liaised with health professionals to meet people's health needs.

Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People's needs in respect of their protected characteristics were assessed and supported.

Relatives said staff treated people with care and we observed this to be the case. Staff knew people well and treated them with dignity and respected their privacy. People were involved in a range of activities at the home in line with their preferences.

There were some systems to monitor the quality and safety of the service. The registered manger understood their role. Most staff were positive about the registered manager and said improvements had been made since the last inspection. Staff worked in partnership with relatives, health and social care professionals and voluntary organisations.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture (RSRSRC) is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support: There were limitations to the building which was designed to accommodate a larger than recommended number of people and was not best suited to increasing people’s independence and skills. The provider told us the local authority, who owned the building were considering separating the house into two smaller units.

Some further improvement was needed to increase people’s choice and control across all aspects of their lives. People had a personalised plan for their care. However, improvement was needed to evidence that people were supported to develop skills achieve outcomes and integrate in the community.

Right care: Overall care was person-centred and promoted people’s dignity, privacy and human

rights. However, improvement was needed to evidence that people were encouraged and consistently supported to develop and maintain skills and that any goals and outcomes were regularly reviewed.

Right culture:

Improvements had been made to provide more accessible information about the service to people but these had not addressed the communication needs of everyone at the service.

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

Rating at last inspection and update.

The last rating for this service was requires improvement (published 30 November 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

The last rating for this service was requires improvement (published 30 November 2020). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

This was a planned inspection based on the previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.