Wiltshire Heights Care Home

Accommodation was provided over 3 floors accessed by stairs and lifts. People had their own rooms which were en-suite and communal areas such as dining rooms, a library, and lounges. People could also access secure gardens from the ground floor.

We observed there were enough staff available to meet people's needs however, feedback from people and staff was at times there was not enough staff available. The provider used a dependency tool to calculate staffing numbers and used agency staff to fill gaps in rotas. We have made a recommendation about using feedback from people and staff to help calculate staffing numbers.

People who experienced distress did not have detailed guidance in place to help staff to understand how to provide support. We observed 2 occasions where people were not responded to in a timely way. Other risks to people's safety had been assessed and guidance was in place to help staff manage those risks.

Care plans were in place, but some were conflicting. The provider had changed systems prior to our inspection which had been a challenge and were carrying out monthly checks on the quality of recording. Senior staff also reviewed care plans monthly to make sure they were up to date. People had been given the opportunity to record their wishes with regards to end of life care.

People enjoyed the food and could have family and friends to eat with them if they wished. Menus were available informing people of choices. Systems in place for people choosing their meals were not effective for people with short term memory loss. The provider recognised this and gave assurance they were reviewing mealtimes across all their services. Despite this area for development, we found people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and relatives told us people were safe at the service. Staff had been provided with training on safeguarding and understood how it applied to their role. New staff had been given a comprehensive

induction which gave them knowledge and skills needed for their roles. Refresher training was provided in a range of areas and staff told us they could ask for training if needed.

The home was clean and cleaning schedules were in place to record what was cleaned and when. Personal protective equipment was available for staff, and we observed them using this safely. Staff were provided with guidance and training on infection prevention and control. Health and safety checks were carried out across the building and for all equipment. We did find rooms that needed to be locked were open and shared this with the provider. They gave assurance these rooms would be kept locked.

People, relatives and professionals told us staff had a kind and caring approach. We observed some positive interactions between staff and people. We also observed some interactions that were not person-centred and shared that feedback with the registered manager. The provider told us their head of dementia care was working with the service to develop staff skills and knowledge to provide good dementia care.

People had a range of activities to choose from if they wished. During our inspection we saw a variety of activities taking place to cater for a wide range of interests. The service had a minibus which was used to take people out to the local community or access local services.

Staff worked with healthcare professionals to meet people's health needs. Local GPs visited the home weekly and other professionals were contacted if needed for advice. Staff had daily handovers and regular meetings to keep updated with people's needs. Staff told us there was good communication amongst the team and good teamworking. Feedback from professionals confirmed this.

Quality monitoring systems were in place and shortfalls found during this inspection had already been identified by the provider. There was a service improvement plan in place to identify actions needed to make improvement and who was responsible for this action. Incidents and accidents were recorded, and any necessary actions carried out. Analysis of incidents, falls and other data was completed by the registered manager and the provider to identify any patterns or trends.

People, relatives, staff and professionals told us the registered manager was visible and approachable. People and relatives felt able to complain if needed and we saw complaints were well managed. People thought the service was well managed. Relatives told us they felt able to visit any time and were always made to feel welcome.