About the service Welford Court Limited is a residential care home providing personal and nursing care in an adapted building. At the time of inspection 14 older people were using the service. The service can accommodate up to 14 people on two floors.
People’s experience of using this service and what we found
Quality assurance and audit processes did not cover all aspects of the service which meant some issues relating to people's care and safety were not promptly identified and followed up. There had been some recent changes to the managerial structure, including a new management level post which needed time to become embedded.
We have made a recommendation about quality assurance and audit processes in the service.
Risks associated with people’s care were assessed and reviewed regularly. We found items in people's rooms such as denture cleaning tablets and prescription cream which were not stored in cupboards. This increased risk to people's safety if others entered the room and accidentally used or consumed these products.
All staff had up to date checks with the disclosure and barring service (DBS). Medicines were administered by trained staff. Protocols were in place for people who received medicines 'as needed' but these were not always up to date. Staff followed infection control practices to reduce risks to people, however, storage of toiletry items in communal shower/bathrooms presented a risk of cross contamination.
Referrals were not always made promptly when people's health needs changed. People did not have mental capacity act assessments and evidence of best interest decisions in place when they were not able to make decisions for themselves, or had fluctuating capacity.
Staff received training suitable for their roles, including specialist training, and were up to date with annual refresher training. Feedback was mixed about whether people felt there were enough activities for them to do.
The service was working on an action plan with the local authority to make improvements in a number of areas. Some improvements had been made to the exterior of the property so there was a level access pathway to the front door. Access to the garden remained difficult from the main living area of the service.
The CQC rating was not displayed on the website and notifications to the CQC of certain incidents did not always take place promptly.
People felt staff cared for them safely. Staff were aware of their responsibilities and how to keep people safe from the risk of abuse. People received care from kind and caring staff who knew them well.
People's privacy and dignity were respected, and their independence was promoted. People received choice in their daily menus and staff were aware of people's dietary needs.
Care files contained a range of care plans which set out people's care needs and how people wanted to receive their care. No complaints had been received in the last twelve months. People and staff felt confident they could raise any issues and these would be dealt with appropriately. People and their relatives were supported to discuss end of life preferences if they wished.
People and staff spoke positively about the registered manager, staff enjoyed working at the service and felt team work and communication was good. People's views were gathered via regular resident meetings and annual surveys. Regular staff supervision had been recently introduced, along with regular team meetings.
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 October 2019).
Why we inspected
The inspection was prompted due to information received from the Local Authority. The Local Authority funded some people’s care and they found the service was not complying with their contract. We decided to undertake an inspection and look at all areas of the service.
We have found evidence the provider is not complying with the requirement to display their CQC rating on their website. We also found evidence that the provider needs to make and embed improvements. Please see the safe, effective and well led sections of this full report for further details.
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.