Wavertree Bungalow

Updated 14 April 2023

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 Health and Social Care Act 2008.

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

This inspection was completed by three inspectors and two inspection managers. For one day a specialist advisor supported the inspection team.

Service and service type

Wavertree Bungalow is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Wavertree Bungalow is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We communicated with three people who were staying at the home and 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 also spoke with two people’s family members and eight members of staff including the registered manager. We also looked at 12 people’s care records and a sample of medication records.

Updated 14 April 2023

About the service

Wavertree Bungalow is a short stay service providing accommodation with nursing and personal care for up to five people in one adapted building.

The service provides care and support for autistic people and people with a learning disability who had been identified as benefiting from a short stay at the home. At the time of our inspection four people were using the service.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

On the first day of our inspection, the system for reviewing and having oversight of the needs and risks to people staying at Wavertree Bungalow was ineffective. At the end of this inspection the registered manager and provider had ensured that risk assessments were now in place. There was an improvement in the assessing and monitoring of risks in people’s care and support. There was also a series of improvements and upgrades being made to the environment.

However, there remained no overall assessment of the safety of the environment from the perspective of the people staying at the home. There remained some aspects of the environment that could pose a risk to people and parts of the garden and outdoor space were not safe for people to use. We highlighted these to the registered manager who ensured prompt actions were taken.

People were not always supported to have maximum choice and control of their lives and staff did not consistently support them in the least restrictive way possible and demonstrate how this was in the person’s best interests; the policies and systems in the service did not always support this practice.

The systems in place for administering people’s medication were not always safe.

There were enough suitably qualified and experienced staff available to meet people’s needs safely. Staff knew people well and were knowledgeable about their needs.

We have made a recommendation about records.

Right Care:

Staff used assistive technology with the idea of helping people. However, some intrusions into people’s privacy had not been considered.

We have made a recommendation regarding the use of assistive technology.

People were well treated and supported during their stay at Wavertree Bungalow. People were relaxed and comfortable and their family members told us they thought their family members were happy and well treated when staying at the home.

Staff members listened to people. Staff sought people’s opinions and asked them questions throughout the day and made adjustments to the support provided based upon people’s choices. This was done in a friendly and respectful manner. It was clear that people staying at Wavertree Bungalow were comfortable and interacted positively with the staff supporting them.

Right Culture:

The provider had not always ensured that the safety and quality of the service had been effectively assessed. There was also a lack of effective assessment of the experience of people staying at the home and people being able to do things they enjoyed and were meaningful to them.

We have made a recommendation about the design, décor and homeliness of the environment.

The registered manager was quite new to the service and had a positive impact on the culture within the home. They had made a series of improvements and had an ongoing improvement plan for the service.

The registered manager was encouraging continuous learning and improvements within the home and they had started working with stakeholders within this process. The registered manager was open and responsive to our feedback during the inspection process.

The provider has other services, such as hospitals where the primary focus is providing treatment. However, Wavertree Bungalow is a care home providing short term accommodation for autistic people and people with a learning disability, alongside personal care and if needed nursing care. Some of the terminology, parts of the environment and culture at the service used a medical model and did not always promote ordinary living.

We have made a recommendation about assessing the service using the principles of Right Support, Right Care, Right Culture.

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

Rating at last inspection

This service was first registered with CQC in May 2016. This is the first inspection since the service changed its registration to that of a care home.

Why we inspected

This was a planned inspection as the service had not been inspected since the service registered as an adult social care location.

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.

Enforcement and Recommendations

At this inspection, we have identified breaches in relation to failings in how the provider monitored the safety of the service, a failure to ensure there was an effective system for the safe use of medicines; and a breach of good governance for the provider failing to monitor the quality and safety of the home.

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.