About the service:

Waverley House is a residential home that was providing personal and nursing care to 41 people aged 65 and over at the time of the inspection.

People’s experience of using this service:

People told us they felt safe. However, we found the home was not always safe. Staff were not consistently deployed to meet people’s needs in a timely manner. We have made a recommendation about this.

Risks within the environment were not always suitably managed in a timely manner. We have made a recommendation about this.

We received mixed feedback about the quality and choice of food at the home. The registered manager confirmed they were actively addressing these concerns. We have made a recommendation about this.

We saw complaints and concerns were actively addressed. However, systems for monitoring complaints were not consistent. We have made a recommendation about this.

The registered provider had a comprehensive auditing system, however we noted this had failed to identify concerns within the environment. We have made a recommendation about this.

Staff received training relevant to their role and said they were supported by the management team at Waverley House.

Consent was recorded in people’s care files and relevant deprivation of liberty applications had been submitted. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and relatives told us Waverley House was a nice place to live. It was repeatedly described as a “home from home”.

People told us their privacy, dignity, rights and needs were respected. Care plans reflected people’s individual care needs and how these could be met. A variety of activities were available to people.

People, relatives and staff told us the service was well-led and praised the registered manager and deputy manager for their support within the home. We saw people and relatives were encouraged to express their views and influence how the home was managed.

Rating at last inspection: Good (21 April 2016)

Why we inspected:

This was a planned and scheduled inspection.

Follow up:

The next scheduled inspection will be in keeping with the overall rating. We will continue to monitor information we receive from and about the service. We may inspect sooner if we receive concerning information about the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 8 and 10 March 2016 and was unannounced.

Waverley House provides personal and nursing care for up to 47 people most of whom are living with dementia. At this inspection 40 people were living there. The accommodation was provided over three floors.

A registered manager was in post but was not present during our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were safe as staff had been trained and understood how to support people in a way that protected them from danger, harm and abuse. People were supported to make informed decisions about risk by staff.

There were enough staff to support people and to meet their needs. The provider had systems in place to adapt to the changing needs of people and to make provision for additional staffing when required. Before staff could start work the provider undertook checks to ensure they were safe to work with people.

People received their medicine from staff who were trained to safely administer these and who made sure they had their medicine when they needed it. The provider undertook checks to ensure staff followed safe practices when helping people with their medicines.

Staff had the skills and knowledge to meet people’s needs. Staff attended training that was relevant to the people they supported. Staff were supported by the provider and the registered manager who promoted an open and transparent culture. The provider encouraged staff development and made resources available for people to benefit from staff members newly acquired skills.

People were involved in decisions about their day to day care. When people could not make decisions for themselves staff understood the steps they needed to follow to ensure their rights were upheld. Staff provided care and support which was personalised and respected people’s likes and dislikes. People took part in activities they liked and found stimulating. People were involved in the day to day running of their home.

People were supported by staff who knew them well and had good relationships with them. Staff made sure people were involved in their own care and information was given to them in a way they could understand. People’s independence was encouraged and staff respected their privacy and dignity.

People had a choice of food to eat and were prompted to maintain a healthy balanced diet. People’s routine health needs were looked after and people had access to healthcare when they needed it.

People and staff felt able to express their views and felt their opinions mattered. The provider and registered manager undertook regular quality checks in order to drive improvements. The provider engaged people and their families and encouraged feedback. People felt confident they were listened to and their views were valued.

Most of the people we met with were not able to describe their thoughts and feelings about the service they experienced. One person who was told us, “Staff are wonderful” and “Can’t fault the place”. A relative we spoke with told us that, “Staff are polite” but added they had, “Had a few little issues with the home”. These had been discussed with the manager and the person said they had felt, “listened to”. Another visiting relative told us that, “On the whole I am happy”. The manager was described as approachable and “Apparent” and that, “He knows what’s going on”. Relatives said they felt involved and had been consulted in regard to their family members care planning. Overall they felt they were kept informed about changes or concerns.

We found that people’s needs were assessed and care and support was planned and delivered in line with the individual’s needs. We observed people being offered choice and staff communicating in a calm and helpful manner. We saw decisions were being made in peoples best interests but these were not always recorded clearly.

Food served was cooked and presented well and people told us they liked the meals. Information about special diets had not always been communicated effectively amongst care and catering staff. People had mixed experiences at lunchtime with some having good social interaction and others eating quietly in chairs spaced out around a communal lounge.

There were quality monitoring programmes in place, which included people giving feedback about their or their relatives care. There were also systems to regularly audit risks to health, safety and welfare of those using the service.

The people we spoke to who were able to give us their views told us that they were happy with the care provided. One person told us “very pleasant here and always a good meal”. The relatives we spoke with were very pleased with the level of care provided. Comments included “it is all very good” and the staff are “wonderful” in how they support people with complex behavioural needs.

There were enough staff to meet people’s needs. Staff were given appropriate training and support. We saw that staff responded calmly when people were disoriented or needed emotional support. It was obvious that the staff knew people well, as they were able to tell us details about each person’s likes and dislikes.

People said they felt safe in the home and would be able to tell the staff or the manager if they were unhappy. The relatives we spoke to felt fully involved with decisions about the care and health treatment of their family member. They said they would feel able to raise any concerns. We saw that complaints were taken seriously and investigated.

The care records contained clear information about people’s care needs and showed that the staff arranged the health care people needed. Medicines were safely stored and the records were well maintained.

We were not able to talk to all the people who live in Waverley House as some of them are unable to communicate verbally. However there was a calm, peaceful atmosphere in the home, and we saw that people were settled and staff spoke to them gently and kindly. We spoke to relatives of three people who all said that they were very happy with the standard of care given, and that they felt included by staff. They were welcomed at any time. All said that any concerns had been listened to and addressed promptly.