Inspection on 01/12/05 for Wingates Residential Home

This inspection was carried out on 1st December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Wingates Residential Home 07/08/08

Wingates Residential Home 11/01/08

Wingates Residential Home 03/05/06

Wingates Residential Home 09/06/05

Wingates Residential Home 20/10/04

Wingates Residential Home 10/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Wingates Residential Home 95 Chorley Road Westhoughton Bolton Lancashire BL5 3PG Lead Inspector Rukhsana Yates Unannounced Inspection 1st December 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Wingates Residential Home Address 95 Chorley Road Westhoughton Bolton Lancashire BL5 3PG 01942 813840 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Sabir Khan Mrs Shila Khan Mrs Christina Nicola Crowther Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the home is registered for a maximum of 25 service-users to include: Up to 25 service-users in the category of OP (Old Age not falling within any other category). The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. 9th June 2005 2. Date of last inspection Brief Description of the Service: Wingates is a privately owned care home offering residential care and support for up to 25 older people. Wingates is situated on a main road in the Westhoughton area of Bolton. There are pubs and shops nearby, and the home is on bus routes for the town centre. The accommodation is on two floors and includes the original building and a purpose built extension. The home has 23 single rooms of which 2 have en-suite facilities, and one shared room. There is a car park and well maintained garden areas. Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over the course of a day. Some of the day was spent talking with 6 residents, either in the lounge or their own rooms, the manager and 2 staff members. The ways in which staff supported residents and interacted with them was observed, and lunch was taken with residents. The remainder of the day was used to look at paperwork relating to the care of residents, health and safety, staff files, and also looking around the building. What the service does well: What has improved since the last inspection? Since the last inspection, the way in which care plans have been completed and organised has improved. There are more activities, better management overall, and better arrangements for making sure meals contain the vitamins that residents need. There is better communication between staff and with district nurses. These and other changes are now resulting in residents feeling happier and more alert. Physical changes have made the home brighter and more pleasant for residents. The manager has introduced proper recruitment procedures for new staff members, and is working hard to make sure the home keeps improving. Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Each person considering moving to Wingates has their needs assessed, and is given information about the home before admission. The admission process ensures that anyone new to the home knows what to expect of the service and that it can meet their needs. EVIDENCE: Records and discussions showed that the manager visits prospective residents, in their own home or in hospital, to assess whether the home can meet their needs. The files of two residents admitted within the last two months contained comprehensive information about their needs and preferences. There were notes of the initial assessment, a personal profile and brief history, activity and diet plans, a statement of terms and conditions and an admission checklist for the areas explained to the resident about the running of the home. A care plan had been developed from the initial assessment. One of the recently admitted residents was interviewed and confirmed that the process had been smooth and the manager and staff had been informative and helpful. He felt that he had made a very good choice in coming to Wingates and had confidence in the ability of staff at the home to meet his needs. Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 10 Each resident’s personal, health, social care needs and risk assessments are reflected in their care plan. Identified risk areas and health needs are well managed ensuring residents’ wellbeing is maintained. Residents feel their rights to privacy and respect are upheld. EVIDENCE: Four resident files and care plans were examined. There was pertinent and useful information in each person’s care plan, covering needs relating to personal care, continence, eating and drinking, mobility, hearing, vision, orientation and insight, sleeping routines, teeth, pressure area and skin care, medication, medical history and foot care. The notes showed that referrals are made to opticians, district nurses, chiropody and other health services as necessary. Each person has an activity plan, diet plan and is weighed regularly. Good risk assessments were seen for moving and handling, falls, self medication and pressure area care. The manager reported improved communication and good, cooperative relationships between the home and district nurses, resulting in better outcomes for residents in terms of skin care and health maintainance. Day and night reports are completed to a good standard, and a keyworker system has been introduced to ensure that Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 10 residents’ day-to-day activities and changes in need are highlighted and monitored. Since the last inspection, the way in which care plans have been developed, completed and organised has improved significantly. The registered person should now ensure that the manager is given the time to complete all plans to the standard and keep reviews up to date. All of the residents consulted felt that staff in the home always treat them well and with respect. One said “The staff are lovely, extremely good… they don’t grumble at anything”. Another said “we definitely get good care here” and all commented on the patience, politeness and cheerful nature of staff at the home. During the inspection staff were seen to have a pleasant rapport with residents, maintained their dignity when assisting with personal care and spoke to residents with sensitivity and respect. Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 The continuing improvement in the number and type of activities is helping residents to remain alert and occupied. The open visiting arrangements, and the use of local facilities, helps residents to maintain contact with their relatives, friends and the community. Residents feel their daily routines are flexible and they are helped to exercise choice. Meals at the home are highly thought of, and the chef is commended for developing the way in which residents’ nutritional needs are met and their enjoyment of food increased. EVIDENCE: Residents reported an increase in the number and type of activities since the last inspection. One said “the staff are lovely and there are more things to do”. Each resident now has an activity plan in which their recreational interests and wishes are recorded. Keyworker files have been set up so that staff can record the activities undertaken and enjoyed by each person during the week. The manager stated that activities taking place within the home included jigsaws, making Christmas cards, reminiscence, bingo and singalongs. Saturday evenings are now designated as social evenings when residents are offered alcoholic drinks of their choice. There is regular communion at the home and church visitors come to socialise with residents throughout the year. Where possible staff will accompany a resident to the local shops or pub. A school Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 12 choir is to visit during the Christmas period and a meal has been booked at the local pub restaurant. The manager and staff are clearly enthusiastic about increasing the activities and the related beneficial effects of activities on residents, but current staff vacancies are having an impact on staff time allocated. The home is recruiting to address this issue. Residents consulted said they can choose when to get up and go to bed. They have choices at mealtimes and may have meals in their own rooms if they wish. They have a choice as to where to spend their time during the day, but one lounge/dining room was not suitable to use due to wheelchairs being stored in there. With regard to meals, the home has a chef who has worked there for several years. He completes a diet plan with each resident on admission. The plan identifies allergies, dietary needs, likes and dislikes, preferred food and drinks. Since the last inspection, the chef has attended a training course about food fortification and has clearly gained some knowledge and ideas that have been put into practice. As a result, residents are coming off unappetising food supplements, and having meals similar to the other residents instead, with the nutritional value of the meal having been increased in various ways. These measures have increased the enjoyment of mealtimes for residents who were taking supplements, and have improved their weight and health. At present, the only area for improvement is an increase in choice for the teatime meal. A limited choice of soup and sandwiches has become more frequent due to the lack of staff available to assist residents in the dining room at that time. Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Staff awareness of protection guidelines and planned training help to ensure that the correct action is taken should any abuse and protection issues arise. EVIDENCE: Discussions with the manager, and minutes of meetings with staff, show that the manager and deputy have worked well since the last inspection to explore and improve the attitudes of staff towards residents, and to check staff knowledge and understanding of abuse and whistle-blowing policies. Eight members of staff have been booked to attend the Bolton Metro Protection of Vulnerable Adults course, and the manager is to obtain the updated multidisciplinary guidelines. Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The continuing ongoing redecoration and refurbishment programme at Wingates is resulting in a more comfortable and suitable living environment for residents. There are good standards of cleanliness and hygiene, although care should be taken to maintain the provision of paper towels at all times to ensure good infection control. EVIDENCE: It was noted at the last inspection that positive and significant changes had been made to the environment in the home. Further progress was in evidence at this visit. A room that was previously a lounge has been altered and redecorated to create a pleasant dining room with a serving hatch through to the kitchen. The bright and comfortable lounge and conservatory area is used by most of the residents during the day. Residents said that they were consulted about and chose the colour schemes in communal areas. One commented “Its changed a lot. The redecorating is lovely and we appreciate it”. Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 15 The registered person is to identify wheelchair storage space so that the additional lounge/diner can be used for its intended purpose. Other areas that are being, or need to be, considered within the continuing refurbishment plan include replacement of carpets on the stairs and first floor corridors, rails in corridors that don’t have them, new curtains in lounges and some bedrooms, a bigger drugs room and a less cluttered, better organised office. The home was clean on the day of the inspection and residents said that standards of cleanliness are very good. Many toilets needed the supply of paper towels replenishing, and this was addressed during the visit. The conservatory felt cold on the day and the radiator was off. It is recommended that a thermometer is kept in all rooms to monitor that each room is being maintained at a comfortable temperature. Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 Difficulties in staff recruitment have resulted in pressure on the staff group to try to cover the shifts, resulting in understaffing at times, although this is being addressed. Proper recruitment procedures ensure that staff employed are suitable. Staff receive training to ensure that they are competent in their roles, although individual training and development plans need to be completed for all staff. EVIDENCE: At the time of the inspection, the home had four care assistant vacancies, two of which are to be filled in the near future. As the staff complement is at its lowest, it has been difficult to cover shifts if someone is off sick. Significant cover has been provided by the manager and deputy, with the manager regularly working several hours more than her contracted hours, and not having sufficient time to carry out all the management tasks required of her. On the day of the inspection there was a senior with one carer instead of two. It is recognised that the home is actively seeking to recruit additional staff members to address this shortfall. The manager has introduced proper recruitment procedures for new staff members. The file of a new staff member was examined and contained evidence of a POVA check, an application form and pre-employment questionnaire, and a signed declaration of fitness to work. A CRB check had also been obtained. A brief induction record book had been completed. Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 17 In terms of staff training, five members of staff have obtained NVQ qualifications and other staff are due to commence. The manager is working hard to identify staff training needs and to make arrangements to address them, but due to the time constraints mentioned, has not been able to complete appraisals with all staff members in order to develop individual training and development plans. This must be addressed, along with a comprehensive induction for new staff (See Skills for Care induction standards, formerly TOPSS) so that each member of staff has the full range of training and refresher training they need in line with their development plan. Residents consulted spoke highly of the staff team, their helpfulness and their willingness to work hard, although they said that staff are often too busy to sit and talk to them when shifts aren’t fully covered. Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 The competence and commitment of the manager is resulting in positive changes to care practices in ways that improve the quality of life for residents and support for staff. The home seeks the views of residents and needs to develop a plan that shows residents and visitors how the service is being improved. Residents’ financial interests are safeguarded. Staff training and health and safety checks ensure the environment is safe, although some improvement is needed in respect of recording fire safety checks. EVIDENCE: The manager has been in post at this home for less than a year. In that time she has developed her competence and confidence in the role and worked hard, with the support of the deputy, to make significant improvements that have had a positive impact on residents and staff. There has been a significant reduction in the number of outstanding requirements since the last two Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 19 inspections. Staff have had supervision meetings with the manager, although staffing difficulties have meant she has not had the time to ensure supervision is carried out at the required frequency. The manager has achieved NVQ Level 4 and is due to undertake the Registered Manager’s Award. There are now regular staff meetings and the manager is committed to fostering an open and supportive atmosphere within the home. Her ‘hands on’ role enables her to monitor staff and get to know the residents well. However, the registered provider needs to recognise that management duties and responsibilities are wide-ranging and time consuming, and currently the manager is not supernumerary to the care hours provided due to having to work long hours to cover shifts. Similarly the deputy has responsibility for managing medication and has been to the home on a day off to check it in. The staff and manager are clearly committed, as supported by a range of evidence, and are working hard to produce positive outcomes for residents. This must be recognised, appreciated, and addressed, if progress made is to be maintained, and further progress for the home is to continue. A perceived lack in this area introduces the risk of low morale and this should be avoided. In terms of quality assurance, the manager seeks the views of residents, and minutes of residents’ meetings were seen. A questionnaire has also been sent to the district nursing team, as suggested at the last inspection, with useful responses received. In addition to these measures, visiting social workers should be asked for their views, and comments made by residents should be recorded. These views need to be collated, analysed and used to put together a quality assurance plan for the home to be shared with residents, relatives, the CSCI and visiting professionals. The home may wish to consider producing a periodic newsletter for this purpose so that information about changes, events, etc, is presented in a reader-friendly format. The home now has a computer that will be helpful for this purpose, and there are several positive changes over the last few months that can and should be shared with interested parties. The arrangements for managing and accounting for residents’ monies were found to be safe and secure. Current certificates were seen in respect of gas and electrical safety in the home. Some fire checks are carried out and logged but do not cover the full range of checks required. The home needs to obtain a fire precautions log, and complete all checks at the required frequency. Staff at the home receive training in health and safety issues. Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP27 Regulation 18 Requirement The home must update the CSCI on progress towards increasing the staff complement to ensure shifts are adequately covered at all times. The update must include measures to ensure that the manager has the time to carry out the full range of management tasks. An individual training and development profile must be in place for each staff member. (Previous timescale of 3.10.05 not met). The quality monitoring system must be developed to inform an annual improvement plan for the home. (Previous timescale of 5/12/05 not met). A fire precautions log containing all the required checks must be obtained and completed. Timescale for action 06/02/06 2 OP30 18 06/02/06 3 OP33 24 31/03/06 4 OP38 23 06/02/06 Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP19 Good Practice Recommendations As part of the ongoing refurbishment, priorities should include rails in remaining corridors, completion of carpet and curtain replacement, and the identification of rooms for the purposes of storing medication and wheelchairs. Room temperatures should be checked regularly. Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Wingates Residential Home DS0000009309.V268987.R01.S.doc Version 5.0 Page 24 - 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. 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