Background to this inspection
Updated
5 January 2024
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.
This was a targeted inspection to check on a concern we had about the effectiveness of the provider’s systems and processes to keep young people who lived at Wellfield safe. The ratings from the last inspection have remained the same.
Inspection team
The inspection was carried out by a lead CQC inspector, along with an additional CQC inspector.
Service and service type
Wellfield is a children’s home which is registered with the CQC for accommodation for people requiring personal or nursing care as well as treatment of disease, disorder or injury. Ofsted are the lead regulator for services registered as children’s homes, however, the service was not registered with Ofsted at the time of our inspection.
The service can accommodate two people. The service provides therapeutic psychological support to children and young people with mental ill health and / or additional needs, such as neuro-developmental disorders.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
The inspection was unannounced.
What we did before the inspection
We used a range of information to plan this inspection, including on-going monitoring information such as complaints and concerns about the service, as well as information received from other stakeholders. We also used information that we found during our last inspection.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
We spoke with staff who worked at the service and members of the management team, including the registered manager, as well as professionals from other stakeholders such as the local authority. We also spoke with any young people who lived at the service.
We reviewed a range of information both during and following the inspection. This included important information such as care records, as well as policies and procedures.
Updated
5 January 2024
The published date on this report is the date that the report was republished due to changes that needed to be made. There are no changes to the narrative of the report which still reflects CQCs findings at the time of inspection.
About the service
Wellfield is a residential placement for young people aged 13-17-years with complex emotional, mental health and behavioural needs, as well as neuro-developmental disorders that require specialist psychological therapy and intervention. The provider can accommodate two young people at a time. The provider is currently registered with the Care Quality Commission (CQC) as a care home, for the regulated activities of ‘accommodation for persons requiring nursing or personal care’ (ANPC) (a regulated activity relating to adults aged 18 years and over) and ‘treatment of disease, disorder or injury’ (TDDI). Wellfield does not provide a service for adults, it is a service ‘wholly or mainly for children’, and functions as a children’s home. As such, the regulation of accommodation and care provided by Wellfield is the responsibility of Ofsted, as the regulator for children’s homes.
At the time of our inspection there were two young people using the service.
People’s experience of using this service and what we found
Young people were treated with kindness, compassion and respect by staff. We observed positive interaction between staff and young people, which supported dignity and respect.
Environmental risk assessments were individualised and incorporated into young people’s care plans.
Staff supported young people to explore and embrace their identity and provided care that was sensitive to equality and diversity.
Young people received thorough and detailed assessments, plans and interventions that were individualised to their needs and risks.
All staff at Wellfield were trained in minimum level 2 safeguarding children eLearning, with all leaders and staff involved in care planning trained to level 3. Each level required the successful completion of an assessment for the staff member to be signed off as competent. This level of training was compliant with Intercollegiate Guidance (2019).
Staff had all received accredited training in positive behaviour support and restraint at advanced level before carrying out any direct work with young people.
Young people living quarters were maintained to a good standard or repaired in a timely manner when damage occurred. They had choice and control over the décor of their accommodation.
The management and organisation of most record keeping in Wellfield was good. Recording of medicines administration and the disposal of medicines was not always completed in line with the service’s own guidance and protocol. For example, we saw instances where only one staff member had signed to confirm administration and disposal of medicines, limiting the assurance that young people received their prescribed medicines in a safe, and effective manner; and also not preventing the misuse of unused drugs.
Incidents were not always notified to CQC in accordance with regulatory registration. We found an example where a member of staff had been removed for professional misconduct whilst at work and several examples where notifications were not completed in a timely manner.
We expect health and social care providers to guarantee autistic young people and young people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The provider was able to demonstrate how they would meet the underpinning principles of Right support, right care, right culture:
Right support: Model of care and setting maximises young people’s choice, control and independence. The provider adopted the least restrictive practices underpinned by a positive behaviour approach. Right care: Care is person-centred and promotes young people’s dignity, privacy and human rights. Staff knew young people well and responded to them appropriately and sensitively. Young people took part in activities and pursued interests tailored to them. They gave young people opportunities to try new activities. Staff acted appropriately as advocates for young people when they were best placed to do so.
Right culture: Ethos, values, attitudes and behaviours of leaders and staff ensure young people accessing facilities lead confident, inclusive and empowered lives. Staff understood young people well. They got to know them and considered this a key element of personal care.
Young 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. Any courts orders depriving them of their liberty were adhered to.
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 provider was requires improvement (published 11 March 2021) but was not in breach of regulations.
At our last inspection whilst improvements had been made, the provider was not yet able to demonstrate over a sustained period that management and leadership was consistent, or that staff practice led to good outcomes for young people.
There was no registered manager in post. We were assured that staff would continue to receive oversight from the provider and other members of the senior management team until another manager was appointed.
At this inspection we found management and leadership was much improved with a registered manager now in post.
Why we inspected
We undertook a full inspection of this provider prompted by a review of the information we held about this it.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wellfield on our website at www.cqc.org.uk.
Enforcement
We have identified breaches at this inspection and have issued a requirement notice
You can see the actions we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.