Background to this inspection
Updated
27 January 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was completed by 2 inspectors.
Service and service type
William Wilberforce is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. William Wilberforce is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with the registered manager, senior carer workers, carer workers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with 6 people who used the service about their experience of the care provided and 4 relatives. We reviewed a range of records. This included 5 people's care records and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
27 January 2023
About the service
William Wilberforce is a care home which provides accommodation and personal care for those who may have dementia or a physical disability. The service can support 64 people in one adapted building. At the time of the inspection 62 people were using the service.
People’s experience of using this service and what we found
People who required staff to administer their medicines did not always receive the right support. We could not be assured that staff followed the prescribers’ instructions when administering time specific medicines to people. People were not always offered the opportunity to express to staff if they required pain relief.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.
The provider’s quality assurances systems had not identified the concerns we found during the inspection. The audits in place were not robust and lacked detail to evidence what had been reviewed as part of the audit. Records to support the safe management of medicines and records to show the service followed the principles of the Mental Capacity Act (MCA) were not always completed.
People were happy living at the service. Staff engaged with people in a meaningful way and respected their diversity. Risks to people were assessed and reviewed on a regular basis. Staff were recruited safely and understood the principles of keeping people safe.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection.
The last rating for this service was good (published 25 October 2019).
Why we inspected
We received concerns in relation to staffing levels and seeking medical attention in a timely manner. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for William Wilberforce on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to safe management of medicines and management oversight at this inspection.
We have made a recommendation in relation to the provider following the principles of MCA and regarding analysis of themes and trends related to accidents and incidents.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.