The inspection took place on 12 January 2019 and 15 January 2019 and was unannounced.

Wilford House is a ‘care home’ located in Stafford. 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.

Wilford House accommodates up to 30 people in one building. At the time of this inspection there were 27 people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the CQC 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.

At our last inspection of the service on 8 January 2018 we found the care of people did not always meet their needs and reflect their preferences, because the provider did not work collaboratively with the relevant person, or carry out an assessment of people’s needs. People were not always receiving safe care that met their preferences.

At the time of this inspection we found that the provider and registered manager had made significant improvement to make the home a safer place, to involve people in the planning and delivery of their care and to ensure systems were ion place to monitor and check the quality of the service.

Medicine management had required improvement previously and our findings at the time of this inspection identified an ongoing breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 safe care and treatment. You can see what action we told the provider to take at the back of the full version of the report.

People felt that activities could be improved, however the registered manager could demonstrate they were looking to address this.

There were sufficient numbers of staff on duty at any one time to meet people's needs in a safe way. However, the increased needs of one person was impacting upon staffing levels and the registered manager was actively looking to address this issue before it impacted upon the quality of care for others living at the home.

Staff had been safely recruited to their roles. They received regular support and supervision. Staff felt well trained to carry out their role effectively and meet people’s individual needs.

There were systems in place to reduce the risk of the spread of infection and environmental issues were being addressed to ensure risks were reduced further.

The provider followed the principles of the Mental Capacity Act 2005 (MCA). People were supported to have choice and control of their care and support. People’s decisions and choices were listened to and respected.

People's health and well-being was monitored and supported and needs were being met by staff and with the appropriate support from health professionals. People’s nutritional and dietary needs were catered for.

Staff were kind and respectful and they knew people well. People's privacy was respected and staff supported people to maintain their dignity. Staff had a good knowledge of people's needs. We received positive feedback regarding staff and how peoples’ needs were met.

Care plans were sufficiently detailed and person-centred, giving members of staff and external professionals relevant information when providing care to people who used the service. Plans were being reviewed to ensure the most up to date information was available. Information was reviewed and updated to ensure staff could deliver responsive support as people’s needs changed. Information was stored securely.

There were effective procedures in place to respond to any concerns or complaints. The registered manager responded promptly and effectively to concerns.

The registered manager was approachable and responsive. People were inv

This inspection took place on 8 February 2018 and was unannounced. Wilford House is divided into three separate floors and provides support and care for up to 30 older people. At the time of this inspection 23 older people lived at the home, some of whom were living with dementia. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This was the first time Wilford House had been inspected under its current registration. The home had previously been registered under a different provider. This was therefore the first time the service had been rated Requires Improvement.

There was an experienced registered manager in post on the first day of our inspection visit. Following our inspection visit the provider notified us that the registered manager was on leave from the home for an unspecified period. An interim manager had been appointed to manage the home in their absence.

A requirement of the service’s registration is that they have a registered manager. 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 provider was not consistently identifying and managing risks to people at Wilford House. Environmental risks were not always managed to ensure people were protected against harm. In addition, the provider was not managing the risks of infection to people at the home. Medicines were not always managed safely.

People's rights to have their personal details held securely and confidentially was not being respected. People were not always offered opportunities to participate in leisure and recreational activities of their choice, or to meet their social needs.

The provider did not always follow the principles of the Mental Capacity Act 2005 by ensuring that people consented to their care, or were supported by authorised representatives to make decisions.

Care records and documentation required improvement to ensure there were full, up to date records of the care people needed and the care they received.

The provider did not have effective systems in place to assess, monitor and improve the quality of care people received at the home.

Staffing levels were sufficient to provide safe care and support to people. Recruitment procedures ensured people of good character were employed at the home.

People were supported to access a range of health care services. When people became unwell staff responded and sought the appropriate support.

The provider reported and investigated accidents, incidents and safeguarding issues when these arose.

People’s nutritional needs were met and they were supported to eat and drink sufficiently to maintain their health.

People said staff were kind and respectful toward them. People’s feedback on the service was sought by the provider. People told us they felt they could raise concerns or complaints if they needed to.

We found there were three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.