Wentworth House

Wentworth House is a care home in Salford which is registered with CQC to provide care for a maximum of 25 people. There were 23 people using the service at the time of the inspection.

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

We found record keeping needed to improve and some care plans lacked important details about the care people required. Some people did not have appropriate care plans in place, despite living at the home for several months. Audits were carried out to monitor the quality of service, however these needed to improve to ensure gaps in record keeping were identified and addressed.

Some medicines were not stored securely, mainly creams and sluice room doors were not always locked to prevent people being placed at risk. Fire doors were seen to be held open by inappropriate means which could stop them closing properly. We raised these concerns with the care manager and these areas of concern were addressed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, an MCA/Best Interest decision had not been completed for one person with bed rails in place.

There were enough staff to care for people safely and correct staff recruitment procedures were followed. Staff understood about safeguarding and how to report concerns. Equipment and the premises were well-maintained

There were systems in place to seek feedback from people living at the home, including the use of satisfaction surveys. Out of hours spot checks were also undertaken and staff supervisions held.

Rating at last inspection

The last rating for this service was good (published March 2020).

Why we inspected

This inspection was prompted by a review of the information we held about this service. This report only covers our findings in relation to the Key Questions safe and well-led which contain those requirements.

For those key questions not inspected (effective, caring and responsive) we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

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 Wentworth House on our website at www.cqc.org.uk.

Enforcement

We have identified a breach in good governance, particularly in relation to record keeping.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

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

We found the following examples of good practice.

Robust processes were in place to ensure professional visitors to the home did not spread or catch COVID-19. All visitors were required to complete a lateral flow test and have their temperature taken, before putting on PPE. Although the home was closed for general visiting, a letter had been sent to relatives, which clearly explained the process when accessing the home to visit relatives receiving end of life care. This ensured relatives knew what was expected to keep them and others safe.

Other than social distancing and changes to visiting processes, the home had kept things as normal as possible, including completion of a daily activities programme. This had helped people living at the home to cope with reduced family contact. However, contact with families had been maintained as much as possible via window visits, phone and video calls.

The home had specific admission criteria for use during the pandemic, which included people having to isolate for 14 days upon admission. However, they had been flexible in finding a safe way for a person who was unable to isolate to be admitted for the specialist support they required, whilst ensuring the rest of the people living at the home remained safe.

The home had detailed plans in place regarding isolation, zoning and cohorting, however as they had not experienced any cases of COVID-19 to date, these had not been required. The home had been proactive in working closely with the local authority, to ensure they were ready to deal with any outbreaks.

Premises were clean throughout. The cleaning schedule had been amended to include additional cleaning of frequent touch points. To support cleanliness and infection control, night staff completed deep cleans of areas difficult to do during the day, such as lounges and dining rooms.

Wentworth House is registered to provide personal care and accommodation for up to 25 adults. The home is situated in a residential area of Swinton, Salford. It specialises in care for older people and people with dementia.

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

The provider had invested heavily in technology through the provision of an interactive magic table which had resulted in increased stimulation and extremely positive outcomes for people. There was also positive opportunities to connect with the community, including partnership working with a local school.

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People received person-centred care which was responsive to their needs. Feedback about the service from people and those close to them was consistently positive. People and relatives spoke extremely highly of the service and told us how they recommended it to others.

People were protected from the risk of abuse and avoidable harm by staff who understood how to recognise and respond to concerns. The environment was extremely clean, welcoming and well maintained. People were safely supported to receive their medicines, as prescribed. People's needs were assessed appropriately. People told us staff were extremely kind, caring, attentive and treated them with dignity and respect.

Leadership was strong at the service and there was an open culture. Both the manager and the provider had a visible presence and it was clear they were extremely passionate about providing quality care. Staff told us morale was very good and they felt well supported in their role.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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 (published 8 July 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Wentworth House is registered to provide personal care and accommodation for up to 25 adults. The home is situated in a residential area of Swinton, Salford. It specialises in care for older people and people with dementia. The home is owned by Wentworth House Care Services Ltd which registered with CQC in April 2015. This was our first inspection at this location and there were 24 people living at the home.

People living at the home told us they felt safe. The staff we spoke with had a good understanding of safeguarding, whistleblowing and how to report any concerns.

We found medication was ordered, stored and administered to people safely. There were also audits of medicines to ensure there were no shortfalls in practice.

Staff were recruited safely with references from previous employers sought and DBS (Disclosure Barring Service) checks undertaken. This would ensure that staff were suitable to work with vulnerable adults.

There were sufficient staff working at the home to meet people’s needs. Feedback from people living at the home, visitors and staff was that staffing levels were sufficient. Night time staffing levels had also recently been increased to support a person receiving 1:1 care due to being at high risk of falls.

Staff received an induction when they started working at the home, as well as receiving appropriate training and supervision to support them in their role.

The home worked within the requirements of the MCA (Mental Capacity Act) and DoLS (Deprivation of Liberty Safeguards). We saw appropriate assessments had been completed if there were concerns about a person’s capacity. DoLS referrals had been made as necessary to the local authority. Staff spoken with displayed a good knowledge about MCA/DoLS and what action they would take if they had concerns about a persons capacity. All relevant documentation relating to these decisions was held in peoples care plans.

We saw people received enough to eat and drink, with people also making positive comments about the food provided at the home. The staff we spoke with knew about people who were at risk with regards to their nutrition such as if they had lost weight or needed support to eat. Where people had suffered weight loss, appropriate referrals had been made to the dietician service.

All of the people we spoke with during the inspection, including people living at the home and visiting relatives made positive comments about the care provided. The home had recently been nominated as one of the top 20 care homes in the north west based on feedback and reviews from friends and relatives at www.carehome.co.uk . The mayor from Salford was planning to visit the home following this award.

People told us they felt staff treated them with dignity and respect and promoted their independence where possible. We saw people being offered choices about how they wanted their care to be delivered.

People felt the home was responsive to their needs and we saw examples of staff doing this during the inspection when assisting people to walk around the home, administering medication and helping people to transfer in and out of their seat.

Each person living at the home had their own care plan, which was person centred and provided staff with the necessary information about peoples care.

There was a complaints procedure in place which allowed people to voice their concerns if they were unhappy with the service they received. The home also had a large number of compliments on record, where people had expressed their satisfaction with the service provided.

All of the people we spoke with told us they felt the service was well-led and that they felt listened to and could approach management with concerns.

There were systems in place to monitor the quality of service such as audits, resident meetings, staff meetings, accident/incident monitoring and the sending of satisfaction surveys. These systems would help to ensure the quality of service was able to continually improve.

Staff told us they enjoyed their work and liked working at the home and told us they felt there was an open and positive culture. The staff told us they felt listened to and that action was taken based on feedback from staff.