CQC report explained · a nursing home
What the CQC found at Wilton Manor Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found effective arrangements for safeguarding, managing falls, pressure injuries, malnutrition, dehydration and medicines. They also found enough suitably skilled staff and daily checks of call bell response times.
- Effective?
- Outstanding
- Staff had strong training and development, including specialist training for dementia care. The home used creative approaches to improve eating, drinking, sleep, falls prevention and other health outcomes.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Relatives were welcomed and involved in care decisions, and staff adapted their approach to people's communication and preferences.
- Responsive?
- Good
- Care plans were detailed, personalised and reviewed regularly. People were supported with choices about routines, activities, communication, end of life care and contact with relatives.
- Well-led?
- Good
- The home had a clear management structure, regular audits and a continuous improvement plan. At the inspection, the registered manager had resigned and the new manager had not yet started, with the deputy manager due to manage temporarily.
What inspectors found, April 2019
Rated Good overall, with Outstanding outcomes in Effective and no concerns identified at inspection.
Inspectors visited on 5 and 8 March 2019 without giving notice. They spoke with people, relatives, staff and health professionals. They observed care and reviewed care plans, medicines records, complaints, training and safety audits.
The home was rated Good for Safe, Caring, Responsive and Well-led. Inspectors found enough trained staff, safe medicines systems, clean surroundings, kind care, personalised support and effective checks on quality.
Effective was rated Outstanding. Staff training and development were especially strong. Inspectors also found very good results in nutrition, hydration, falls prevention, pressure care and support for people living with dementia.
The overall rating stayed Good, as it had been at the previous inspection published in December 2016. Effective improved from Good to Outstanding. The report says no concerns were identified and the service would be re-inspected within the usual published timeframe for services rated Good.
Skilled staff
Inspectors found a strong culture of training and development. Staff took on extra responsibilities and used their skills to improve people's care.
“The service demonstrated a passionate and unwavering commitment to providing high quality training” from the report
Food and hydration
The home used personalised drinks, snacks, flexible meal times and attractive adapted food to help people eat and drink enough.
“There was an exceptionally strong emphasis on the importance of eating and drinking well which was fully embedded throughout the whole service.” from the report
Personalised care
Care plans reflected people's goals, abilities, routines and preferences. People had choices about daily routines, personal care and activities.
“People's care plans were comprehensive and reflected their personal goals, skills, abilities and preferred routines.” from the report
Kind and respectful care
People and relatives described staff as kind, patient and respectful. Staff spent time with people and supported privacy during personal care.
“People told us that staff treated them with dignity and respect.” from the report
Quality improvement
Managers used audits, feedback and meetings to identify improvements and set actions. The report says this approach had improved care.
“The provider had embedded effective quality improvement systems.” from the report
Inspectors raised no specific concerns in this report.
- 01How was the handover managed after the registered manager resigned, and who is currently responsible for running the home?
- 02How will you assess and update my relative's care plan if their health, mobility, eating or drinking needs change?
- 03How do you monitor falls, pressure care and hydration for each person, and how would you tell us about any changes?
- 04What training and specialist support do staff have for dementia, nursing needs and end of life care?
- 05How are activities chosen to match each person's interests, abilities and communication needs?
This was an unannounced inspection covering all five CQC questions and both the premises and care; the overall rating remained Good from the previous inspection, while Effective improved to Outstanding. This explanation was written from the published report of 26 April 2019 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 2016
Rated Good; inspectors found safe, kind and personalised care, but there was no registered manager and staff supervision was sometimes irregular.
This was an unannounced inspection on 28 October and 1 November 2016. Inspectors spoke with people living at the home, relatives, staff and health professionals. They observed care and reviewed care plans, staffing, medicines, complaints, accidents and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, personalised care plans, respectful staff and good access to health professionals.
The home had improved since the August 2015 inspection. Earlier problems with cleanliness and staff training had been addressed. However, the previous manager had left three weeks before this inspection, and the interim manager was not yet registered with the CQC. Staff supervision was also described as sporadic.
Safe care and medicines
Inspectors found that risks were assessed and managed, and medicines were stored, given and recorded safely.
“People received their medicine safety, as prescribed and on time. Medicines administration records (MAR) were completed correctly.” from the report
Kind and respectful staff
Staff built positive relationships with people and respected their privacy, dignity, choices and independence.
“Staff developed caring and positive relationships with people; they were sensitive to their individual choices and treated them with dignity and respect.” from the report
Personalised care
Care plans included people's preferences, routines and needs. Staff knew how people wanted to be supported and reviewed plans regularly.
“People received personalised care from staff that supported them to make choices and were responsive to their needs.” from the report
Improvements since the previous inspection
The provider had acted on the earlier problems with cleanliness and staff training.
“At this inspection we found appropriate action had been taken and issues in relation to staff training and the cleanliness of the home had been addressed.” from the report
No registered manager
needs fixingThe registered manager had left three weeks before the inspection. An interim manager was running the home but had not yet registered with the CQC.
“There was no registered manager in place for the service.” from the report
Irregular staff supervision
needs fixingStaff received supervision, but it was not happening consistently. The interim manager had identified this and introduced a programme for supervision and appraisals.
“Although staff received support through supervisions, these were sporadic.” from the report
Incomplete recruitment records
minorRecruitment checks were completed, but records did not always show that gaps in applicants' employment histories had been fully explored. The manager said this would be recorded correctly in future.
“However, the records did not always show where gaps in the employment history of potential new staff were fully explored.” from the report
Mixed views about food
minorMost people liked the food and were offered choices, but some people said the quality could be better.
“People had varied views on the quality of the food offered.” from the report
- 01Who is currently the registered manager, and if there is still an interim manager, when will they be registered with the CQC?
- 02How often do staff now receive supervision and annual appraisals, and how is this checked?
- 03How do you make sure staff have enough time to sit with people, chat and support activities?
- 04How are gaps in new staff members' employment histories checked and recorded?
- 05What changes have been made to the food since the mixed feedback recorded in this report?
This was an unannounced comprehensive inspection covering all five key questions and checking improvements from the August 2015 inspection. This explanation was written from the published report of 14 December 2016 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 Wilton Manor Care Home
5 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- April 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: OutstandingCaring: GoodResponsive: GoodWell-led: Good
- December 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016Requires improvementstayed Requires improvementSafe: Requires improvement
- November 2015Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- October 2010
Registered with the Care Quality Commission on 1 October 2010.
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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