CQC report explained · a residential care home
What the CQC found at Wolfe House Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, December 2018
Rated Good overall, but inspectors found the home was not consistently well-led and needed better staff deployment and person-centred management.
This was an unannounced inspection on 14 December 2018. Two inspectors spoke with people, staff, the manager, providers and a social care professional. They reviewed care plans, medicines records, incident records, training, audits and meeting notes.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found that people were protected from abuse, medicines were managed safely, staff were trained, people received kind and respectful care, and care plans and activities supported individual needs.
Well-led was rated Requires Improvement. Staff were not always deployed so meals were served promptly. Inspectors also found that the manager did not always show a person-centred approach, and people had not always been involved in planning the menu.
The overall Good rating means the home met the expected standard in most areas, but the leadership issues needed attention. The report says improvements had been made since the November 2017 inspection, including better care plans, capacity assessments and medicines competency checks.
Safe medicines support
Inspectors found medicines were stored, recorded and given safely. Staff competency was checked and staff used a do-not-disturb tabard while administering medicines.
“We observed staff administering medicines and saw they wore a 'do not disturb' tabard, checking the MAR as well as each pack of medicines before giving them to each person.” from the report
Kind and respectful staff
Staff knew people well and were observed treating them warmly, patiently and with dignity. People were supported to make choices and keep some independence.
“People were cared for by staff who showed patience and attention towards them as well as anticipating their needs.” from the report
Detailed care plans
Care plans included communication, mobility, health, nutrition, interests and personal preferences. This gave staff useful information for providing individual care.
“There was sufficient detail in the records to enable staff to understand what care was needed for a person.” from the report
Activities and inclusion
The new activities lead increased the range of activities and helped people take part, including people who stayed in their rooms.
“This had improved people’s access to activities that were more person-centred.” from the report
Improvement since 2017
The home had improved its care plan format, mental capacity processes and checks on medicines competency since the previous inspection.
“We found at this inspection improvements had been made.” from the report
Delays at lunchtime
needs fixingPeople were taken to the dining area well before lunch and some waited for a considerable time. Inspectors recommended reviewing staff deployment, especially during busy periods.
“At lunch time we found people waiting for some time before receiving their meal.” from the report
Inconsistent person-centred leadership
needs fixingThe manager did not always make sure staff practice was person-centred or that people were supported consistently. This contributed to the Requires Improvement rating for well-led.
“Although the registered manager was very hands on and knew people well, they did not always demonstrate a person-centred approach.” from the report
Communication during transfers
needs fixingDuring one hoist transfer, staff did not explain what was happening. The person appeared worried when they were moved.
“Neither of them explained to the person what was happening and as such when they were moved they looked worried, as if it was unexpected.” from the report
- 01What changes have been made to staff rotas and breaks so people do not wait for meals or find the lounge without staff?
- 02How are residents now involved in choosing meals, vegetables and other menu options?
- 03How do staff explain hoist transfers and other care before they begin?
- 04What checks are in place to make sure the manager and staff consistently use a person-centred approach?
- 05How have the improvements to care plans and mental capacity assessments been maintained since this inspection?
This was an unannounced inspection covering all five CQC questions, with records, care, medicines, staffing, activities, leadership and feedback reviewed. This explanation was written from the published report of 29 December 2018 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 2017
Rated Requires Improvement; inspectors found safe, responsive care, but legal rights, respectful independence and records needed improvement.
This was an unannounced inspection on 1 November 2017. Inspectors spoke with people, a relative, the manager and staff. They observed care and checked care plans, medicines, staff files, training, complaints and quality checks.
The home was rated Good for Safe and Responsive. Inspectors found enough staff, safe medicines management, suitable recruitment checks, a clean environment and care that generally responded to people's needs. People were described as happy, and staff were often kind.
The overall rating was Requires Improvement. The other three areas, Effective, Caring and Well-led, were rated Requires Improvement. Inspectors found failures in mental capacity processes, respect and independence, record keeping and quality audits. There were three breaches of legal regulations.
Enough skilled staff
Inspectors found enough staff on duty and did not see people waiting for support. Recruitment checks and staff training were in place.
“People were cared for by a sufficient number of staff who had the right skills.” from the report
Safe environment
The home was clean and hygienic despite building work. Risks from the work had been assessed and emergency arrangements were in place.
“People lived in a home which was free from infection.” from the report
Responsive care
Staff knew people's health needs, histories and preferences. Activities were available and people could raise concerns with the manager.
“People's care plans reflected their needs and preferences and people received responsive care because staff knew them well.” from the report
Kind interactions
Inspectors saw staff being caring and reassuring. People's privacy was maintained during personal care, and relatives were welcomed.
“During the inspection we observed kind and pleasant interactions between people and staff.” from the report
Activities and social contact
People could take part in exercises, quizzes, arts and crafts, music and other activities. Staff also supported people with one-to-one time and outings.
“There was a variety of activities going on at the home.” from the report
Mental capacity processes
seriousThe home did not always record decision-specific capacity assessments or best-interest discussions. This affected decisions about room use, vaccinations and sensor mats.
“People's legal rights were not always protected because staff did not always follow the guidance of the Mental Capacity Act (2005).” from the report
Respect and independence
seriousStaff sometimes discussed people in front of them and did not always explain meals. Mobility aids were kept out of reach, and people were sometimes discouraged from walking or choosing when to get up.
“People were not always enabled to be independent.” from the report
Care records
seriousSome records were completed in advance and did not match what actually happened. There were also missing or incomplete records for creams, inhaler instructions and some health conditions.
“The lack of contemporaneous records in relation to people was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Quality audits
needs fixingAudits were carried out, but evidence was not always recorded. Medicines competency observations were also not written down.
“We recommend that audits carried out on the service are robust and competency checks in relation to medicines administration are recorded in order to evidence that staff are following best practice.” from the report
- 01What has been done to make sure every person has a decision-specific mental capacity assessment and, where needed, a recorded best-interest decision?
- 02How do staff now make sure people can reach their mobility aids and choose when to get up, walk or rest?
- 03How are creams, inhalers, diabetes and epilepsy care now recorded and checked?
- 04How do you record medicines competency checks and prove that quality audits have been completed properly?
- 05What building work has been completed, and how are remaining works affecting people's rooms, mobility and daily life?
This was an unannounced comprehensive inspection covering all five key questions, with records, care, staffing, medicines, safeguarding, complaints and quality systems checked. This explanation was written from the published report of 14 December 2017 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 Wolfe House Care Home
3 rated inspections over 3 years: the service has held its Good rating throughout.
- December 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2017Requires improvementdown from GoodSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- December 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- June 2011
Registered with the Care Quality Commission on 1 June 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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