28 and 29 April 2015
During a routine inspection
This inspection took place on 28 and 29 April 2015 and was unannounced. Windermere Road Nursing Home is registered to provide accommodation, nursing care and personal care for up to 12 adults with a learning disability, physical disability and/or complex health issues. Care is provided in three bungalows that are all linked to a shared kitchen, office and medicines room.
11 people were living at the home when we visited and most people needed help with all aspects of nutrition, personal care and moving about. People also needed staff to help them if they became confused or anxious. Staff support was provided at the home at all times and people required the support of one or more staff when away from the home.
There was 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 and associated Regulations about how the service is run.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. People had decisions made on their behalf that were not fully documented to make sure their changing needs and circumstances were addressed. Some people did not receive their medicines as prescribed as a result of administration errors. You can see what action we told the provider to take at the back of the full version of this report.
Whilst most staff supported people in a thoughtful and caring manner, we observed some instances when staff did not communicate effectively or did not fully consider the situation from the perspective of the person being supported. Most permanent staff knew people well and understood their needs. Some bank or agency staff lacked this detailed knowledge to help them support people in line with their needs and preferences. The registered manager was working to recruit a full staff team to reduce the reliance on bank and agency staff.
Some people had complex physical needs and healthcare professionals said staff followed their guidance but some felt this was not always sustained. Concerns were raised about staff not always following eating and drinking plans and postural guidance precisely.
Staff supported people to take part in activities they knew matched the person’s individual preferences and interests. Most of the time people were encouraged to make choices and to do things for themselves as far as possible. In order to achieve this, a balance was struck between keeping people safe and supporting them to take risks and develop their independence.
Staff felt well supported and had the training they needed to provide support to each person. Staff met with their line manager to discuss their development needs and action was taken when concerns were raised. Learning took place following any incidents to prevent them happening again. Staff understood what they needed to do if they had concerns about the way a person was being treated. Staff were prepared to challenge and address poor care to keep people safe and happy.