Wensley House Residential Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

There were enough staff on each shift to keep people safe and meet their needs. Staff had been trained although further specific training in areas such as dementia was required to ensure staff met people’s individual needs. There was evidence that learning was taken from individual incidents and adverse events, accidents and incidents were investigated. Staff knew how to recognise and report abuse or poor practice. Risks to people's safety and wellbeing had been assessed and mitigated. People lived in a safe, clean environment and received their medicines in a safe way and as prescribed. There were systems in place to ensure people were protected against the risk of infection.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s experience of care and support had continually improved as the provider and registered manager had acted on feedback, listened to concerns and sought to improve the lives of people living in Wensley House. Relatives we spoke with had positive involvement around incidents and safeguarding and felt there was an ‘openness’ in the home. One relative confirmed this approach saying, “The manager kept me informed when [person] required medical support. I would say they went well over and above the call of duty and genuinely cares about the welfare of the residents.”

Staff said they had opportunities to discuss and review incidents and reflect on their practise. One staff member said, “When there is a concern or a safeguard, for example we had a resident that fell twice in one night, we were kept informed about the safeguarding in the handover and discussed why it happened.”

The registered manager told us, “We have a weekly multi-disciplinary meeting held online on a Wednesday. The Community Matron visits weekly, and we have the support of the dementia and frailty team who have allocated a worker to us who we can contact when we need. District nurses We also work closely with our Local Authority, though social workers, the safeguarding team, quality assurance officers and our contracts manager. All these partnerships help us to reflect on changes or incidents and further develop our practise.”

A health professional told us, “We work with Wensley House to provide support the home in avoiding unnecessary hospital admissions.” They achieved this by constantly reviewing and reflecting on people health needs, incidents, discussing symptoms, causes and identifying solutions. Health professionals all told us that as a result of a shared, open, consultative approach, unnecessary hospital admissions had been avoided. This demonstrated a commitment to continually identify and embed good practices.

The provider had systems in place to continually identify concerns, ensure these were investigated and learnt from, to help reduce the risk of them from happening again. Staff were able to share with us specific incidents or safeguarding outcomes and learning. However, we have reported in the Well Led domain that the provider did not routinely share with staff trends, patterns or formally have lessons learned as a routine meeting discussion.

People’s needs were assessed prior to moving to the home and reviewed when they moved into the service. This helped ensure the risk assessments and care plans were current and relevant. Relatives told us when people had moved to Wensley House they had settled into their new home positively, and where prior to this they had a number of health concerns, these had quickly improved in Wensley House. One relative said, “My [relative] recently moved from another home which was found to be underperforming. Wensley house is a complete contrast; a step-change for improvement in my [relative’s] care.” A second relative said, “I am extremely satisfied with the way my [relative] has been treated since arriving at Wensley House. We have had a few times when they were very poorly but this has always been picked up very quickly and the right care has been given. [Registered manager] has always kept me up to date with everything.”

Staff spoken with and the registered manager told us about the range of checks in place before a person moved in. These included initial enquiries, feedback with relatives and visits to the person for pre-admission assessments. People and their relatives were further encouraged to visit the service before their admission and to keep in contact to report any changes. One staff member said, “I initially review the resident's reference and admission information when they join our service, and then I speak with them to learn more about their preferences. In the care plan, I will update my observations and results.”

Health professionals who supported the home were overall positive. They said staff worked well with them, referred people when needed and maintained a continuity of care to benefit people’s health needs. One professional said, “Staff have been very proactive with one person, for example calling the GP, paramedics and the mental health team when needed. This person is new to the care home, but the manager already knows a lot about them and has been trying different ways to engage with them and always asking for medical checks.” A second visiting professional said, “Wensley house staff have worked hard to complete training and become competent to carry out care in order to support their residents. They have been extremely supportive and only work within their competencies and confidence. This provides continuity of care to people. We also run clinics once a week. The purpose is to assess people for acute illnesses and work in partnership with their GP and staff team to provide care to residents of Wensley house to support the home in avoiding unnecessary hospital admissions.” Overall, the staff team worked positively and pro-actively with health professionals to identify and mitigate risks to people’s health, improving the consistency and continuity of care they received.

Processes were operated to ensure people’s needs were assessed and known when they moved into the home. People were supported to access the health care support they needed, when they needed this. Guidance given by health professionals was available to staff so they could act on it. People had a hospital passport which contained key information about their health to share with health professionals. However, we found examples where a risk assessment had identified a health need but was not documented within the care plan. For example, epilepsy in one person record. The provider was aware of the omissions and was in the process of acquiring and updating all records to a new electronic care planning system. Staff were aware of the undocumented risks, and treatments to manage those were in place.

People told us they felt safe living at the service which was confirmed by all relatives spoken with. One person said, ““I feel very safe here, before was not so good, but since I moved things are better and I am not worried living here.” People and relatives told us staff supported them with kindness and care, that staff were approachable, warm and kind. People and their relatives told us they would speak with staff if they were unhappy or had concerns. One relative said, “This is the first time for years that I have not had to worry about their safety.” A second relative said, “I have been very happy and completely satisfied with the care and support provided by Wensley House. I feel my [relative] is very safe living there.”

Staff were knowledgeable about how to recognise potential harm or abuse and how to raise those concerns. Staff received training in safeguarding and told us they knew how to keep people safe from avoidable harm. One staff member said, “I feel safe working at Wensley House. When there was a concern, for example we had a resident that fell twice in one night, we were kept informed about this through handover. If I have safety concerns, I will discuss it with the seniors and the [registered] manager, and the issues will be addressed.”

Throughout our visit we observed people were comfortable around staff. People were relaxed with the staff and their appeared to be a positive rapport between them. Staff were attentive and mindful of people’s assessed safety risks, such as reduced mobility but they were kept safe because staff were present, and equipment was appropriately used to enable them to freely access the building.

There were processes to monitor, report and escalate concerns about people’s safety. Safeguarding information was prominently displayed for people, visitors and staff to see. The contact details of external agencies that staff could report their concerns to were displayed openly in the home. Concerns were reported to the local authority appropriately and the registered manager worked openly with external professionals to minimise the risk.

People and where appropriate, their relatives were involved in managing their individual risks to ensure care met their needs in a safe way. One person said, “I am well looked after, [registered manager] visited me to do an interview. There were dozens of things they wanted to know about me, it was very thorough. Then when I moved here, they asked again, just to check things were the same. If I need to see a doctor or the nurse, then they are very quick to get that done and keep me up to date. I think I am well looked after; I don’t worry much about that.” Relatives said staff knew how to keep their family member safe, and were communicated with well about their family member’s care, with any changes or incidents also being reviewed with them.

Staff recognised risks to people and were consistent in their knowledge as to how they supported people to mitigate risk in the least restrictive way. People were supported to do the things they wanted to do, and staff helped them to do this safely. Staff said that nights can be challenging for people living with dementia as they can be awake at these times, some not being aware it is night. One staff member said, “During the night shift, if residents are still awake, we do listen to music and dance, we have little tea parties, the resident will have visitors sometimes they visit at nine or ten o’clock at night.” This demonstrated that person centred care was provided in a way that was safe and supportive and enabled people to do the things that matter to them.

We saw staff supporting people safely around the home and engaged with them through a range of activities. For example, a group dancing activity and numerous 1:1 moments where staff spent time talking and acknowledging people. Staff were patient and proactive in supporting people, identifying when people may be unsettled or anxious. We observed them swiftly identify this change and support people until they were again settled and content. People’s care plans and risk assessments were personalised when completed with a good understanding of the person’s needs and how to meet these. However, some records needed strengthening or completing which we have referenced elsewhere in this report.

Incidents and accidents, changes to people health, wounds or bruises were reported to the management team in a timely way. This meant that prompt reviews of their care were then taken, and families kept informed as things changed. When needed, referrals were made to health professionals for follow up. In addition to daily monitoring, staff carried out regular reviews to ensure care plans and risk assessments remained relevant and up to date.

People said they felt safe living in Wensley House. People did not express any concern in relation to the safety of the environment. One person said, “The building is well looked after. There is a lift which always works so I can get about the house and if anything needs fixing then [maintenance] is on it.” Relatives also did not raise concerns about the safety of the premises.

Staff were aware of what to do in the event of a fire and took part in regular fire drills. One staff member said, “I was part of fire drills and we have been trained. The senior in charge of a shift is the fire Marshall, I know what to do in case of fire at Wensley House.” A second staff member said, “The fire marshal is the senior on duty or the manager, I have attended a fire drill and been present at a real fire evacuation.”

The environment of the home appeared safe and well maintained. Equipment had been installed following a recent legionella finding and regular testing was in place. We saw the maintenance staff carrying out routine checks of equipment and around the service and making repairs where needed. People had access to a secure garden area and a choice of communal areas to use throughout the day. Key coded access meant people were secure in the home in line with their assessed interests.

Premises and fire safety checks had been carried out to ensure the premises was safe to live in. The home manager described the environmental checks they carried out when they did the daily walk around the building and anything they noted of concern was acted upon immediately. We observed the home was safe to live in. The home was clean and tidy, which ensured people were able to move around the home safely. Work was being carried out where needed to ensure the home was safe to live in.

Although fire drills were carried out as required, the registered manager was reminded they also need to carry out a simulated evacuation. Simulating the evacuation of the various compartments against the clock gives them the length of time it would take to evacuate in an emergency. The registered manager said they would act and where needed substitute people with staff who would be unable to take part.

People were supported by sufficient numbers of staff who they felt provided them with safe care that met their needs. One person said, “There is enough staff, we don’t need to wait for long periods when we ask for something, the staff know what they are doing, and doesn’t change. Some of them have been here as long as I have which is reassuring and tells you they are happy in their work.” A relative also commented that there were enough staff. They said, “There appear to be sufficient staff during the day and weekends. When my relatives have had problems during the night, the night staff have always dealt with it appropriately and informed me in a timely manner.

Staff felt supported by the management team. They, said they felt they had the skills to provide care safely and effectively and had the training needed to carry out their role. The registered manager explained the process to us and said, “Staff receive supervisions in which they are given constructive feedback about what they are doing well, where they can improve, and how we will support them. They are also encouraged to share any concerns that they have, confidentially if needed, and also any support they need from us after discussing their own goals and aspirations and how they better feel empowered in their role.” Staff agreed with this approach with one staff member confirming this saying, “I have received all the mandatory training I need to help me improve my work. I have supervision to help me know whether I am improving or not through feedback in my supervision.”

Staff were responsive and attentive to people's needs and requests and supported people at their own pace. They were not rushed and took their time to ensure the support and assistance given was appropriate and completed. When staff assisted somebody, they remained with them without distraction until completed. When staff carried out care related tasks such as transfers or use of equipment they did so with calmness, authority and competence. People were at ease when staff assisted them which suggested they carried out the task competently.

The management team had not carried out regular competency assessments to ensure staff had the skills to keep people safe from harm and risk. Although we found this had not negatively impacted people’s safety or care, a competency assessment evaluates a staff members knowledge, understanding, and skills in areas such a moving and handling, medicines and safeguarding. The registered manager acknowledged this was a continuous process and would takes steps to ensure this was part of supervision and development and took immediate steps to introduce this.

We identified some gaps in training when reviewed against people’s assessed needs. For example, risk assessments identified areas such as choking, epilepsy and dementia as needing support and monitoring. Staff had not received training to an appropriate level to meet those assessed needs. They took immediate steps to organise training in these areas, and staff confirmed that training in areas such as dysphagia had been booked.

People lived in a clean environment and were protected from the risk of infection. One person said, “I think this home is very clean. Not like where I was before, that wasn’t clean one bit, but I like it here, it is bright and fresh, my room is ever so comfortable.” A second person echoed this view and said, “My room is kept clean in fact my room is spotless, so is the whole place. The cleaners do a fabulous job I think.”

We saw throughout our visit that the home was clean, bright, and free from malodour. Personal protective equipment [PPE] was available to staff, and we observed that staff were using it correctly. There were hand washing facilities available with clear guidance to use properly and clinical waste was securely stored in lockable bins. The sluice area was kept locked when not in use with cleaning materials securely stored. Domestic staff were observed to use appropriate cleaning products when carrying out their duties and were quick to respond when additional cleaning was required.

There had been a recent legionella outbreak within the home that was being managed by other external organisations. That did not form part of this assessment as actions were underway to address that and instal equipment to protect against a recurrence. Staff had received relevant training in infection control and had access to up-to-date policies, which reflected best practice guidance. Staff understood the actions to take if an infection broke out. Cleaning schedules were in place for routine daily cleaning and additional deep cleaning when needed. Regular audits were undertaken to ensure the areas of the home were maintained to a good standard.

People and relatives told us staff gave them their medicines at the required time and ensured these were taken as prescribed. One person said, “I always get my medicines, they bring them in and wait for me to take them. They even explain to me what they are for as I forget sometimes.”

Staff said they received training to manage and administer medicines and this was regularly updated. The registered manager told us the GP assigned to the service rarely visited, which impacted medicine reviews. They said that as an example, antipsychotic medicines were reviewed, but at the request of the staff, not following national guidance about the use of such medicines. The registered manager said they had escalated this to the local authority integrated care team who oversee GP surgeries to find a resolution. Overall, the registered manager said there could be a lack of communication between different health professionals, which although not the fault of the home, may impact some living there.

People were assessed to ensure they were safe to manage their own medicines, and where they could, people were able to do so. Medicines were stored, administered and disposed of safely. Medicines were stored securely, in a temperature controlled environment. Clear records were maintained of medicines that were administered. Medicines were managed by senior care staff who were trained and assessed when their training concluded to ensure they were safe to administer unsupervised. There were checks of medicines and audits to identify any concerns and address any shortfalls.