Archived: Wavertree House

Updated 7 September 2016

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 home, and to provide a rating for the home under the Care Act 2014.

The inspection took place on 1 August 2016 and was unannounced. The inspection team consisted of one inspector. On this occasion we did not ask the provider to complete a Provider Information Return (PIR). This 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. Prior to the inspection we looked at previous inspection reports and notifications that had been submitted. A notification is information about important events which the provider is required to tell us about by law. We used this information to decide which areas to focus on during our inspection.

The home was last inspected in June 2015. We found areas in need of improvement in relation to the detail within care plans and risk assessments, insufficient staffing to meet people’s one to one needs, a lack of mental capacity assessments for people who lacked capacity and insufficient protocols for ‘as and when required’ medicines. The home received an overall rating of 'Requires Improvement'. At this inspection it was apparent that significant improvements had been made.

During this inspection we spoke with seven people, six members of staff, two visiting relatives and the manager. We reviewed a range of records about people’s care and how the home was managed. These included the individual care records for five people, medicine administration records (MAR), four staff records, quality assurance audits, incident reports and records relating to the management of the home. We spent time observing care and support in the communal lounges, observing the lunchtime experience people had, an activities session and the administration of medicines.

Updated 7 September 2016

The inspection took place on 1 August 2016 and was unannounced.

Wavertree House provides accommodation for up to 36 older people. On the day of our inspection there were 31 people living at the home. Wavertree House is a residential care home that provides support for older people living with sight problems, some of whom are living with dementia and diabetes. Accommodation was arranged over three floors with stairs and a lift connecting each level. Each person had their own flat and there were communal lounges, a communal dining room and gardens. The home is situated in Hove, East Sussex. Wavertree House belongs to the provider The Royal National Institute of Blind People (RNIB), which is a national charity.

The home had a manager who was in the process of applying to be the registered manger. A registered manager is a ‘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.

We previously carried out an unannounced comprehensive inspection on 1 and 2 June 2015 and some areas of practice, such as staffing levels to enable staff to spend more one to one time with people, detail within care plan and risk assessments, the recording of mental capacity assessments and appropriate protocols for the administration of ‘as and when required’ medicines, were found to be in need of improvement. At the inspection on 1 August 2016 we found that significant improvements had been made. However, an area that needed improvement related to peoples’ dining experience.

People were happy with the choice and range of food that they were provided with, however, there was mixed feedback in relation to the quality and quantity of food that was provided. When asked if they enjoyed the food, one person told us “Well, that’s a bone of contention, sometimes it’s perfectly alright, other times it is awful”. Another person told us “The lunches are pretty good, it is the suppers that sometimes leave a lot to be desired”. Whilst a third person told us “It’s better than it was, but it is best if I don’t comment”. This is an area in need of improvement.

People’s safety was maintained. They were cared for by staff that had undertaken training in safeguarding adults at risk and who knew what to do if they had any concerns over people’s safety. Risk assessments were personalised and ensured that risks were managed whilst still enabling people to maintain their independence. There were safe systems in place for the storage, administration and disposal of medicines. Some people administered their own medicines. For those that received support from staff, people told us that they received their medicines on time and records and our observations confirmed this.

There were sufficient numbers of staff to ensure that people’s needs were met and that they received support promptly. When asked why they felt safe, one person told us “If there is an emergency you press the button and they’re there”. Another person told us “They check on you every night before bedtime to make sure you’re safe and that is important to me”.

Staff were suitably qualified, skilled and experienced to ensure that they understood people’s needs and conditions. Essential training, as well as additional training to meet people’s specific needs, had been undertaken or was planned. People told us that they felt comfortable with the support provided by staff. When asked if they thought staff had the relevant skills to meet their needs, one person told us “Yes they know what you’re trying to tell them and know what you’re talking about”. Another person told us “The staff are well trained”.

People’s consent was gained and staff respected people’s right to make decisions and be involved in their care. Staff were aware of the legislative requirements in relation to gaining consent for people who lacked capacity and worked in accordance with this. People confirmed that they were asked for their consent before being supported and our observations confirmed this.

People’s healthcare needs were met. People were able to have access to healthcare professionals and medicines when they were unwell and relevant referrals had been made to ensure people received appropriate support from external healthcare services. One person told us “I get to see the doctor straight away, you only have to ask and they’ll get the doctor for you”.

All of the people living in the home had varying degrees of sight loss. The home was adapted to enable people to orientate around the home safely. Although in the process of redecoration, paint colours had been chosen to provide contrast to areas such as doorways and corridors. Coloured and textured flooring enabled people to differentiate between different areas and levels of the building.

Positive relationships had been developed between people as well as between people and staff. There was a friendly, caring, warm and relaxed atmosphere within the home and people were encouraged to maintain relationships with family and friends. People were complimentary about the caring nature of staff, one person told us “They are very good, they are naturally kind and caring”. Another person told us “They’re all lovely girls, you couldn’t ask for a better staff team”.

People’s privacy and dignity was respected and their right to confidentiality was maintained. People were involved in their care and decisions that related to this. Care plan reviews, as well as residents’ meetings, enabled people to make their thoughts and suggestions known. People’s right to make a complaint or comment was welcomed and acknowledged and action had been taken in response to people’s concerns.

People received personalised and individualised care that was tailored to their needs and preferences. Person-centred care plans informed staff of people’s preferences, needs and abilities and ensured that each person was treated as an individual. Staff had a good understanding of people’s needs and preferences and supported people in accordance with these.

People, staff and relatives were complimentary about the leadership and management of the home and of the approachable nature of the management team. One person told us “She’s alright, there is no problem there”. Another person told us “We’ve had a new manager and she is getting things done and trying to do things to make things better for us”. There were quality assurance processes in place to ensure that the systems and processes were effective and people’s needs were being met.