July VII Limited t/a Wykenhurst Residential Home

We found the following examples of good practice.

¿ People and their family members had been consulted on how visiting arrangements should be implemented at the home. Individual visits were arranged by prior appointment, with visitors consenting to a Lateral Flow Test (LFT) and to wear Personal Protective Equipment (PPE) in line with government guidance and provided by the service.

¿ People also kept in touch with family and friends using video and telephone calls.

¿ Staff completed regular touch point cleaning and the provider had introduced a room disinfection system to ensure the risk of cross infection was minimised.

¿ The layout of communal areas had been reviewed to promote social distancing as much as possible, whilst maintaining a homely feel.

¿ There was a plentiful supply of PPE and overall staff wore PPE in line with government guidance.

¿ There was a three times weekly COVID-19 testing programme for staff and people were tested every four weeks. If people or staff tested positive, they would be required to self-isolate in line with government guidelines.

¿ Staff had received training in Infection Prevention Control (IPC) procedures that included, COVID-19 awareness, donning and doffing and had their competencies assessed through supervision and observations.

¿ The provider was proactive to ensure the IPC policy was current and reviewed when new government guidance was issued.

Wykenhurst Residential Home is a residential care home providing personal care for up to 25 people in one large building adapted from three adjoining Victorian properties. It specialises in supporting older people with mental health needs or dementia who may also have physical disabilities. At the time of our inspection, there were 23 people living at the home.

People’s experience of using this service and what we found

Staff were clear how to identify and report any abuse involving the people who lived at the home. The risks to people’s health, safety and welfare had been assessed, recorded and kept under review. Staffing levels enabled people’s needs to be met safely, and the provider followed safe recruitment practices. The provider analysed and sought to learn from any accidents or incidents involving people. Steps had been taken to protect people from the risk of infections.

People’s individual needs and requirements were assessed with them before they moved into the home. Staff received training and ongoing management support to enable them to fulfil their duties. People had enough to eat and drink and any risks associated with their eating or drinking were managed with appropriate specialist input. Staff worked with community health and social care professionals to ensure people’s needs were met and their health monitored. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were caring and friendly towards the people they supported, and encouraged people and their relatives to have their say about the care provided. People were treated with dignity and respect at all times.

People’s care plans provided staff with clear guidance on their individual needs, and encouraged a person-centred approach. People were supported to participate in a range of social and recreational activities. People understood how to raise any concerns or complaints about their care. People’s wishes and choices about their end of life care were established with them.

The management sought to engage effectively with, and involve, people, their relatives and staff. Staff felt the management team were approachable and supportive. The provider had quality assurance systems and processes in place to help them monitor and improve the quality of people’s care. Staff and management understood the need to promote equality and diversity in their work and consider people’s protected characteristics.

Rating at last inspection

The last rating for this service was good (published 12 October 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Wykenhurst Residential Home provides accommodation and personal care for up to 25 people with mental health needs. There were 23 people living at the home when we visited.

A registered manager was in post and present during our inspection. 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.

Staff lacked knowledge of the implications of the Mental Capacity Act 2005 for their work with people. The provider had not fully assessed whether people living at the home were being deprived of their liberty in order to make associated applications to the local authority.

People were protected by staff who had been trained in how to recognise and report abuse. The risks to people had been assessed, recorded and managed. The provider organised their staffing requirements based upon people's needs and followed safe recruitment practices. Systems and procedures had been put in place to ensure people received their medicines safely.

Staff participated in an ongoing programme of training, and had the necessary skills and knowledge to meet people's needs. People had the support they needed to eat and drink, and any associated risks had been assessed and managed. Staff helped people to maintain good health, and requested professional medical advice and treatment as necessary.

Staff adopted a caring and compassionate approach towards their work. People were able to express their views about the care provided on a day-to-day basis. Staff treated people with dignity and respect.

People received care and support that was tailored to their needs. People's relatives were involved in the care planning process. People knew how to complain and benefitted from the key worker system in use. The provider actively sought feedback on the service and responded to this.

The provider promoted an open and inclusive culture within the service. People and their relatives found the management team approachable. Staff felt well-supported by the management team and able to challenge practice. The registered manager understood their responsibilities. The provider had developed and implemented quality assurance systems to drive improvement.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found.

Is the service safe?

People who lived in the home and their relatives told us they were pleased with the care provided. They told us their views were respected and listened to.

We saw that people's medication was managed appropriately so that they received the right medication at the right times.

We saw that there were enough staff to attend to people's needs.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one.

Is the service effective?

People told us that they were happy with the care they received. One person said, 'It's good' and another said, 'It's fabulous'. They told us that the provider, the registered manager and the staff had asked them what their needs were and how they would like them met. A relative said, 'They talk to me and xxx about their care'.

Care records confirmed people's needs and preferences had been recorded and care and support had been provided in accordance with their wishes.

People told us they were happy to talk about their personal problems and preferences with staff. They said that staff obtained help for them if they were unwell. This meant people were helped to keep in good health, have access to health care services and received ongoing support.

Is the service caring?

People we talked with told us staff took the time to find out about their background. Staff we talked with knew people's needs well and how they wanted to be supported. This meant that staff cared about the person as an individual and were concerned about their well-being.

People that we talked with told us that they found the provider, registered manager and the staff easy to approach about any issues they had. This meant that people were listened to and they felt that their views mattered.

Is the service responsive?

People had been assessed before they moved into the home so that arrangements could be made to meet their needs.

People and their relatives told us they talked with the provider, the registered manager and the staff about what was important to them. They talked the about activities they took part in and their meals. They told us that their support packages had been changed to include their wishes.

Is the service well led?

We found that the management and staff treated people with compassion, dignity and respect. Staff we talked with showed they understood those values as they discussed how they supported people. This meant the service promoted an open culture that was centred on the individual and helped them to take control of their life as much as they were able.

The provider had systems in place to assess and monitor the home so that potential improvements in meeting people's care needs could be identified and put into place.

People told us that they felt able to raise any issues with the owners, the manager or staff should they have any concerns. Staff spoke of their awareness of how to keep people safe from harm. Staff told us about the training that the home had arranged for them to attend so that they would recognise abuse and how to report it.

People told us that staff were always available when they needed help. They said that the staff were friendly and always acted professionally. One person said, 'This is my home. I live here' and another said 'I love it here'.

People who used the service said that they were well looked after. They told us that the staff always asked them how they would like things to be done, always respected their privacy and treated them with respect. They said staff talked to them about how they liked their support to be provided.

Staff provided health and social care support well. Community services were accessed to support people when necessary.

People told us that they felt able to raise any issues with the manager or staff should they have any concerns. Staff spoke of their awareness of how to keep people safe from harm. Staff told us about the training that the service had arranged for them to undertake so that they would recognise abuse and how to report it.

People told us that staff were always available when they needed help. They said that the staff were friendly and always acted professionally. One person said, 'Yes, they're pretty good here' and another said, 'They are very good to me here'.

People we talked with said their comments were listened to. The service's management held regular meetings with the people who use the service to find out what people thought about how their care was delivered.

You can see our judgements on the front page of this report.