Archived: Wells Place Care Home

Updated 18 March 2016

We undertook an unannounced focused inspection of Wells Place Care Home on 17 and 18 December 2015. This inspection was done to check that improvements to meet legal requirements planned by the provider after our comprehensive inspection on 23 and 25 June 2015 had been made. The team inspected the service against four of the five questions we ask about services: is the service safe, effective, responsive and well led. This is because the service was not meeting some legal requirements.

Before our inspection we reviewed the information we held about the home and the action plan given to us by the provider following our previous inspection. We also reviewed information from other professionals and the public since the last inspection.

The inspection was undertaken by one inspector and an expert by experience in the care of older people. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We spoke with six people living in the home and seven visitors which included people’s relatives or representatives. During our inspection we also spoke with the registered provider, an acting manager from one of the provider’s other locations and eight members of staff, which included nurses, care workers and ancillary staff.

Due to their needs, some people living at Wells Place were unable to share their views. We observed the interaction between staff and people living at the home and reviewed a number of records. This included six people’s care records, the provider’s quality assurance systems, service improvement plan, records relating to staff training, supervision and appraisal and staffing rotas.

Following our inspection the acting manager sent us additional information about staff training and supervision which we requested.

Updated 18 March 2016

We carried out an unannounced comprehensive inspection of this service on 23 and 25 June 2015. Breaches of legal requirements were found in relation to person centred care, safe care and treatment, good governance and staffing. As a response to this, the provider wrote to us to say what they would do to meet legal requirements in relation to these breaches. We undertook this focused inspection on the 17 and 18 December 2015 to check they had met the legal requirements. Whilst the provider has made some improvements, we found they had not fully met their own action plan. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Wells Place Care Home’ on our website at www.cqc.org.uk

Wells Place Care Home is registered to provide accommodation and nursing care for up to 42 older people, some of whom are living with dementia. Accommodation is arranged over three floors, with access to the lower and upper floors via stairs or a passenger lift. 38 people were using the service at the time of our inspection.

At the time of this focussed inspection a registered manager was not in place. An operations support manager for the provider was temporarily fulfilling the role as manager of the home. 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.

People living at Wells Place Care Home had needs relating to living with dementia, mobility and general health. We were not assured that staff had the skills and knowledge to meet these needs. Staff had not received all the training they needed to deliver care safely and effectively. There were inconsistencies in staff’s experience of training, supervision and support. We found that care practices were not effectively monitored to identify shortfalls in staff performance.

People who used the service and their relatives were complimentary about the conduct of staff and improved staffing levels. However, because improvements were needed in staffing skills and knowledge in supporting people with dementia, people were not always provided with meaningful activities to meet their needs and reduce social isolation. Areas in the home were not suitably designed for people living with dementia.

The service had taken action to review records about people’s care and this was still in progress at the time of our inspection. Care plans for people reflected their identified needs and the associated risks. Further work was required to embed and sustain the practice of effective care planning.

We saw new aspects of quality assurance and there were some systems in place to look at the quality of the service. However, the service required sustained and effective leadership to maintain this and provide guidance and stability to staff.

Following our inspection the provider informed us they had placed a voluntary embargo on new admissions to the home. In addition, the local authority safeguarding team and commissioners had begun action to review people’s care.

At this inspection we found continued breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014. We also identified a new breach in relation to managing complaints. You can see the action we have told the provider to take at the end of the report. We will carry out another comprehensive inspection to check on all outstanding legal breaches.