Widecombe House

Updated 15 April 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by one Inspector.

Service and service type

Widecombe House 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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Prior to the inspection we looked at the information we held about the service. This included feedback or notifications which the provider is required to send to us by law. We also sought feedback from the local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used this information to plan our inspection.

During the inspection

We spoke with eight people who lived at the home and five visitors to the home about their experience of the care provided. Some people living at the home were unable to talk with us. We used the principles of 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 spoke with six members of staff including the registered manager, deputy manager, care staff and the activities co-ordinator. We also spoke with three visiting health professionals.

We reviewed a range of records. This included four people's care records and multiple medication records.We looked at three staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, including governance systems, policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found and provide additional evidence. Following the inspection we were contacted by three health professionals and nine friends and relatives of people living in the home who shared their views of the service people received.

Updated 15 April 2020

About the service

Widecombe House is a residential care home that provides accommodation and personal care for up to 18 older people. At the time of our inspection there were 18 people were living at the home.

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

People, their relatives and health professionals told us people living at Widecombe House were well cared for and staff were respectful, kind, and caring. People's rights to privacy and dignity were understood and promoted by staff.

People told us they felt safe. Staff were trained in safeguarding and knew what to do if they were concerned about the welfare of any of the people who lived at the home.

People continued to receive care that was personalised, responsive to their needs and effectively delivered to ensure the best outcomes were achieved. People were placed at the centre of their care and staff developed strong relationships with people and fully understood what caused each person stress or anxiety. Staff involved people and their relatives in their care and support, so they felt consulted, empowered, listened to and valued, which achieved good outcomes for people.

Staff were passionate about helping people to live happy and fulfilled lives. The home developed and provided meaningful activities for people tailored to people’s individual hobbies and interests. Staff understood the importance of meaningful occupation in helping people to maintain their independence.

Staff continued to demonstrate a strong commitment to supporting people to receive a comfortable, dignified and pain-free death. Staff understood the importance of spending time with people to comfort and reassure them whilst respecting their individual wishes. The home received many letters and cards sent by relatives thanking staff for the care, compassion and support they gave to their loved ones at the end of their lives.

Risks to people's health and welfare were assessed and care plans were in place to manage and mitigate the risk. Where people had risks associated to their health needs care plans did not contain sufficiently detailed information to guide staff. However, staff we spoke with were knowledgeable about these health needs and had received training in these areas. We made a recommendation to the provider to ensure records contain sufficient information for staff to follow.

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 supported this practice. The principles of the Mental Capacity Act (MCA) were followed. However, improvements could be made within the home regarding the way best interests decisions were recorded. We made a recommendation to the provider about this.

People received care from staff who had received suitable training and induction. There were sufficient numbers of staff on duty to meet the needs of people living at the home and spend quality time with them. During the inspection visit we observed staff had the time they needed to support people safely. If people needed assistance this was provided promptly, and staff were always present in communal areas to observe people and keep them safe.

Appropriate recruitment procedures were in place to help ensure only suitable staff were employed.

Records showed people were referred to the appropriate health care professionals when necessary and that their advice was acted upon. This meant people were supported to maintain good health.

People were very complimentary about the meals provided at the service. Mealtimes were a social affair and meals were enjoyed in a calm and relaxed environment. Where people were at risk of poor nutrition, advice from health care professionals was sought and their recommendations followed.

People received their medicines safely and as prescribed. Appropriate arrangements were in place for obtaining, recording, administering and disposing of prescribed medicines.

People, relatives and staff expressed a very high level of confidence in the leadership and management of the home. Comments included, “The management are lovely. You never feel as if the home is ‘managed’, it’s very personal, more like a home” and “It’s managed well. The care is being provided to a high level even when they [managers] are not here and that’s a sign of good leadership.”

People and their relatives were listened to and there were systems in place to obtain people's views about their care. People and relatives were encouraged to provide feedback on the service and felt they could raise concerns.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 19 August 2017).

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.