Waverley

About the service

Waverley is a residential care home providing personal and nursing care to ten people at the time of the inspection. The service can support up to 14 people.

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

Right Support

Where decisions had been made for people who lacked capacity to make specific decisions, there was a lack of documented consultation with relevant family members, social workers or advocates. However, the service supported people to have choice, be independent and have control over their own lives.

People’s strengths were promoted and there was a focus on what they could do, so people had a fulfilling and meaningful everyday life.

Staff enabled people to access specialist health and social care support in the community.

Right Care

Some people’s care plans had not been reviewed to ensure they still reflected people’s needs. This short fall had not been identified in the provider’s quality monitoring processes.

The principles of STOMP (stop over medicating people with learning difficulties) were not always followed.

The service had enough appropriately skilled staff to meet people’s needs. However, some aspects of staff training were not delivered by appropriately trained staff.

Staff promoted equality and diversity in their support for people. People received kind and compassionate care.

Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

People could communicate with staff and understand information given to them. This was because staff supported them consistently and understood their individual communication needs.

Right culture

People were supported by staff who knew how to protect them from potential abuse.

The systems and processes in place to identify, report and investigate safeguarding concerns were used effectively by the registered manager and his staff.

Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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

The last rating for this service was Good (published 27 February 2021).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support Right care Right culture. The inspection was prompted in part due to concerns received about allegations of abuse. A decision was made for us to inspect and examine those risks.

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 monitor the service and will take further action if needed.

We have identified breaches in relation to risk management, medicines, consent to care and treatment, and leadership.

Follow up

We have found evidence that the provider needs to make improvements. Please see the safe, effective 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 will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

Waverley is situated in the seaside resort of Mablethorpe in Lincolnshire. It can accommodate up to 14 people who experience learning disabilities and/or autistic spectrum disorder. It can also accommodate older people. On the day of the inspection 14 people were living in the home.

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

People lived in a safe environment. Staff worked to reduce the risks of harm to people in their care. People were supported by enough numbers of staff who knew their needs well. Their medicines were managed safely, and staff followed government guidance to reduce the risks of the spread of infection during the COVID-19 pandemic.

The quality monitoring processes in place had been reviewed since our last inspection and we saw there were improvements in this area. However, there was still a lack of clear evidence to show areas of care had been monitored, and effective oversight of the service.

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.

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 guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Waverley worked within the principles and values that underpin Registering the Right Support and other best practice guidance. This ensured that people could live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.

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 requires improvement (25 April 2019).

Why we inspected

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 coronavirus and other infection outbreaks effectively.

We received concerns in relation to the management of people’s nursing care needs. As a result, we undertook a focused inspection to review the key questions of safe 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 requires improvement to good. This is based on the findings at this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this full report.

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

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.

Waverley is situated in the seaside resort of Mablethorpe in Lincolnshire. It can accommodate up to 14 people who experience learning disabilities and/or autistic spectrum disorder. It can also accommodate older people. On the day of the inspection 14 people were living in the home.

Waverley worked within the principles and values that underpin Registering the Right Support and other best practice guidance. This ensured that people could live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.

People’s experience of using this service:

• Improvements were needed to the way in which some risks to people’s health, safety and welfare were assessed and recorded.

• Improvements were needed to the way in which governance systems were recorded.

• People enjoyed living at Waverley and they were supported by staff who knew them well.

• People were treated with respect and their privacy and dignity was maintained.

• People were supported to have choice and control of their lives and were encouraged to express their views and opinions about the care they received.

• People’s healthcare needs were met and they were supported to have a varied and balanced diet.

• Staff were trained and supported to deliver the care people wanted and needed.

• Staff understood how to keep people safe from harm or abuse and how report any concerns they may have for people’s safety.

• The manager was well respected by people who lived at Waverley and the staff team.

• The manager promoted an open and inclusive culture and worked in partnership with external agencies to ensure people received the care and support they needed.

Rating at last inspection:

Waverley was last inspected on 20 & 21 April 2016 (report published 17 June 2016) and was rated as good overall.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

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

Follow up:

We will continue to monitor intelligence we receive about Waverley until we return to visit as per our reinspection programme. If any concerning information is received we may inspect sooner.

People living at the home were of mixed ages. Some people required more assistance either because of physical illnesses or because they were experiencing difficulties coping with everyday tasks.

There was a registered manager in post. 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.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves. At the time of our inspection there was no one subject to such an authorisation.

We found that there were sufficient staff to meet the needs of people using the service. The provider had taken into consideration the complex needs of each person to ensure their needs could be met through a 24 hour period.

We found that people’s health care needs were assessed, and care planned and delivered in a consistent way through the use of a care plan. People were involved in the planning of their care and had agreed to the care provided. The information and guidance provided to staff in the care plans was clear. Risks associated with people’s care needs were assessed and plans put in place to minimise risk in order to keep people safe.

People were treated with kindness, compassion and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home. The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence and control over their lives.

Staff had taken care in finding out what people wanted from their lives and had supported them in their choices. They had used family and friends as guides to obtain information and accessed a number of different resources within the community.

People had a choice of meals, snacks and drinks. And meals could be taken in a dining room, sitting rooms or people’s own bedrooms. Staff encouraged people to eat their meals and gave assistance to those that required it. Some people helped with the preparation of meals and setting tables for meals.

The provider used safe systems when new staff were recruited. All new staff completed training before working in the home. The staff were aware of their responsibilities to protect people from harm or abuse. They knew the action to take if they were concerned about the welfare of an individual.

People had been consulted about the development of the home and quality checks had been completed to ensure services met people’s requirements. Since our last inspection the provider had updated and refurbished many parts of the home.

People told us they were always asked for their verbal permission/consent by staff before they undertook any care needs and their responses were respected. The home followed legal requirements if people lacked the capacity to make informed choices.

The people we spoke with told us they were happy living in the home, some of whom had lived in the home for many years One person told us, ' It's much better than the other place I was in.' People told us they received the care and support they needed from kind and caring staff.

Medicines were stored safely and administered appropriately. People told us they received their medicines on time.

There were sufficient staff to meet people's needs.