Background to this inspection
Updated
15 December 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
We visited the service on 10 November 2016. Our inspection was unannounced and the inspection team consisted of two adult social care inspectors.
We spoke with eight people who used the service and five of their family members. We also spoke with nine members of staff and the registered manager and reviewed recruitment files of six staff members. We looked at the care records relating to six people who used the service, which included, care plans, daily records and medication administration records. We observed interaction between people who received support and staff.
Prior to the inspection we reviewed the information we held about the service including the Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed other information we held about the service including notifications of incidents that the registered provider sent us since the last inspection, including complaints and safeguarding information.
We contacted local commissioners of the service, the local authority safeguarding team to obtain their views. No concerns were raised about the service.
Updated
15 December 2016
This was an unannounced inspection carried out on the 10 November 2016.
Walton Manor is a two storey care home situated in the Walton area of Liverpool, Merseyside and is registered to provide accommodation, nursing and personal care for up to 49 people. The service is fully accessible and fitted with aids and adaptations to assist people with their mobility. A passenger lift and staircase provide access to the first floor. The service is located close to a busy shopping area with good public transport links.
There was a registered manager in post at the service. 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 service is run.
We last inspected the service in August 2014 and the registered provider met all the regulations we reviewed.
We have made a recommendation about the environment. Improvements had recently been made to parts of the environment, including the redecoration of corridors and bedrooms and the replacement of flooring. However, further improvements to the environment were required to help promote the independence of people living with dementia.
Risks people faced had been identified and plans which were in place provided staff with guidance on how to reduce the risk of harm to people. However, sufficient checks were not carried out on pressure relieving equipment to minimise risk to people. During our visit the registered manager and staff took immediate action to rectify this.
Medicines were stored appropriately, managed safely and comprehensive audits completed. However, care plans for PRN (as required) medication were not in place for staff guidance. This meant that people could be administered more medication than required. The registered manager informed us that this would be reviewed immediately.
There were sufficient numbers of staff on duty to meet people's needs. Robust recruitment processes were in place and the required recruitment checks had been completed to ensure that staff were suitable for the role they had been appointed to prior to commencing work.
Health and safety checks had been carried out on the environment and equipment used. The service was clean and tidy and the registered manager carried out regular checks on the cleanliness of the environment to ensure this was maintained. There was a fire risk assessment in place and checks of the fire safety equipment had been carried out. Staff had received training in fire prevention and safety.
Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and put it into practice. Where people were being deprived of their liberty for their own safety the registered manager had made Deprivation of Liberty Safeguard (DoLS) applications to the local authority.
Staff understood their role and responsibilities. Staff received training to ensure they had the skills and knowledge to support the people living in the service. Staff were supported in their roles and received regular supervision and appraisals. New members of staff received a comprehensive induction into their roles.
People could choose when, where and what they wanted to eat. Additional drinks and snacks were
made available to people in between main meals and staff knew people's food preferences. People were provided with a varied and balanced diet and they were supported to make choices in relation to their food and drink.
People were assisted to access other healthcare professionals to maintain their health and well-being, when required.
Staff spoke kindly to people and respected their privacy and dignity. Staff knew people well and had a caring approach. Staff responded to people without delay and cared for people in an unrushed manner.
Records were comprehensive and kept up to date. Care plans contained detailed information on each person and how their support was to be delivered. Information was regularly reviewed with people living at the service. This meant that people received personalised care in line with their wishes and preferences.
People were provided opportunities to give their views about the care they received from the service. Some people chose to use these opportunities to become more involved with their care and support. Relatives were also encouraged to give their feedback on how they viewed the service.
There was an effective complaints system in place. People and staff knew who to raise concerns with and there was clear line of accountability amongst senior staff.
The registered manager demonstrated a 'hands-on' approach and knew people well. Quality monitoring audits were effectively used to identify where actions needed to be taken and to drive future improvements in the service. Accidents and incidents were reported and analysed to identify any patterns and themes.