Care service description

Wenham Holt Nursing Home is a family run residential care and nursing home for up to 50 people with a range of needs. The home provides nursing care to older people with dementia, people with a terminal illness, and people with learning and physical disabilities. At the time of our inspection there were 44 people living at Wenham Holt. There is a 16 bedded continuing healthcare unit which is part of the home, (continuing healthcare is care outside of hospital that is arranged and funded by the NHS). This is referred to in the report as the ‘unit’. The home is set in extensive grounds providing peaceful and attractive outside areas for people to enjoy.

Rating at last inspection

At the last inspection, the service was rated Good.

Rating at this inspection

At this inspection we found the service remained Good.

Why the service is rated Good

People were protected from the risk of potential abuse and appropriately supported by staff to manage assessed risks to their health and wellbeing. Staffing levels and recruitment processes were appropriate to support people safely. People’s medicines were managed safely. The environment was monitored and managed to minimise the risks to people from emergencies such as fire and other health and safety related hazards including infection control.

Staff completed training and received supervision to maintain and develop their skills and knowledge to support people according to their needs. 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 support this practice. The service had made improvements in their systems and records to ensure people’s health needs were consistently monitored, evaluated and any concerns were acted on.

People were cared for by kind and caring staff. Staff knew people well, their preferences and changing needs and people were treated with dignity and respect. People nearing the end of their life received compassionate and supportive care and their decisions were known and respected.

People’s care and support needs were set out in a written plan that described what staff needed to do to make sure personalised care was provided. People received care and support in line with their care plan to achieve positive outcomes in their health and wellbeing. A range of activities was available to meet people’s interests and needs for social interaction and stimulation. A system was in place for people and/or their representatives to raise concerns and make complaints and any received had been acted on. People told us they felt the registered manager and business manager listened to them and had addressed any concerns they raised.

The home provided a welcoming, inclusive and homely environment with a friendly and positive ‘can-do’ culture. Staff understood and acted in accordance with the provider’s values to promote personalised care for ‘everyone’ including people their relatives and staff. Systems were in place to make sure the service was managed efficiently and to monitor and assess the quality of service provided. Feedback from people, their relatives and other professionals was gathered, evaluated and acted on to drive continuous improvement to the service.

Further information is in the detailed findings below

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This inspection was unannounced.

Wenham Holt Nursing Home is a family run care home situated in a rural area close to the village of Liss. The home is registered to provide care and accommodation for up to 50 people and provides nursing care to older people with dementia, people with terminal illness, and people with learning disabilities and physical disabilities. At the time of our visit 42 people were living at Wenham Holt.

There is a 16 bedded continuing healthcare unit which is part of the home, (continuing healthcare is care outside of hospital that is arranged and funded by the NHS). Four beds had also been commissioned by the South Eastern Hampshire Clinical Commissioning Group (CCG) to provide short term intensive rehabilitation or end of life care. These are referred to as Community nursing  beds. A clinical commissioning group is an NHS organisation set up to organise and deliver NHS services in a local area.

There is a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People felt safe and comfortable. They were supported by a team of trained and enthusiastic staff, who knew them well. Staff understood the requirements of the Mental Capacity Act and the deprivation of liberty safeguards which meant they were working within the law to support people who may lack capacity to make their own decisions.

Although people were generally provided with effective care we found some improvements could be made in the way the service evaluated and monitored people’s health and wellbeing. Staff made good use of a variety of specialist health and social care professionals to ensure peoples’ diverse needs were met.

People said staff were gentle and friendly and we observed many positive and caring interactions. Visitors were welcomed and encouraged to take part in the life of the home. Staff respected people’s preferences and wishes and encouraged people to be as independent as possible. The range of activities provided reflected people’s interests. Staff worked hard to provide interesting opportunities to everyone and found creative ways to enable people to live as full a life as possible.

The service had a clear vision and values and these were reflected in the care, support and treatment provided. The registered manager was very visible and led by example. Staff felt well supported and valued. Everyone we spoke with said they would recommend the home to others.

At the time of our inspection, Wenham Holt was providing care to 41 people’. Fourteen of these were being cared for within the 16 bedded continuing healthcare unit, (NHS continuing healthcare is free care outside of hospital that is arranged and funded by the NHS). Four beds at the service had also recently been commissioned by the South Eastern Hampshire Clinical Commissioning Group (CCG) to provide short term intensive rehabilitation or end of life care. (A clinical commissioning group is an NHS organisation set up to organise and deliver NHS services in a local area). In addition to these specialist services, Wenham Holt was providing general nursing care to people with a range of needs including dementia, learning disabilities and physical disabilities. This inspection looked at the experiences of people within each of these areas of the home.

We spoke with the registered manager, the business and environmental manager, two registered nurses,

four care workers, the activities co-ordinator and the chef.

We spoke with two people using the service who told us about their experiences of the care they received. One person commented, "I am well looked after here". They added, "All the staff are very good, if you have a problem they sort it out…there is nothing they could do better".

We spoke with four relatives; they were all positive about the care their family member received. One told us, "There is always a good atmosphere... staff are always very helpful, always there for you". Another relative told us that staff, "Always spoke to [their relative] as if they were a person". They added, "It would be hard to find anything they could do better; I was lucky and fortunate to have found this home".

We found that people were treated with dignity and respect and their care was delivered in a person centred manner. People’s needs were assessed and care was delivered in a manner that took account of people’s preferences. People were supported to be as independent as possible. We found that the service placed a strong emphasis on providing people with good nutrition, which helped to promote the wellbeing of people who used the service.

There were effective staff recruitment and selection processes in place and new staff were given an induction so that they understood the aims and objectives of the service and what was required of them. Staff told us that they felt supported by the management of the service.

The service had some arrangements in place for monitoring the quality of care so that people were protected against the risks of inappropriate or unsafe care and treatment. However we found some care records, including care plans, contained inaccurate or incomplete information.

We looked at the care records of six people who lived at the home and we spoke with six relatives who were visiting the home at the time of our inspection.

We saw that staff treated people who lived in the home with respect. We saw staff gave people choices throughout our visit and they asked people before providing care.

People told us: “The care is very good; I have no complaints at all”.

We spoke with relatives of a person living at the home. They told us: ‘Staff are very attentive, they are always coming around offering drinks and food to the residents. It’s really good, the care is good”.

Another relative told us: “The care provided is absolutely ace”. And “It’s [Wenham Holt] an up beat place”.

We found that people's needs were assessed before they moved to the home and each person had a detailed and individualised care plan.

We found that the home was sufficiently staffed. One person who lived at the home said: “Yes there is always plenty of staff around”.

Staff told us they enjoyed working at Wenham Holt Nursing Home. One person said, “I really enjoy my job and I get a great deal to job satisfaction.” And, “We make sure the people who live here have a good quality of life”.

People told us that staff were friendly and approachable and provided support with their care. People felt they were involved in their care and were encouraged to be independent and active.