CQC report explained · a residential care home
What the CQC found at Wellington House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some incidents were not investigated to check whether abuse had occurred, and lessons were not always learned. Some risk assessments were out of date, although medicines were stored safely and records showed medicines had been given.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Requires improvement
- People were not always treated with kindness and respect, and care was not always person-centred. Inspectors also saw kind interactions, respect for privacy and support for independence.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Requires improvement
- Management checks had not consistently identified or fixed problems. Care plans, incident records and safeguarding notifications were not always complete or properly overseen.
What inspectors found, March 2022
Rated Requires Improvement; inspectors found caring staff and some safe practices, but concerns about dignity, safeguarding, records and management oversight.
This was an unannounced focused inspection on 16 and 21 December 2021. Two inspectors spoke with four people, one relative and eight staff. They observed interactions and checked care plans, medicines records, staff records and management systems.
People said they were happy living in the home. Staff knew people well, supported independence and respected privacy in some situations. Infection prevention measures, medicine storage and medicine administration records were satisfactory.
However, care was not always respectful or person-centred. Some incidents were not properly recorded, investigated or reported. Care plans and risk assessments were out of date, and staff did not always receive the one-to-one support hours people were meant to receive.
The overall rating fell from Good to Requires Improvement. Safe, Caring and Well-led were all rated Requires Improvement. Effective and Responsive were not inspected at this visit, so their previous ratings were carried forward.
People felt happy
People told inspectors they were happy living in the home. Inspectors also saw friendly and enjoyable interactions between some staff and people.
“People told us they were happy living at the service.” from the report
Privacy and independence
Staff knocked before entering bedrooms and supported people to do as much of their personal care as possible. People were also supported with laundry, cooking and other independence skills.
“People were encouraged to be as independent as possible.” from the report
Medicines records
Medicines were stored safely, administration records had no unexplained gaps, and people were supported to take part in managing their own medicines where possible.
“Medicine administration records (MARs) were signed to show people had received their medicines and there were no unexplained gaps.” from the report
Infection control
Inspectors were assured about infection prevention, the use of protective equipment, testing, visiting arrangements and outbreak arrangements.
“We were assured that the provider was meeting shielding and social distancing rules.” from the report
Incidents and safeguarding
seriousSome incidents were not fully recorded, investigated or reported to the manager, local authority or CQC. The home had not always taken action to reduce the risk of similar incidents happening again.
“Incidents were not always reviewed to determine if there was possible abuse which needed further investigation.” from the report
Dignity and respect
seriousStaff language and some written descriptions of people were not respectful. One person was not supported with changing their bedsheets for weeks, and staff had not considered support with a personal grooming issue.
“The provider had failed to ensure people were always treated with dignity and respect.” from the report
Out-of-date care information
needs fixingSome care plans and risk assessments did not reflect people's current needs or the support being used. Inspectors found missing or outdated information and had some records amended during the inspection.
“However, a number of these risk assessments needed to be updated.” from the report
Management oversight
seriousQuality checks did not always lead to action. The manager was not aware of some incidents, care plan audits had not been recorded, and a known floor risk had not been sufficiently reduced.
“There was a lack of oversight at the service.” from the report
Planned support hours
needs fixingThere were enough staff to keep people safe, but rotas showed days when staffing was below the level needed for planned one-to-one or two-to-one support. The provider was recruiting more staff.
“There were a number of days where staff numbers were below the level needed to provide people with the one to one or two to one support they expected to receive.” from the report
- 01What action has been taken to investigate incidents and report safeguarding concerns since the inspection?
- 02How do you now check that staff speak about and treat people with dignity and respect?
- 03How are care plans and risk assessments kept up to date, and how often are they audited?
- 04Are planned one-to-one and two-to-one support hours now being provided on every relevant shift?
- 05What changes have been made to management oversight, incident records and quality checks?
This was a focused inspection of Safe, Caring and Well-led only; Effective and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 1 March 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, December 2020
Wellington House was rated Good; inspectors found safe care and strong management, but the provider had delayed reporting some significant events.
This was an unannounced focused inspection on 19 November 2020. Two inspectors spoke with five people and five staff, and reviewed care, medicines, recruitment, safety and management records. They also checked infection prevention and control arrangements during the coronavirus pandemic.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safe recruitment, safeguarding procedures, risk assessments and medicines systems. They were assured that infection control measures were in place.
The manager and staff were described as open, supportive and focused on personalised care. The home had effective checks and audits, although there had been a delay in reporting all significant events to CQC. Effective, Caring and Responsive were not inspected during this visit, so their previous ratings were used in the overall rating.
Enough suitable staff
Inspectors found suitable staffing levels and a contingency plan for reduced staffing. Recruitment checks included references, identity, employment history and DBS checks.
“There were suitable numbers of staff available to support people.” from the report
Safeguarding and risk management
Staff knew how to recognise abuse, report concerns and use whistleblowing procedures. Risks such as choking, falls, diabetes and anxiety-related behaviour were assessed and had guidance for staff.
“Staff knew what constituted abuse and poor practice and their knowledge was updated through regular training.” from the report
Medicines support
Medicines were stored, given and disposed of according to procedures. People were supported to take medicines independently where possible.
“Some people required staff to give them their medicines and other people self-administrated, which promoted their independence.” from the report
Positive leadership and culture
Inspectors found an open and supportive management approach. Staff said the atmosphere and teamwork had improved, and inspectors saw respectful and relaxed interactions.
“We observed these values in practice during the inspection.” from the report
Infection control
Inspectors were assured that the home had arrangements for PPE, testing, social distancing, shielding, hygiene and managing possible outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Delayed reporting of significant events
needs fixingThe provider had not always told CQC promptly about all significant events. The home had identified this as needing improvement and had learned lessons, but timely reporting remains important.
“There had been a delay in the provider informing us of all significant events that that occurred at the service.” from the report
- 01What changes have you made to ensure all safeguarding incidents and other significant events are reported to CQC promptly?
- 02How do you maintain safe staffing levels if several staff are unavailable?
- 03How do you support each person to take medicines independently while keeping them safe?
- 04How are people's individual risks, including diabetes, choking, falls and anxious behaviour, reviewed and communicated to staff?
- 05How have you balanced coronavirus restrictions with people's wishes to go out and take part in community activities?
This was a focused inspection of Safe and Well-led, including infection control; Effective, Caring and Responsive were not inspected and their previous ratings carried over into the overall rating. This explanation was written from the published report of 17 December 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Wellington House
4 rated inspections over 5 years: the service has held its Requires improvement rating throughout.
- March 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- December 2020Goodstayed GoodSafe: GoodWell-led: Good
- September 2017Goodup from Requires improvementSafe: GoodCaring: GoodWell-led: Requires improvement
- September 2016Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2014
Registered with the Care Quality Commission on 14 April 2014.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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