Archived: RNIB Wavertree House

The Care Quality Commission (CQC) last inspected RNIB Wavertree House in July 2014. At this inspection we found the service was in breach of Regulation 20 of the Health and Social Care Act 2008. This was because care records were not accurate or fit for purpose.

During the inspection, we spoke with the registered manager, deputy manager, two care staff and four people who lived at the home. We spent time reviewing eight care plans in details.

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is it effective?

Individual plans of care were devised and developed. These were comprehensive focusing on the health and social care needs of the person. Care plans looked at specific areas of care including personal care, nutrition, communication, and visual and sensory impairment.

Care plans had been reviewed and updated. Where people's care needs had changed, this was incorporated into the care plan. Staff told us care plans were sufficiently detailed and updated regularly. People we spoke with confirmed they were aware of their care plan and care staff regularly read them their care plan.

Risks to people were assessed and individual risk assessments developed. Risk assessments looked at specific areas of people's needs. These included; falls, aggression, and mobility.

Not all care plans had been updated to reflect whether the person was involved in the formation of their care plan and agreed with the content. Care plans did not consistently reflect whether people agreed with any changes to their care plan or how their care was delivered. We have identified this as a provider may wish to note.

We spoke with six people who used the service. We also spoke with the registered manager, deputy manager, three care workers, care supervisor, activities coordinator and laundry worker.

Below is a summary of what we found. The summary describes what people who used the service and the staff told us, what we observed and the records we looked at. If you want to see the evidence supporting our summary please read the full report.

Is it safe?

Systems were in place to make sure that all staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. Feedback was sought from people which helped the home develop and learn.

The service was clean and tidy. We found that shortfalls highlighted at the last inspection of the service had been addressed and people were safeguarded from the risk of cross infection.

People spoke positively about the cleanliness of the home. We saw that dedicated housekeepers were employed. The home had a quality assurance framework in place to monitor standards of cleanliness and infection control.

The premises were safe and well maintained. We saw that staff had regularly tested safety equipment such as fire alarms. Floors and carpets were in good condition, which minimised the risk of people tripping.

Call bells allowed for people to summon assistance. People we spoke with commented that their call bell were answered promptly by care workers.

Is it effective?

People had their care needs assessed and staff understood what people's care needs were.

Before someone moved into the home, a pre-admission assessment took place. This allowed for the home to meet with the person and ensure they can safely meet their care needs.

People received appropriate support from healthcare professionals when required. Examples seen, included referrals to other professionals such as GPs, speech and language therapists (SALT) and the district nurses.

Care plans were not always correct and fit for purpose. The home did not consistently review care plans on a monthly basis. This meant that information for not available to care workers to provide the care required. We have asked the service to take action.

Care plans did not always demonstrate that the person was involved in their care plan and agreed with the content. We have asked the service to take action.

Is it caring?

People we spoke with commented that they were treated and privacy and respect. One person told us, 'They always knock before they come into my room.'

Care workers we spoke with demonstrated a sound understanding of the principles of privacy and dignity.

The service employed dedicated activity coordinators who organised daily events. We saw that people were encouraged to participate but could also request activities to engage with.

People were wearing hearing aids, glasses and footwear of their choice. We saw that people had their hair neatly done and people were dressed in accordance to their individual preference and lifestyle choice.

Is it responsive?

There was a complaints policy and procedure in place if people or their representatives were unhappy, which was monitored by the provider.

People we spoke with felt confident in approaching members of management with any concerns.

Where people's health had deteriorated, we saw that the home took appropriate action. We saw that the home worked closely with district nurses, GPs and other healthcare professionals.

Resident and staff meetings were held to explore how positive changes could be made.

Is it Well-led?

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

The home had a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continually improving.

Staff had the necessary knowledge, skills and experience to meet the needs of people at all times.

Following receipt of concerning information about the delivery of safe care and claims that there were insufficient numbers of staff to meet the needs of the people who used the service, we carried out a responsive inspection.

During the inspection we spoke with six people who used the service and seven members of staff, these included the area manager, assistant manager, four care workers, a domestic care staff and a supervisor.

We observed the delivery of care and treatment of people. People we spoke with confirmed they were happy at RNIB Wavertree House. One person told us, 'It's wonderful, I'm so impressed.'

Staff we observed had an understanding of the support needs of people who used the service and were confident about meeting those needs. We found that the documentation used for care planning had been reviewed recently, was detailed and person centred.

We saw that the service was kept clean however, there were still not effective systems in place to reduce the risk and spread of infection.

During our inspection we looked at staffing rotas and observed levels of staffing. We also spoke with staff members and people who used the service. We saw that the service had enough qualified, skilled and experienced staff to meet the needs of people.

There were 28 people who used the service at the time of our inspection. We looked at supporting care documentation and staff documentation. There was not a registered manager for the service. We spoke with the manager, the deputy manager, two senior care workers, three care workers, an activities co-ordinator, seven people who used the service and a visiting relative. We observed care workers supporting people in the service.

This told us people's care needs had been assessed and reviewed, and care and treatment had been planned and delivered as detailed in their individual care plan. Comments received from people who used the service included, 'You're in a community, I'm very happy here,' 'It's very good here. What I like is that it's quiet and peaceful,' 'It's good here. The treatment is co-operative here with the manager and the staff,' and 'Best care you can find because it's geared towards the blind.'

All the people we spoke with told us they thought the service was kept clean. However, there were not effective systems in place to reduce the risk and spread of infection.

Appropriate arrangements were in place in relation to obtaining, storing, administering and recording medication. All the people we spoke with told us where their medication had been administered this had worked well.

Records and processes in place ensured staff who worked in the service had the right skills and qualifications to undertake their job. Staff had training and development opportunities and told us they were well supported.

Systems were in place to review and monitor the quality of the care provided.