The Worthies provides personal care and accommodation for up to 26 older people. At the time of our inspection there were 25 people living at the home.This was an unannounced inspection, which meant the staff and provider did not know we would be visiting. This inspection took place on the 20 and 21 September 2017. This inspection was brought forward because we had received concerns from a whistle blower. The concerns related to how people were being cared for, the culture of the home and some environmental concerns. Some of the concerns were substantiated. However, it was evident that the provider and registered manager had taken action and had addressed some of these concerns prior to the inspection.
A registered manager was in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission 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 home is run.
At the last inspection in October 2016, the service was rated good overall, with improvements needed to ensure people were safe. This was because we did find some recording omissions and inaccuracies in regards to people's medicines. There were no breaches of regulation.
During this inspection, we found people’s medicines were still not managed safely, in respect of the administration and the disposal of pain patches. We also found that a person that was at risk of choking was not being provided with a suitable textured diet and thickened drinks to reduce these risks. We also brought to the provider’s attention some environmental issues in respect of hot water, which could pose a scalding risk to people, a loose handrail leading down some stairs and a slight odour in parts of the home. There was also a lack of signage where there was low headroom leading down from the stairs. Whilst action had been taken to address these concerns, the provider’s own checks had not identified these shortfalls with prompt action being taken.
People were receiving care that was effective and responsive to their changing needs. Care plans were in place that described how the person would like to be supported and these were kept under review.
People had access to healthcare professionals when they became unwell or required specialist help. People were encouraged to be independent and were encouraged to participate in activities in the home and the local community.
People were treated in a dignified, caring manner, which demonstrated that their rights were protected. People confirmed their involvement in decisions about their care. Where people lacked the capacity to make choices and decisions, staff ensured people’s rights were protected. This was done by involving relatives or other professionals in the decision making process.
Staff were knowledgeable about the people they were supporting and spoke about them in a caring way. Staff had received suitable training enabling them to deliver safe and effective care. People were protected because staff went through a thorough recruitment process.
Staff confirmed they received support and guidance from the management of the service. Sufficient staff supported people living at The Worthies and this was kept under review. People’s views were sought about the service. There was a programme of change, which included refurbishment of the environment and developing the skills of the staff to improve the way they supported people living with dementia. They were supported by the Dementia Wellbeing Service in introducing these changes.
We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.