CQC report explained · a residential care home
What the CQC found at Wharfedale House - Care Home Physical Disabilities
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, May 2022
Rated Requires Improvement; inspectors found better care records and personalised support, but concerns remained about agency staffing, checks on quality and leadership.
This was a follow-up inspection after the previous Requires Improvement rating. Inspectors visited on 22 February 2022, reviewed records and spoke with people living at the home, relatives, staff, managers and other professionals.
There was enough staff, but the home relied heavily on agency workers. Some people said agency staff did not know their needs and that they did not always feel safe with them. Medicines records, risk assessments and environmental checks had improved, and the home was no longer in breach of the regulations identified at the previous inspection.
Responsive care was rated Good. Inspectors found that care plans recorded people's preferences, communication needs were considered and complaints were recorded. Safe and well-led care were both rated Requires Improvement because quality checks were not always strong, accidents and incidents were not analysed for patterns, and the home did not yet have a registered manager in post.
Improved risk management
Risks to people's health and welfare had been assessed, with plans to reduce those risks. Environmental safety checks had also been completed and identified problems were dealt with promptly.
“Risks to people's health and welfare were assessed and clear plans put in place to manage and mitigate identified risks.” from the report
Safer medicines records
The home had introduced an electronic system for agency staff to record medicines. Staff who gave medicines had training and competency checks.
“At this inspection we found the service had a system in place for agency staff to record medicine electronically.” from the report
Personalised care
Inspectors found that people's preferences and communication needs were recorded and understood by staff. People had choices about their routines and activities.
“Most people told us there was a person-centred approach with routines flexible depending on people's preferences on any given day” from the report
Complaints led to action
The home kept a complaints log and identified staffing as a recurring theme. It increased afternoon staffing in response to concerns.
“The service had increased afternoon staffing levels in response to the concerns raised.” from the report
Heavy reliance on agency staff
seriousAlthough staffing numbers were sufficient, the home relied heavily on agency workers. Some people said these workers did not know how to support them, and some declined support from them.
“There was enough staff however, the service was highly dependent on agency staff.” from the report
Weak analysis of incidents
needs fixingAccidents and incidents were recorded, but the home had not analysed them for patterns or trends that could help prevent further risks.
“We saw evidence accidents and incidents were being recorded however, there was no overall analysis identifying any patterns or trends which could be addressed” from the report
Quality checks needed strengthening
needs fixingThe provider carried out audits, but some were not robust and improvements needed to become more firmly established.
“However, some of the audits we received were not robust and needed further embedding in practice.” from the report
Leadership still unsettled
needs fixingThe new manager had started to improve governance, but there was no registered manager in post during the inspection. The registration process was still underway.
“The service did not have a registered manager in post.” from the report
Masks were not always worn correctly
needs fixingInspectors saw staff wearing masks incorrectly during the visit. The leadership team said it would address this immediately.
“We observed staff not wearing masks correctly during our inspection.” from the report
- 01How are you reducing the home's reliance on agency staff, and how do you make sure agency workers understand each person's care plan before supporting them?
- 02What has changed in the way accidents and incidents are analysed for patterns and possible risks?
- 03Has the new manager now become registered with CQC, and how are you making sure improvements continue?
- 04What checks now confirm that staff wear personal protective equipment correctly?
This was a follow-up inspection focused on Safe and Well-led; the report says the other key questions were not inspected and previous ratings were used, although Responsive was reported as Good. This explanation was written from the published report of 4 May 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, March 2021
Rated Requires Improvement, with Inadequate well-led arrangements; inspectors found unsafe records, medicines concerns and weak leadership.
This was a focused inspection after CQC received concerns. Inspectors reviewed Safe and Well-led only. They spoke with eight people, four relatives and eight staff, and checked care, medicine, recruitment and management records.
People generally spoke positively about familiar staff. They said staff knew their needs and made them feel safe. Staff were seen using protective equipment, and the home was visibly clean, although cleaning records and some cleaning arrangements needed improvement.
Inspectors found that risk assessments, care records, food and drink charts and weight records were not always accurate or up to date. Medicine records did not always match, and some agency staff had not been shown to have the skills needed for people's complex care.
The overall rating fell from Good to Requires Improvement. Safe was rated Requires Improvement and Well-led was rated Inadequate. CQC found breaches relating to safe care and treatment and good governance, and required the provider to submit an action plan.
Familiar staff
People valued staff who knew them well and understood how they wanted their care provided.
“People told us the best thing about the service was the familiar staff who cared for them and made them feel safe.” from the report
Positive views of care staff
People and relatives were positive about the care provided by staff, including during the pandemic.
“I feel the staff are actual carers. They do actually care for my (relative). The care is very, very good.” from the report
Protective equipment
People said staff used protective equipment, and inspectors saw staff using it in line with coronavirus guidance.
“People told us staff always wore personal protective equipment (PPE) when caring for them and we saw staff wearing PPE in line with guidance” from the report
Safe recruitment checks
The provider carried out pre-employment checks intended to prevent unsuitable staff being employed.
“Pre-employment checks were carried out to protect people from the employment of unsuitable staff.” from the report
Risk and care records
seriousSome risk assessments and care plans did not reflect people's current needs. Daily records, including food, fluid and weight records, were incomplete or inaccurate.
“Risk assessment relating to the health, safety and welfare of people using the service had not be completed, reviewed regularly or included in management plans.” from the report
Medicine safety
seriousPaper and electronic medicine records did not always match. There were also concerns about timing, staff signatures and the recording of creams.
“The provider had failed to ensure the proper and safe management of medicines which is a breach of regulation 12 (medicines)” from the report
Agency staff checks
seriousThe home relied heavily on agency staff, including at night, but did not have recorded evidence that all agency staff had the competence needed for people's complex care.
“There was no recorded evidence to demonstrate the provider had checked their competencies in these areas” from the report
Weak leadership and audits
seriousFour managers had led the home over the previous year, with short periods without a manager. Audits did not identify or follow through important improvements.
“The systems in place to monitor and improve the quality of the service were not effective.” from the report
Cleaning evidence
minorThe home looked clean, but there were no records to confirm enhanced cleaning of touch points. Some surfaces and cleaning product dilution also needed attention.
“Staff told us they were cleaning touch points throughout the home but there were no records to confirm this was taking place.” from the report
Complaints recording
needs fixingNot all informal concerns had been recorded, so the provider could not always show how it had responded and acted.
“We noted at inspection that not all informal concerns people had raised had been recorded to allow the provider to respond and take action appropriately.” from the report
- 01What has changed so paper and electronic medicine records now match, including records for agency staff?
- 02How do you now check that risk assessments and care plans reflect current needs, including pressure area care, eating and drinking, weights and choking risks?
- 03How do you check the skills and competence of agency staff before they work with people who have complex health and social care needs?
- 04Who is now responsible for the home, and how are audits checked to make sure identified actions are completed?
- 05How are cleaning of touch points and informal complaints now recorded and reviewed?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 11 March 2021 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 Wharfedale House - Care Home Physical Disabilities
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- May 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Wharfedale House - Care Home Physical Disabilities →
- March 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Inadequate
Read what inspectors found at Wharfedale House - Care Home Physical Disabilities →
- April 2018Goodstayed GoodSafe: GoodResponsive: GoodWell-led: Good
- October 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 12 January 2011.
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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