Archived: Wellesley Lodge Residential Home

We found the following examples of good practice.

The service was managing an outbreak of COVID-19 at the time of our inspection. The service had followed guidance to respond immediately and appropriately to the outbreak to ensure the safety of people and staff.

The registered manager had been open and transparent with relatives about the outbreak and supported relatives in making decisions about safe visiting. Staff made sure visits were conducted in a safe way and in line with current guidance. When relatives were not able to visit, they kept in touch with people through video and telephone calls. Staff kept relatives updated about people through telephone calls, emails and newsletters.

Visitors were screened for symptoms of infection and given information about the safety procedures they should follow. People and staff were tested for COVID-19 at appropriate intervals and the service made sure staff and visiting professionals were vaccinated against COVID-19. Staff only worked at this location which helped reduce cross infection risks. The service had experienced staffing pressures due to COVID-19 but had been able to manage this to make sure people experienced the same level of service.

Staff had been trained in current infection prevention and control (IPC) guidance and in the use of personal protective equipment (PPE). There were designated areas for donning and doffing of PPE and handwashing facilities were easily accessible to people, staff and visitors. Staff followed current guidance and practice throughout our visit.

Enhanced cleaning took place throughout the environment on a daily basis. The environment was clean and hygienic. Communal spaces were used creatively to ensure people could continue to interact with each other and staff in a safe way.

The registered manager was the designated lead for IPC at the service and undertook regular audits to make sure staff complied with current guidance and practice. Any concerns picked up through these checks were acted on without delay. The service’s IPC policy was up to date and in line with current guidance.

Further information is in the detailed findings below.

Wellesley Lodge Residential Home is a residential care home which can support up to 22 people in one adapted building. The services specialises in supporting older people living with dementia. At the time of this inspection the service was providing personal care to 17 people.

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

People were safe at the service. Staff knew how to safeguard people from abuse and how to minimise identified risks to people’s safety. Health and safety checks were carried out of the premises and equipment to make sure they were safe. The premises was clean and tidy. Staff followed good practice when providing personal care and when preparing and handling food which reduced hygiene risks.

There were enough staff to meet people’s needs safely. The registered manager regularly checked that staffing levels were meeting people’s needs at all times. The provider undertook pre-employment checks on all new staff to make sure were suitable to support people. Staff were given relevant training to help them meet people’s needs. The registered manager made sure staff had regular opportunities to review and improve their working practices to help them provide effective support to people.

People and their representatives were involved in planning and making decisions about the care and support they needed. People had an individualised care plan which set out their preferences for how their care and support needs should be provided. Staff understood how people’s needs should be met and provided the care and support which had been planned for people.

Staff were kind, caring and knew people well. They supported people in a discreet and dignified way which maintained people’s privacy and independence. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported to stay healthy and well. Staff helped people to eat and drink enough to meet their needs and to take their prescribed medicines. Staff made sure people could access health care services when needed and worked well with other healthcare professionals to ensure a joined-up approach to the care and support people received.

Staff supported people to participate in activities and events and to maintain relationships with the people that mattered to them. There were a range of comfortable spaces around the premises where people could spend time in, when not in their room. Since our last inspection the provider had been redecorating and refurbishing the premises to make this a more accessible and pleasant place for people to live. Further redecoration and refurbishment was planned.

People and their representatives had no concerns about the care and support provided by staff. They knew how to make a complaint if needed. There were arrangements in place to make sure any accidents, incidents and complaints were fully investigated which included keeping people involved and informed of the outcome. Learning from complaints and investigations was acted on and shared with staff to help them improve the quality and safety of the support they provided.

People and their representatives spoke positively about the management of the service, particularly the new registered manager who had been appointed since our last inspection. The registered manager made sure they and staff were clear about their duties and responsibilities, to help people achieve positive outcomes in relation to their care needs.

People, their representatives, staff and others were encouraged to have their say about how the service could improve. The registered manager used their feedback along with other checks, to monitor, review and improve the quality and safety of the service. Senior staff worked proactively with other agencies and acted on recommendations to improve the quality and safety of the service for people.

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 good (published 2 August 2017).

Why we inspected

This was a planned inspection based on the previous rating of good.

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.

At the last Care Quality Commission (CQC) inspection in October 2015, the service was rated ‘Good’ overall but we rated the service ‘requires improvement’ for the key question, ‘is the service well led?’ We did not find the service in breach of regulations but we found some gaps in audit systems and there was a lack of robust scrutiny and oversight at provider level. There was also no registered manager in post. A registered manager is a person who has registered with 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.

At this inspection we found the service remained ‘Good’. Improvement had been made to the well led question. The range of quality monitoring checks of the service had been improved to give the provider better assurances that key aspects of the service were effective. There was improved scrutiny of the service at provider level including meetings every three months with trustees on how the service was meeting its aims and objectives for people. There was also a registered manager in post. We have revised the rating for the well led question to Good. The service demonstrated they met the regulations and fundamental standards.

People continued to be safe at Wellesley Lodge Residential Home. Staff knew how to protect people from the risk of abuse or harm. They followed appropriate guidance to minimise identified risks to people's health, safety and wellbeing. There were enough staff to keep people safe. The provider maintained recruitment checks to assure themselves of staff’s suitability and fitness to support people.

The environment was clean and staff followed good practice to ensure risks to people from poor hygiene and cleanliness were minimised. Staff also made sure the environment was clear of slip and trip hazards so people could move freely around. The premises and equipment were regularly maintained and serviced to ensure these were safe. The provider maintained appropriate arrangements for the safe management of medicines. People received these as prescribed to them.

People continued to receive support that was personalised and which met their specific needs. Senior staff reviewed people’s needs regularly to ensure the support they received continued to meet these. Staff received relevant training and felt well supported by senior staff. Staff knew people well and had a good awareness and understanding of their needs, preferences and wishes.

People were supported to eat and drink enough to meet their needs. People were also supported to stay healthy and to access healthcare services when needed. Staff encouraged people to participate in activities and events and to maintain relationships with the people that mattered to them. Staff were warm and welcoming to visitors to the home and friends and families were free to visit when they wished. There were good links with the local community which helped to enhance the quality of people’s lives.

Staff treated people with dignity and respect and ensured people's privacy was maintained particularly when being supported with their personal care needs. People were encouraged to do as much as they could and wanted to do for themselves to retain their independence. People were prompted to make choices and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People and relatives were satisfied with the support provided by staff. The provider maintained arrangements to deal with people’s complaints appropriately if these should arise.

People and staff spoke positively about the management of the service and were encouraged to provide feedback about how the service could be improved. The provider had plans in place to make improvements that people had asked for.

The provider was working proactively with other healthcare professionals and organisations to enhance the quality of people’s health and wellbeing. This helped staff to stay abreast of best practice in falls prevention and end of life care and improve their understanding and awareness of how to support people to stay healthy and well and reduce unnecessary admissions to hospital.

Some people were not able to express their views and so we observed the care provided. We saw that people were spoken to with respect and that their views were sought before providing care. People's wishes were respected and staff were observed to engage positively with people using the service. We spoke with five staff members who knew the needs of the people who used the service well. Up-to-date care plans were in place that identified people's needs and included people's preferences for their care. We saw that the service worked actively with a range of health professionals.

Medication was stored and administered safely. There were appropriate checks in place for the maintenance and service of equipment. We saw from the duty rota that there were sufficient levels of staff on duty, and staff confirmed this was the case. One person we spoke with said 'You are never waiting long if you need something. Everyone is very helpful.' The service had an effective system to deal with any complaints.

We saw from people's records, their individual care and support needs had been assessed and care plans were in place to meet these needs. We observed that people using the service were consulted as far as possible, about their preferences in relation to their care. We also spoke to the local authority commissioning team about their contact with the service and learnt there were no issues. We saw there were well managed systems in place for cleanliness and infection control.

Staff were aware about what they should do to protect people who may be at risk of abuse, harm or neglect. They had also received regular training to keep their skills and knowledge refreshed.

We saw senior staff regularly reviewed and assessed the quality of service provided. We also saw people using the service and their representatives were asked for their views about the quality of service provided.