Wellington House

Updated 1 March 2022

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 was made up of two inspectors.

Service and service type

Wellington House 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

We reviewed information we had received about the service since the last inspection. We sought and received feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and one relative about their experience of the care provided. We spoke with eight members of staff including the registered manager, the operations manager, senior care workers, and care workers. We observed people and staff’s interactions when people were in the communal areas of the service.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at one staff file in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, records of meetings, further recruitment information and the recruitment policy and quality assurance records.

Updated 1 March 2022

About the service

Wellington House is a residential care home providing personal care to up to 10 people who have a learning disability or autism and/or have mental health support needs. The service is provided within one adapted building based in a residential area. At the time of the inspection 10 people lived there. Three people using the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

People told us they were happy living at the service. However, we identified areas where people’s support needed to be improved.

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 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.

Based on our review of the key questions Safe, Caring and Well-led: The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support:

• Model of care and setting maximises people’s choice, control and independence.

People were supported to express their views and make decisions about their care. People were supported to be independent and undertake tasks for themselves.

Right care:

• Care was not always person-centred and did not always promote people’s dignity, privacy and human rights. For example, staff did not always follow people’s care plans to support people to make day to day choices.

Where incidents and accidents had occurred, they were not always well recorded or reported to the manager. Incidents where not always investigated to determine if there were safeguarding concerns. Action had not always been taken following incidents to reduce the risk of them re-occurring.

Staff knew how to support people. However, people’s care plans were not always up to date. Staff were not always aware what was in people’s care plans.

People’s privacy was respected.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff did not always ensure people using services lead confident, inclusive and empowered lives.

Staff did not always demonstrate a respectful approach towards people. For example, we had concerns about how some staff spoke or had written about people.

The registered manager had identified some issues in relation to staff culture, but these had not been quickly addressed. Checks on the quality of the service had not always been effective in leading to improvements.

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

Equipment used to support people with their medicine had not always been calibrated to ensure if was working effectively. Medicines were stored correctly, and administration records were completed. There were enough staff to keep people safe. The provider was recruiting more staff as people were not always receiving their one to one support hours.

Staff had not always been well supported after incidents where incidents may have resulted in staff being hurt. The registered manager was aware of their responsibilities under duty of candour and worked in partnership with other services. However, incidents were not always shared with partners. Safeguarding incidents were not always reported to CQC when they needed to be.

People were protected from the risk of infection.

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

Rating at last inspection

The last rating for this service was Good insert date (published on 17 December 2020).

Why we inspected

We received concerns in relation to the culture at the service. As a result, we undertook a focused inspection to review the key questions of safe, caring and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the Safe, caring and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wellington House on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safeguarding people from abuse, treating people with dignity and respect, and good governance at this inspection.

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 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.