Wentworth Residential Home is a ‘care home’ that provides accommodation for a maximum of 20 adults, of all ages, with a range of health care needs and physical disabilities. At the time of the inspection there were 18 people living at the service. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Wentworth Residential Home provides accommodation over three floors. Some bedrooms are on the ground floor where communal areas are also present. The remaining bedrooms are on the first and second floor which is accessed by chair lifts. Staff continuously monitor people if they remain in their rooms to ensure people’s needs are met at all times. People are able to access a patio and garden area. The home is near to St Austell town centre which people visit.

There was a registered manager in post who was responsible for the day-to-day running of the service. 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. Wentworth Residential Home has been owned by the provider for 38 years and is a family run business. The registered manager is a family relative. and has been in this post for seven years.

We carried out this unannounced inspection on 27 January 2018. At the last inspection, in January 2016, the service was rated Good. At this inspection we found the service remained Good.

On the day of the inspection there was a calm, relaxed and friendly atmosphere in the service. We observed that staff interacted with people in a caring and compassionate manner. People who were able to talk to us about their views of the service told us they were happy with the care they received and believed it was a safe environment. Comments from people included, “All the staff are amazing”, “it’s lovely here”, “What I like about this place is you are treated as an equal” and, “You are treated as individuals, not as a crowd, I’m treated as a person.” Relatives we spoke with told us they were “very pleased” with the care that their family members received. Comments included “it’s a happy home, it feels like home.” Staff ensured people kept in touch with family and friends. Relatives told us they were always made welcome and were able to visit at any time.

Where people were unable to tell us about their experiences we observed they were relaxed and at ease with staff. People’s behaviour and body language showed that they felt cared for by staff. Staff said they were proud to work at Wentworth and told us “The people are lovely. It’s lovely here we [staff] work well as a team.”

People were protected from abuse and harm because staff understood their safeguarding responsibilities and were able to assess and mitigate any individual risk to a person’s safety. People said they felt safe at Wentworth, and relatives echoed this view.

The service was warm, comfortable and appeared clean with no unpleasant odours. The service was well maintained by the in house maintenance staff and using contractors as required. Bedrooms were personalised to reflect people’s individual tastes. People were treated with kindness, compassion and respect.

Some people living at Wentworth were living with dementia and were independently mobile around the service. The service had pictorial signage to help people who need additional support recognising areas of the building such as their bedrooms, toilet and shower rooms.

People received care and support that was responsive to their needs because staff were aware of the needs of people who lived at Wentworth. Staff were prompt at recognising if a person’s health needs ha

This unannounced comprehensive inspection took place on 8 January 2016.

The last inspection took place on 20 August 2014. The service was meeting the requirements of the legislation at that time. Prior to this inspection the CQC had received anonymous information of concern regarding staff struggling to manage the needs of some people living at the service. We were not able to substantiate the concerns raised.

Wentworth is a care home which offers care and support for up to 20 predominantly older people. At the time of the inspection there were18 people living at the service. Some of these people were living with an impairment of their mental health. The service comprised of a detached house over three floors.

The service had a registered manager in post. 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. The registered manager was not present on the day of this inspection. The provider was present.

We walked around the service which was comfortable and personalised to reflect people’s individual tastes. People were treated with kindness, compassion and respect.

We looked at how medicines were managed and administered. We found it was always possible to establish if people had received their medicines as prescribed. Regular medicines audits were consistently identifying if errors occurred.

The service had identified the minimum numbers of staff required to meet people’s needs and these were being met. The service had no staffing vacancies at the time of this inspection. Short notice absences due to sickness were always covered by the existing staff members and agency staff were not used.

Staff were supported by a system of induction training, supervision and appraisals. However, the service did not have plans in place to implement the Care Certificate for new staff who did not have experience of the role. We were assured this would be addressed. Staff meetings were not formally held but staff were able to speak daily to the registered manager and the provider as needed. Staff felt able to air any concerns or suggestions they had regarding the running of the service.

Meals were appetising and people were offered a choice in line with their dietary requirements and preferences. Where necessary staff monitored what people ate to help ensure they stayed healthy.

Care plans were well organised and contained accurate and up to date information. Care planning was reviewed regularly and people’s changing needs recorded. However, we identified one person whose needs had increased and there was no specific guidance for staff regarding how to respond to behaviour that challenged them. Where appropriate, relatives were included in the reviews.

Activities were provided regularly. The service had a minibus and regularly encouraged people to take trips out in to the local area.

The registered manager was supported by the provider who also worked regularly at the service. The policies and procedures held at the service had been reviewed by the registered manager in July 2015. However we found some had not been updated effectively and were not providing staff with accurate up to date information. The provider assured us this would be addressed immediately.

At our last inspection in February 2014 we had concerns about the management of records at the service. We set a compliance action in this regard.

The provider sent us an action plan setting out how they would address the concerns raised at the last inspection. We carried out this inspection to review the action taken by the provider. This inspection was carried out by one inspector.

We gathered evidence against the outcome we inspected to help answer one key question: Is the service safe? We gathered information from people who used the service and a visitor by talking with them.

Is the service safe?

At the time of our inspection we found the service to be safe.

Care plans were individualised and contained information that directed and informed staff to provide appropriate care and support.

We reviewed the medication administration records (MAR). We did not see gaps in these records. This ensured that people received their prescribed medication at the appropriate time.

Creams that were prescribed for people and stored in their rooms had been dated upon opening. This ensured staff were aware of the expiry date of the cream.

At this inspection we saw the management held a training matrix showing which staff had attended certain training programmes. We saw individual staff files contained records of supervision/appraisal and training certificates.

Since our previous inspection the provider had taken action to improve the management and completion of care documents which meant, people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

At our last inspection 10 December 2013 we found people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines. We also had concerns about the manner in which records were held by Wentworth Residential Home. We issued a Compliance Action regarding this breach of Regulation. These are actions a provider must take so that they achieve compliance with the essential standards. This inspection was carried out in order to review these Compliance Actions.

We found the provider had appropriate arrangements in place to manage medicines; people received their medication at the appropriate times. However, creams used by service users were again found to not have been dated upon opening. We saw handwritten entries on medicine charts which did not follow procedure laid down in the medicine policy.

We found people were not protected from the risks of unsafe or inappropriate care and treatment. The daily records were not held securely, risk assessments had not been dated and medicine records were not accurate.

We spoke with the registered manager, visiting healthcare professionals, four staff and six people who lived at Wentworth. We saw people were supported in a calm and respectful manner by staff. People we spoke with, who lived at Wentworth, were positive about the support and care they received.

We found people who used the service had their privacy and dignity respected.

We found people did not always receive their medication at the appropriate time.

The staff at Wentworth told us they felt well supported by the manager, we saw from their records they had received regular supervision. We did not see any evidence of appraisals having been carried out.

People were not protected from the risks of unsafe or inappropriate care and treatment as care plan and risk assessment reviews were not always recorded in a consistent and timely manner. We saw some records were not stored securely.

We received comments from two relatives of people who used the service, a visiting health professional, staff and the manager. We saw staff respected people who used the service, were polite and helpful towards them and that the atmosphere was warm, homely and welcoming.

The relatives of people who used the service were positive in their comments about the home and the staff. Comments made included “The owners and staff are lovely, very kind and look after me well”, “there is always a choice of food and the food is good”. People told us they would feel able to go to the owners or staff if they had any concerns, and they said they felt confident the owners would resolve any issues.

A visiting health professional told us Wentworth Residential Home was “one of the best around”, and they did not express any concerns about the care provided. We found the care documentation did not always identify that people's care needs were consistently met.

People were protected from abuse and staff were trained and supported to carry out their roles, although staff were not always kept informed of relevant guidance and procedures.

The home was hygienic and clean, and free from odours.

People were protected by the home’s recruitment procedures, and staff were supported with training and supervision.

The service had an effective system to monitor quality of care.

People said they were very happy living in the home. Typical comments included it is ‘like home’ and staff are ‘like family,’ and ‘we could not ask for better’. People said that staff were hardworking and caring. Staff were also seen as attentive and said to respond promptly to individual needs. People said the food was to a good standard, and there was enough to eat and drink. Everyone said they were happy with their accommodation. People said they were happy with the activities that are provided at the home.