The inspection of Wheatley Lane took place on 18 January 2018 and was announced. We gave short notice of our inspection because we wanted to make sure we were able to meet people who used the service. The last inspection of this service was in April 2015 when the service was rated as good. Wheatley Lane is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Wheatley Lane comprises three two bedroom terraced houses which provide people with individual bedrooms and shared bathrooms, lounges and kitchens. The home is registered to provide accommodation for up to six people but only five beds were being offered for occupancy at the time of our inspection. On the day we inspected there were two people living in one of the houses and one person in each of the other two.
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.
Staff were not clear about events which needed to be reported under safeguarding procedures and we found some issues had not been reported as needed.
We found inconsistencies in risk management. We saw some risk assessments had been well completed and the risk managed well. However risk assessments had not always been put in place as needed.
Systems were in place to make sure the environment was safely maintained and infection control practices were robust.
Medicines were managed safely.
Staffing levels were appropriate to meet the needs of people. Safe recruitment procedures were followed and people who lived at the home were involved in the recruitment process.
Staff received good support and staff told us the training was effective.
People were supported to have choice and control of their lives but we found little evidence of people being involved in the development or review of their care plans and care documentation lacked the person centred approach we observed staff deliver.
Where appropriate, the registered manager had made application for Deprivation of Liberty Safeguards (DoLS) authorisations. However specific conditions documented on the authorisations had not always been met We recommended that systems be put in place to audit compliance with DoLS conditions to make sure they were met.
People told us the food was good and they had plenty of choice.
We found people accessed health and social care services as needed.
Staff were considerate, caring and friendly in their approach. People told us they were very fond of the staff and that they were respectful of their privacy and dignity needs.
We found inconsistencies in care records. For example some care plans were detailed and up to date whilst others did not fully reflect people’s needs, abilities, goals and aspirations. We also found a lack of documentation available in formats suitable to people who used the service. We recommended the approach to person centred care be reviewed to make sure care plans fully reflected people’s current needs, goals and aspirations and the involvement of people living at the home.
People had access to a range of social and recreational activities within the home and the local community. People told us about clubs and activities they attended and how they were supported to make lifestyle choices. Transport was available to support people in accessing activities of their choice.
People were supported to maintain and make friendships.
Systems to audit the quality of service were in place but we found these were not always effective in identifying issues and therefore driving improvement.
We found two breaches of regulation in relation to safeguarding people and good governance. We made recommendations in relation to consent (management of DoLS authorisations) and person centred care.
You can see what action we told the provider to take at the back of the full version of the report.