Archived: Waypoints Plymouth

Updated 5 March 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The unannounced inspection took place on 21 and 22 January 2019. On the first day of our inspection, the inspection team consisted of one inspector, an assistant inspector, a registration inspector, a specialist advisor for older persons nursing care, and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who lives with dementia. On day two, the inspection team consisted of an inspector, an assistant inspector and a specialist advisor.

Prior to the inspection we reviewed the records held on the service. This included the Provider Information Return (PIR) which is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed notifications. Notifications are specific events registered people have to tell us about by law. In addition, we also reviewed the providers monthly action plans, which they had been submitting in line with their condition of registration, as well as compliments and complaints.

During the inspection we spoke with seven people and six visitors. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed twenty care plans, as well as two medicine administration files. We also spoke with nineteen staff. This included four nurses, seven care staff, the registered manager, the head of care and the home co-ordinator. As well as the receptionist, the maintenance person, the training manager, the chef, and the Nominated Individual. A Nominated Individual has overall responsibility for supervising the management of the regulated activity and ensuring the quality of the services provided.

We reviewed four staff personnel records and the training records for all staff. Other records we reviewed included the records held within the service to show how the registered manager and provider reviewed the quality of the service. This included a range of audits, questionnaires to people who live at the service, minutes of meetings and policies and procedures.

Following our inspection, we contacted external agencies for their views about the service. Where feedback was received, this can be found throughout the report. Services contacted included, the local authority quality assurance improvement team, the clinical commissioning group (CCG), and a speech and language therapist (SALT). As well as the local authority safeguarding team, the older persons mental health team and Healthwatch Cornwall.

Updated 5 March 2019

We carried out an unannounced comprehensive inspection on 21 and 22 January 2019.

At our last inspection in October 2018 we rated the service as requires improvement. This was because the provider's governance framework, to help monitor the management and leadership of the service, and the ongoing quality and safety of the service, had not been fully implemented. In addition, some newly designed systems had not always been robust in identifying areas requiring improvement. The Commission took enforcement action and imposed a positive condition on the providers registration. This meant the provider was required to send a monthly action plan, telling us what action was being taken to help improve the service. We monitored those monthly action plans to ensure they provided the information required.

During this inspection we looked to see if improvements had been made and that the condition had been sufficiently met. The Commission was satisfied with the progress at the service, therefore the rating changed from requires improvement to good, and the condition was removed.

Waypoints Plymouth is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service is registered to provide residential care and accommodation for up to 64 older people who may also be living with dementia. At the time of this inspection, 53 people were living at the home.

Waypoints Plymouth is owned by Waypoints Care Group Limited. The provider also owns two other care homes in Dorset.

The service had 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.

Significant improvements had been made to the providers governance framework, meaning that checks to assess and review the ongoing quality of the service, were now imbedded. However, some small changes were still required to ensure the system was fully effective.

People had their needs assessed prior to moving into the service to help ensure the service was suitable, and had their health and social care needs met in a co-ordinated way. People had care plans in place and people’s communication needs were known, but care plans were not always accurate. The registered manager told us immediate action would be taken to update care records.

People had the opportunity to participate in social activities. However, the registered manager told us they would review social engagement for people, as we found some people did not always have stimulation.

People’s risks associated with their care were known but not always recorded. Immediate action to update people’s records was taken at the time of our inspection. People’s accidents and incidents were monitored for themes and trends and to help reduce reoccurrences.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service also supported these practices. At the time of our inspection the registered manager was taking action to improve the recording of people’s mental capacity and consent in their care plans.

People told us the quality of the food was nice, with plenty choices available. People had their nutrition and hydration needs met by knowledgeable staff, and people now received support with their meals in a respectful manor.

People were looked after by staff trained to meet their needs. Nursing training and competence had now improved. People were cared for with dignity and respect at the end of their life.

People were cared for by kind and compassionate staff, who not only looked after people living at the service, but extended their warmth to people’s family’s. People’s privacy and dignity was promoted and staff gave people as much control over their own care as possible, by offering choice.

People knew who to complain to. People lived in an environment which had been adapted to their needs and a full-time maintenance person helped to ensure the safety and upkeep of the building.

The Accessible Information Standard (AIS) was known and had been considered. The AIS aims to make sure that people who have a disability, impairment or sensory loss get information that they can access and understand

People told us they felt safe. People were supported by sufficient numbers of staff who had been recruited safely and had undertaken training to recognise any potential signs of abuse.

People’s medicines were managed safely, but the providers medicine checks had not always identified when action was required in respect of equipment.

People lived in a service that was assessed for its overall safety, infection control practices were in place and the provider was proactively trying to diminish all odours within the service.

People were cared for in a service which had a positive culture, and care and support was delivered in line with a core set of values. People, relatives and staff were engaged in the development of the service and felt able to share their views and ideas for improvement.

People, relatives and staff spoke highly of the registered manager and told us, improvement at the service had been noticeable and the provider and registered manager remained strongly committed to improving the service.

We did not find any breaches of regulation, however recommend the provider implements findings from their own research into activities suitable for people with dementia, which takes accounts of people's personal backgrounds and hobbies, individual preferences and abilities to provide personalised, meaningful social engagement. In addition, we recommend the provider takes action to strengthen their governance procedures to help ensure it identifies gaps in record keeping and the checking of medical equipment.