This inspection was carried out on 23rd June 2009.
CQC found this care home to be providing an Poor service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Bingley Wingfield Nursing Home Oakridge Court Off Priesthorpe Road Bingley West Yorkshire BD16 4ED zero star poor service 04/03/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Mary Bentley Date: 2 3 0 6 2 0 0 9 Information about the care home
Name of care home: Address: Bingley Wingfield Nursing Home Oakridge Court Off Priesthorpe Road Bingley West Yorkshire BD16 4ED 01274567161 01274566809 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dr A T Ghoneim care home 48 Number of places (if applicable): Under 65 Over 65 48 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 48 The registered person may provide the following category of service only: Care Home with Nursing - Code N, To service users of the following gender: Either, Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP, maximum number of places 48 Date of last inspection Brief description of the care home Bingley Wingfield is registered to provide nursing and personal care for up to 48 people. The original Victorian building has been extended to incorporate a wing of single ensuite accommodation. The home offers both single and shared accommodation, enCare Homes for Older People Page 2 of 11 0 4 0 3 2 0 0 9 Brief description of the care home suite facilities are provided in twenty-five of the single rooms. There are communal rooms on the lower ground floor, the ground floor, and the first floor. The home is situated near Bingley and is close to local bus routes. The area has many shops and local amenities. The home has pleasant gardens that are accessible to people living in the home. Car parking is provided at the front of the building. The home has a second entrance via a ramp for wheelchair access. The home has a no smoking policy. In March 2009 the fees ranged from 398.00 to 585.00 per week. Additional services such as hairdressing and chiropody are not included in the fees. Please contact the home for information about the current range of fees. Care Homes for Older People Page 3 of 11 What we found:
We carried out a key inspection of this service in March 2009. At that time there were three requirements carried forward from the previous inspection which had not been met. New timescales were set for these requirements and the purpose of this visit was to check if the home had made the required improvements. This visit was unannounced and was carried out by two inspectors between the hours of 09:30 and 16:15. During the visit we looked at records, including care records and staff files, we talked to people living in the home, staff and management and we observed staff as they carried out their duties. At the end of the visit we gave feedback to the manager, the owner and the management consultant who has been employed by the home to help improve the service. Two of the carried forward requirements related to the employment of new staff. At previous inspections we found that the home was not completing all the required checks before new staff started work. This meant that people were being put at risk. During this visit we looked at the files of four newly appointed staff. They showed us that the home is getting written references and doing checks against the PoVA (Protection of Vulnerable Adults) and CRB (Criminal Records Bureau) registers. In all four files we saw that PoVA First checks had been done before new staff started work. Three of these files showed that the CRB checks were done before new staff started work. There was one person working in the home who had not yet been issued with a full CRB disclosure. A PoVA First check had been completed for this person and the duty rota showed that they are working under supervision pending receipt of a full CRB disclosure. Discussions with staff confirmed that new care assistants work with one of the senior carers during their induction. In one of the staff files it was not clear if a reference had been obtained from the previous employer. The manager said she had discussed this at the interview but could not find the interview notes. There were no interview notes in any of the files we looked at. There is no information about peoples start date in the files; however this is available on a separate list which is kept on the computer. There were no job descriptions or contracts of employment in the files. The home told us they are dealing with this. We found that the home has taken appropriate action to make sure that the correct recruitment procedures are followed. This helps to protect people by making sure that staff are suitable to work with vulnerable adults. The third carried forward requirement related to making sure that peoples nutritional needs are met. At previous inspections we identified concerns about the availability of food outside set meal times and about the way peoples dietary intake was monitored and recorded. We looked at the care records of six people that the home has identified as being
Care Homes for Older People Page 4 of 11 nutritionally at risk. The home is in the process of implementing a new format for peoples care records. This includes nutritional risk assessments, care plans, weight charts and food/fluid charts. The new food/fluid charts are being used when people are identified as being at risk nutritionally. However, the format of the charts does not allow staff to record accurately what people are drinking and there is nowhere to record the time people eat/drink. There is a small section on the chart to record food taken outside set meal times but there is not enough space to record much detail. This was discussed during the visit. In one persons records we saw that they needed encouragement to eat and drink. The records showed that the person has dietary supplements prescribed for them. There were some omissions on their food charts and it was not clear if this was because staff had forgotten to complete the chart or if the person had refused food. The records do not provide clear information about the persons dietary preferences. However, the person is slowly gaining weight. A nutritional assessment has been completed. On 19 June 2009 the assessment stated that the person is no longer at risk despite the fact that they continue to need diet supplements and encouragement to eat. This was discussed during the visit. In another persons records we saw information about their food preferences. The records said the person can eat independently but needs special utensils. It didnt say what these special utensils were and at lunch time we saw the person eating with a fork and occasionally being helped by staff. The records showed the person has gained a small amount of weight in the last month and the food charts were fully completed showing that the person has all their meals every day. Another persons records showed that the nutritional assessment forms had not been completed and there was no care plan for eating and drinking. The persons weight was recorded monthly and was 44.7 kg on 15 June 2009, down from 46.4 kg in February 2009. The person is on a food/fluid chart but it was not clear if anyone is monitoring the food chart to make sure he/she is receiving an adequate diet. In another persons records the assessment showed that they needed help with eating and needed to have their fluids thickened because of swallowing problems. There was no care plan to tell staff how to help this person. The records showed that a Speech and Language Therapist had visited the person and given advice on how to meet their dietary needs. The persons weight was 63.4 kg in June 2009 when they moved into the home. At the last inspection people who have their meals in their rooms told us that their food and drinks are often cold when they get them. The home has changed the way it serves meals to try to resolve this problem. The hot trolley is now brought up to the ground floor and meals are served from there. During this visit we spoke to some people who have their meals in their rooms, some people said their food is served at the correct temperature. Other people said it varied. One person said it depended on who was on duty and whether they warmed the plates or not. Another person said their tea and food is not always hot and when this happens they leave it because they do not like cold or warmed up food. Care Homes for Older People Page 5 of 11 At lunch time we saw that only a small number of people went to the table to have their meals. Most people had their meals sitting in armchairs with tables in front of them. This does not help to make meal times a social occasion. At the time of the last inspection the home had just employed a new chef. He said there had been problems about the quality of food when he started but these are being dealt with. Kitchen staff have information about peoples special dietary needs and peoples names are put on their trays to make sure people get the right food. The home introduced new menus approximately two weeks ago. They include alternative meals such as omelettes and jacket potatoes which are available at every meal. We found that the home is making good progress on meeting this requirement and there has been an improvement in the way peoples nutritional needs are addressed. They have introduced a lot of changes and in some areas some more work is needed to make sure these changes are fully implemented. Therefore, we agreed to extend the timescale by one month to 23 July 2009. We will visit the home again after that date to check that the improvements have been fully implemented. This was discussed during the visit. At the last inspection we identified concerns about the hot water temperatures in some of the bathrooms. The home has dealt with this, they told us they have adjusted the valves which control the hot water temperatures and have a new way of checking and recording hot water temperatures. During the visit we checked the hot water in two bathrooms and found it was within the recommended safe limits. At the last inspection we told the home that they must keep up to date records of all staff training. We did not look at this during this visit, however the home provided us with some information about staff training. This showed they are making progress in dealing with this requirement and therefore we have extended the timescale to 28 August 2009. During the visit we spent a lot of time in the dining room. When we arrived at 9:30 we saw one person sitting in a wheelchair at the table. We saw that the person was sitting on a sling (used with a hoist to help them move) and also had a pressure relieving cushion. We looked at the persons care records and they showed that they were considered to have a high risk of developing pressure sores and should be helped to change position every two hours. By 2:30 when the person had not been helped to move all morning we talked to the deputy manager about this and she dealt with it. This was discussed during feedback. What the care home does well:
People living in the home and relatives described the staff as very nice and very good. One person said they couldnt be better looked after and said their rooms is always kept clean and tidy. People or those close to them are encouraged to visit the home before making a decision about moving in. This helps them to decide if the home is the right one for them. There is good access for people with disabilities; there is a ramp at the front of the building and there is a passenger lift to all floors. People can choose whether to use the communal rooms or spend their time in their
Care Homes for Older People Page 6 of 11 bedrooms. People are encouraged to have some of their personal belongings, such as ornaments and photographs in their rooms. There are no restrictions of visiting and people can receive their visitors at times that are convenient for them. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 30 17 Records of all training undertaken by staff must be maintained, kept up to date and be available for inspection. To make sure that staff get the training they need to care for people properly. 29/05/2009 Care Homes for Older People Page 8 of 11 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 8 17 People living in the home 23/07/2009 must be provided with adequate quantities of suitable, wholesome and nutritious food and where necessary food must be provided outside set meal times. Records of food provided must be sufficiently detailed to show that people are receiving a satisfactory diet. This is to make sure that peoples needs are met. 2 30 17 Records of all training undertaken by staff must be maintained, kept up to date and be available for inspection. To make sure that staff get the training they need to care for people properly. 28/08/2009 Care Homes for Older People Page 9 of 11 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 12 A more individualised approach to social care should be developed so that people are given the right support to follow their personal interests and make the most of their abilities. More attention should be given to the way meal times are organised to help make them a more relaxed and social occasion for people. The Commission should be provided with detailed plans, including timescales, for the refurbishment of the home. Staffing levels should be kept under review to take account of the changing needs of the people living in the home and the layout of the building. This is to make sure there are always enough suitably trained and competent staff on duty to meet peoples needs in a timely way. Interview notes should be made at the time of interview and kept in the staff files. Staff files should also contain copies of contracts of employment and job descriptions. The results of quality assurance questionnaires should be analysed and an action plan put in place to deal with areas where improvements are needed. People using the service should be given information about the results of the questionnaires. More attention should be given to making sure that staff are following the correct moving and handling procedures. 2 15 3 4 19 27 5 29 6 33 7 38 Care Homes for Older People Page 10 of 11 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 11 of 11 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
