Inspection on 03/05/06 for Wingates Residential Home

This inspection was carried out on 3rd May 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Wingates Residential Home 07/08/08

Wingates Residential Home 11/01/08

Wingates Residential Home 01/12/05

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 Key Unannounced Inspection 3rd May 2006 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.V289372.R01.S.doc Version 5.1 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.V289372.R01.S.doc Version 5.1 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.V289372.R01.S.doc Version 5.1 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. 1st December 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.V289372.R01.S.doc Version 5.1 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 two days. During the inspection, discussions took place with four residents, two staff members and the manager. Several people completed survey forms to give their views of the home. Surveys were received from 6 residents, 6 relatives, 2 GPs, a social worker, optometrist, and the district nursing team. A meal was taken with the residents, and half of the inspection time was spent watching the ways in which staff supported residents and interacted with them. Paperwork was looked at that related to the care and safety of everyone living or working at the home. The inspection covered all the key standards. These standards cover moving in, the care provided, routines and social activities, complaints and protection, comfort, safety and cleanliness, how staff are employed and trained, and how the home is managed. What the service does well: Residents or their relatives are able to visit the home and look around any time to make sure they are making the right choice. Residents feel they are well looked after and that they are treated with respect, describing good care and support. A social worker commented “I have found the manager and staff very helpful with the care needed for my client. They work closely with myself and the family at all times. The manager and staff try to make activities available for resident when time allows. Residents have choices about how they spend their time. As one resident said, “We please ourselves”. All the comments from residents showed that they enjoy their meals at the home and are always given choices at mealtimes. Residents and relatives have confidence in the manager to properly deal with any problems they may have. Residents are happy that the home is clean and comfortable and like the improvements taking place through redecoration. The staff get good support form the manager and trust her to treat them and the residents well. Proper checks are carried out on staff before they can start working at the home. The manager is keen to keep making improvements so that the residents will benefit. Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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.V289372.R01.S.doc Version 5.1 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.V289372.R01.S.doc Version 5.1 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 a residents admitted within the last two months contained a good range of 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 Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 9 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. Senior staff confirmed that they are informed about the needs of new residents verbally, and through written information via daily reports and the care plan. Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 10 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, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each resident’s personal, health, social care needs and risk assessments are reflected in their care plan. Identified risk areas, health needs and medication arrangements are well managed, ensuring residents’ wellbeing is maintained. However, pressure sore prevention needs to be improved in terms of suitable mattresses on beds. 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 Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 11 communication and good, cooperative relationships between the home and district nurses, resulting in some better outcomes for residents. Discussions and feedback from District Nurses highlighted a need for better pressure sore prevention measures to be in place. In particular, the home needs to have suitable mattresses on beds, as advised by District Nurses to protect residents’ skin integrity. All of the residents consulted felt that staff in the home always treat them well and with respect. One said “The staff are very good”. Another said “They come and help me when I ask them and that is good care” 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. Three residents consulted referred to the abrupt and sharp attitude of one member of staff. This issue is being taken seriously and being addressed by the manager. Residents considered the home to be short staffed at times and this issue is addressed under the staffing section of the report. The home’s medication arrangements were inspected by the Pharmacist Inspector on 21.4.05 and again on 20.7.05. The requirements made following these visits have been met. Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 12 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A continuing improvement in the number and type of activities will help 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 ensures that residents’ nutritional needs are well met and that they enjoy their food. EVIDENCE: Residents reported that activities take place “fairly regularly”, although it is difficult due to a shortage of staff in the afternoons. Each resident 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, films, song songs, arts and crafts, bingo and occasional trips out. 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 Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 13 local shops or pub, but this has been limited to date. The manager and staff are clearly enthusiastic about increasing the activities and the related beneficial effects of activities on residents, but time for carrying out activities is an 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. 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. The chef has attended a training course about food fortification and has clearly gained knowledge and ideas that have been put into practice. As a result, residents are enjoying healthy meals and gaining weight if they need to. Since the last inspection, the home has tried to increase choice for the teatime meal, as this was identified as an area for improvement. Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 14 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel able to air their views and are confident that the manager will listen and respond to their satisfaction. 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: Information about how to complain is included in the service users’ guide, which is given to residents and their relatives. Residents confirmed that they are regularly asked for their opinions by the manager, and have confidence in her, saying “She does a good job and she listens to us”. All the survey responses received from residents and their relatives indicated satisfaction with the home’s ability to manage complaints. The main concern highlighted by survey responses related to insufficient numbers of staff on duty at times There have been no formal complaints received by the home or CSCI since the last inspection. Discussions with the manager, and minutes of meetings with staff, show that the manager and deputy have worked well to explore and improve the attitudes of staff towards residents, and to check staff knowledge and understanding of abuse and whistle-blowing policies. There are ongoing arrangements for staff to attend Protection of Vulnerable Adults training and the manager has obtained the updated multi-disciplinary guidelines. Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. EVIDENCE: Over the past year, positive and significant changes have been made to the environment in the home. 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 nice and bright and comfortable.” Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 16 The registered person recognises the need to create wheelchair and additional storage space for the home. 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, new curtains in lounges and some bedrooms and a bigger drugs room. The home was clean on the day of the inspection and residents said that standards of cleanliness are very good. Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 17 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, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff numbers on duty do not allow for the full range of residents’ needs to be suitably met. The recruitment procedures ensure that staff employed are suitable. Staff receive training to ensure that they are competent in their roles, and individual training and development plans are being developed to ensure residents are supported by well trained and competent staff. EVIDENCE: Staff and residents reported that there are often only two care staff on duty during the afternoon and evening. The inadequate staffing levels were also highlighted by visiting health professionals and relatives in written feedback received. This is a reduction from the findings of the inspection carried out in June 2005 when 3 staff were on duty throughout the day. In consideration of the number, range of needs and dependency levels of residents, the registered person is required to ensure that a minimum of three care staff are on duty throughout the day and evening. Students must not be included in staff numbers. Proper recruitment procedures are in place. 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. The manager was advised to update the application forms to make them more relevant, to guide applicants to provide a Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 18 clear chronology of their working history, and to ensure all staff files include a photo of the staff member. In terms of staff training, 53 of the staff have obtained NVQ qualifications and other staff are due to commence. The manager continues to work hard to identify staff training needs and to make arrangements to address them. Good progress has been made in providing training. The training log shows that new staff are working through the Skills for Care induction standards, and records show they are completing a range of mandatory training. Other staff are booked to attend courses on mandatory topics for which updates are required, including infection control. The manager has completed appraisals with some staff and these are being used to develop personal development plans. Records of appraisals show that the manager discusses staff members’ development and support needs, and encourages progress and improvement in care practices. It is important that the manager is given the time to complete development plans. Residents consulted spoke highly of the staff team, their helpfulness and their willingness to work hard, although they said that it was difficult to get the assistance they needed promptly when only two carers are on duty. Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 19 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, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 two years. In that time she has developed her competence and confidence in the role and worked hard, with support, to make significant improvements that have had a positive Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 20 impact on residents and staff. The manager has completed her NVQ Level 4 and has commenced the Registered Manager’s Award. Staff have started to have regular supervision meetings with the manager. There are 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. In terms of quality assurance, the manager seeks the views of residents, and minutes of residents’ meetings were seen. In addition to these measures, questionnaires have been obtained from relatives and visiting professionals. The information received has been collated and issues to be addressed have been identified in a quality assurance plan for the home. The home now produces periodic newsletters so that the quality assurance results and information about changes, events, etc, can be presented in a reader-friendly format. The arrangements for managing and accounting for residents’ monies were found to be safe and secure. Health and Safety training was completed by 5 staff in February ’06. Current inspection certificates were seen in respect of the lift, portable appliances, fire systems and lifting equipment. Fire records showed satisfactory testing in respect of alarms and emergency lighting, and all staff have had fire safety training since the last inspection. Actions to be taken in response to checks should be recorded and a fire risk assessment for the home developed. There have been no fire drills since August ’05. Fire drills must take place regularly with records kept of individuals present and any issues identified during the drill. Accidents in the home are well recorded, the majority of accidents being minor falls. The manager is analysing accidents, and should use this information to inform individual risk assessments. The home has regular management meetings where health and safety issues are discussed. Issues arising from these and action taken to monitor and address issues should be recoded. Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 21 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP8 Regulation 12 Requirement Timescale for action 01/08/06 2. OP27 18 3. OP38 23 The registered person must ensure that adequate pressure sore prevention equipment is in place. Staffing levels must be 17/07/06 increased, particularly during the afternoon and evening, to ensure that the full range of residents’ needs are suitably met. A fire risk assessment for the 17/07/06 home needs to be developed. 5. Fire drills must take place regularly with records kept of individuals present and any issues identified during the drill. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 23 Wingates Residential Home DS0000009309.V289372.R01.S.doc Version 5.1 Page 24 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.V289372.R01.S.doc Version 5.1 Page 25 - 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. 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