This unannounced inspection of Wavelly House took place on 26, 27 and 28 April 2016. Wavelly House is a residential care home without nursing. Wavelly House provides accommodation and support for up to six adults, who live with mental health illness, with associated physical and psychological support needs. The service provides 24 hour recovery support to enable people to regain and maintain their well-being and independence before moving to more independent living accommodation. At the time of the inspection the service was providing support to three people. A fourth person moved into the service during our inspection.Wavelly House is a large detached house situated in a residential area close to Basingstoke town centre. The staff office and spacious communal areas are situated on the ground floor, together with a staff sleep in room. This is a bedroom used by the night staff who sleep at the house to provide 24 hour support. The communal areas and bathrooms have been redecorated and refurbished since our last inspection. There is a quiet lounge if people wish peace and quiet and an enclosed garden to the rear of the house.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.
Without exception people told us they felt safe living at Wavelly House and were supported by staff to understand what keeping safe meant for them as individuals. Staff had completed the provider’s required safeguarding training and were able to recognise the different types and signs of abuse. Staff understood their role and responsibility and knew how to report abuse and protect people from harm.
People were protected from harm because staff had identified risks and managed these to keep people safe. People had support plans which assessed specific areas of risk associated to their mental and physical health diagnoses and provided guidance to prevent or mitigate these risks. Staff worked alongside local mental health and social care services to build and promote people’s independence, whilst protecting them from harm.
There were arrangements in place to address foreseeable emergencies, such as a fire or flooding, for example; people had individual evacuation plans, which were tested regularly to ensure people and staff knew what to do in the event of an emergency.
The registered manager completed a daily staffing needs analysis to ensure there were always sufficient numbers of staff with the necessary experience and skills to support people safely. Staff had undergone robust pre- employment checks as part of their recruitment. People were safe as they were cared for by staff whose suitability for their role had been assessed by the provider and people using the service.
People received their medicines safely, administered by staff who had completed safe management of medicines training and had their competency assessed annually by the registered manager. We observed staff administer people’s medicines safely in accordance with their medicine management plans.
Staff completed an induction course based on nationally recognised standards and spent time working with experienced staff. This ensured new staff had the appropriate knowledge and skills to support people effectively.
Records showed that the provider’s required staff training was up to date. Staff also underwent further training specific to the needs of the people they supported, for example; in relation to supporting people’s well-being and mental health needs.
People were supported effectively by staff who were enabled to do so by the provider’s supervision processes. There were documented processes in place to supervise and appraise staff to ensure they were meeting the requirements of their role.
Staff had received training in relation to the Mental Capacity Act 2005 (MCA) and were able to explain the main principles. We observed people were supported to make their own decisions and choices. It had not been necessary for the registered manager to make any applications under the Deprivation of Liberty Safeguards (DoLS), but she was aware of her responsibilities under this legislation and understood the process if required. People’s human rights were protected by staff who demonstrated a clear understanding of legislation and guidance relating to consent, mental capacity and deprivation of liberty safeguards.
People were supported to live independent lives and therefore chose to eat at different times to suit their daily lifestyle. We observed people were supported to consume sufficient nutritious food and drink to meet their needs.
People were able to manage their own healthcare needs with identified support from staff. Records showed that people had regular access to healthcare professionals to maintain their physical health and mental well-being.
We observed that people were relaxed and happy in the company of staff and chose to spend time with them. Staff were supportive and caring to people and had developed positive relationships with them based on mutual trust and understanding.
Support plans were detailed covering all aspect of a person’s care and support. This ensured that people received care and support in accordance with their individual needs and wishes. Staff had responded promptly to people’s health needs and this had led to positive outcomes for people.
People were comfortable speaking with all staff who knew them well, were caring in their approach and made sure their health and wellbeing needs were met. When people wished to discuss sensitive, personal matters with staff they did so in private.
People’s support plans and assessments were person-centred, which means they were focussed on the individual, their needs and wishes. Support plans detailed people’s personal goals they wished to achieve in the short term and long term with a view to being able to live independently in the community. Staff supported people to achieve their ambitions, to seek work opportunities and to participate in activities to help prevent them experiencing social isolation.
Feedback was encouraged from people and family in the form of regular discussion and communication. The registered manager ensured that all complaints, accidents and incidents were investigated thoroughly and any required action identified was implemented promptly.
There was an open and transparent culture within the service where people, relatives and staff were able to raise any issues or concerns with the registered manager. The registered manager was highly visible within the home and provided clear and direct leadership. We observed staff support people with pride and passion, in accordance with the provider’s values, during their delivery of people’s day to day care.
The registered manager effectively operated a system of regular audits to assess and monitor the quality of the service provided, to drive improvements and ensure staff delivered high quality care.