This inspection was carried out on 9th December 2009.
CQC has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CQC judgement.
The inspector found no outstanding requirements from the previous inspection report,
but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Wykenhurst Residential Home 17-19 Baggallay Street Hereford Herefordshire HR4 0DZ new service which has yet to be given a quality rating 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: Sarah Blake Date: 0 9 1 2 2 0 0 9 Information about the care home
Name of care home: Address: Wykenhurst Residential Home 17-19 Baggallay Street Hereford Herefordshire HR4 0DZ 01432278435 01432344705 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Judith Jones Type of registration: Number of places registered: Conditions of registration: Category(ies) : July V11 Ltd T/A Wykenhurst Residential Home care home 27 Number of places (if applicable): Under 65 Over 65 0 0 0 27 0 dementia learning disability mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Conditions of registration: 27 0 27 0 27 1 The registered person may provide the following categories of service only Care Home only Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories Mental Disorder Code MD maximum number of places 27 Physical disability Code PD maximum number of places
Care Homes for Older People Page 2 of 9 27 Old age, not falling within any other category Code OP maximum number of places 27 Dementia Code DE maximum number of places 27 2 That service users are over 45 years of age 3 That there be no further service users admitted to Wykenhurst 4 That the maximum number of service users accommodated be no more than 24 people Date of last inspection Brief description of the care home Wykenhurst is registered to accommodate up to twenty-seven adults who may require care due to a wide range of care needs. These can include (for those over 65 years) general frailty associated with increasing age, physical disabilities or mental health issues. People aged under 65 years who have care needs arising from their mental health may also be accommodated as well as one younger person with a physical disability. The home consists of adjacent Victorian period houses that have been converted to one property. It is located in one of the original residential areas of Hereford and is within easy reach of the city centre. There are also local facilities e.g. shops, church and public house in close proximity and it is on a main bus route. There is a shaft lift for access. There are sitting rooms, a separate dining room, a hairdressing room and a reasonably sized, accessible and secure garden. The schedule of fees is available from the home. Additional charges are made for hairdressing, chiropody, dry cleaning, toiletries and newspapers (2 papers are provided each day for general use). Care Homes for Older People Page 3 of 9 What we found:
Wykenhurst was previously operated as a partnership by Lyn Rushgrove and Judith Jones. The service is now operated by a private limited company, July VII Ltd. Lyn Rushgrove and Judith Jones are the only two directors of the limited company. Because of this change to the services legal status, it has been registered with the Commission as a new service. Although Wykenhurst has recently been registered with the Commission as a new service, we have a high level of concern about the quality of this service and risks to people using it. At the last key inspection before the change in registration, the service was rated as a zero star i.e. poor service. The providers then failed to comply with seven statutory requirement notices and there are several on-going safeguarding investigations. For these reasons, the company has been registered with conditions applied, as listed above. We will be carrying out a full inspection of this service soon, but because of the risks which we had identified at previous inspections, we carried out an unannounced inspection focused on the areas of highest risk. One inspector carried out this inspection over four hours, to check whether risks associated with peoples health and personal care needs were being managed appropriately. A pharmacist inspector will shortly be visiting the home to check on the management of medication. The home has recently appointed a deputy manager with experience in working with people with mental health needs. On the day of the inspection, the deputy manager was updating peoples care plans and putting them into a new format. He told us that, as he had not yet had the opportunity to talk to the people living at the home, he was working from the old care plans and the knowledge of staff to enable him to write the care plans. This does not show a fully person-centred approach to care planning. Person-centred care has been described by the Mental Health Foundation thus: Being person centred is about listening to and learning about what people want from their lives and helping people to think about what they want now and in the future. Although the approach to care planning was not fully person-centred, it was an improvement on previous care planning, as there was evidence that staff had discussed the care plans with individual people, and that their views had been incorporated into the care plans. We were concerned to see that one persons new care plan included information which was out of date, and contradicted other information elsewhere in the care plan. If staff had followed the out of date information, the person could have been put at risk of harm. It is important that care plans are accurate and reflect peoples current needs. Because the care plans were all being updated and put into the new format, it was not always easy to find information about peoples care needs. We spoke to staff, who showed a very good knowledge of each persons needs and were able to describe how care is provided. Care Homes for Older People Page 4 of 9 Records showed that one person was at risk of developing pressure sores. Staff described how they made sure that the persons position was changed regularly. We saw that the person had appropriate pressure-relieving equipment, and a chart in the persons bedroom showed that staff regularly turned them during the night. The manager told us about some recent verbal altercations between people living at the home. We had also received notifications from the home about other incidents where people had behaved in ways which could pose a risk to themselves or others. Staff told us that they had not received any training in how to manage these incidents, other than through discussion with the manager. We would expect staff to be trained in current good practice, so that they can resolve situations without placing themselves or others at risk of harm. The home has taken some steps to ensure that peoples privacy and dignity is respected, by installing privacy screening in all shared bedrooms. However, there are no locks on bedroom doors, so further improvements are needed to ensure the promotion of peoples privacy and dignity. What the care home does well: 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 5 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 6 of 9 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 6 15 (2)(b) You must ensure that 31/01/2010 people who use the service have their care plan revised as appropriate when their needs and condition change. This is so that people can be confident that their needs will be met. 2 7 15 (2)(b) You must ensure that 30/01/2010 care plans clearly direct staff as to how they should care for and support people who use the service across all of their changing needs and conditions. This is so that people can be confident that staff know how to care for and support them. 3 10 12 (4) You must ensure that 31/03/2010 locks are provided for all bedroom doors. This is so that people can be confident that the service will promote and respect their privacy. Care Homes for Older People Page 7 of 9 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 30 You should ensure that staff are trained in current good practice in the management of behaviour which could pose a risk to themselves or others. Care Homes for Older People Page 8 of 9 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 9 of 9 - 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!
