Inspection on 09/06/05 for Wingates Residential Home

This inspection was carried out on 9th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 01/12/05

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 Announced 09 June 2005 : 09:30 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 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 F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 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 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 CRH Care Home 25 Category(ies) of OP Old Age : 25 Places registration, with number of places Wingates Residential Home F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 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 the Commission for Social Care Inspection. Date of last inspection 20 October 2004 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 accomodation 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 F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and took place over two days. The first day was spent talking with 5 residents, 4 visiting relatives, the manager, 4 staff members. The ways in which staff supported residents was observed throughout the day and lunch was taken with residents. The focus of the second day was paperwork relating to the care of residents, staff files, and looking around the building. 8 residents, 2 social workers, 4 GPs and a District Nurse gave their views of the home by completing questionnaires. There has been a change of Registered Manager since the last inspection. What the service does well: What has improved since the last inspection? There has been a little improvement in the way that residents’ care needs are written down and followed by care staff. There are more activities, and residents are enjoying these and looking forward to these becoming better and more frequent. Residents and relatives now know who to go to if they have any concerns and feel that they will be listened to. Staff are getting more training to improve the way they work and to help keep residents safe. New furniture and redecoration has made the surroundings more pleasant and comfortable. Wingates Residential Home F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 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 F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Wingates Residential Home F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 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 standard(s) These key standards were not assessed at this inspection. EVIDENCE: The home will be assessed against these key standards at the next inspection. Wingates Residential Home F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 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 standard(s) 7 and 8 Residents’ personal, health, social care needs and risk assessments need to be better reflected in their care plans to ensure their well-being, and so that everyone has a good knowledge of each person’s changing needs and how to meet them. EVIDENCE: There were major shortfalls in the care plans noted at the previous inspection. The new manager has clearly made some effort to improve care plans, but further improvement is still required. 4 care plans were looked at, alongside daily reports. Examples of shortfalls identified on this occasion included a diet plan not completed, changes not signed and dated, issues identified in a risk assessment not followed up in the care plan, and vague information. For example, the action relating to the need to manage eczema said “has lots of creams”. A lady with depression was described as “needing reassurance.” Such needs must have records of specific actions to be taken by care staff, details of medication used, and reviews must then show how effective any interventions have been so that they can be changed if necessary. One daily report showed that a person with a sore skin area was not promptly referred. There was a delay of 8 days before the problem was brought to the attention of the district nurse. The person’s care plan did not cover skin care. Wingates Residential Home F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 Page 10 Further evidence of the need for improvement came from district nurse and social workers’ feedback. They were satisfied with the standard of care overall, but highlighted the need to have detailed plans, regular reviews and better communication. They also felt that moving and handling practices needed to be improved, and that accident causes and effects should be closely monitored. It would clearly be useful for detailed accident records to be audited and analysed regularly and the information used to update individual risk assessments. There were other examples given during the visit, and shortfalls to be addressed were discussed with and understood by the manager at the time of the inspection. The manager is intending to introduce comprehensive care plans to address the issues. A computer would be useful in developing a format, and sufficient time allocated to manage this task would ensure that the home works towards better outcomes for residents in terms of their personal and health care needs being met. There are some residents with dementia at the home, and the revised care plans must show how their dementia care needs are being addressed. A requirement is carried forward from the last inspection for better information on pressure area prevention and treatment, and for staff to have training on this topic. Although requirements are still outstanding, positive changes in care practices were reported. Staff and a resident said that residents are having more baths and showers. Staff were clearer about their roles, motivated and enthusiastic, and supportive of the new manager in progressing practices and record keeping. One resident said things were “slapdash” before and that “things are done properly now”. One staff member said “we are told more, involved more. Residents are more alert”. These examples show that there is a willingness to improve and some real progress towards better standards. Wingates Residential Home F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 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 standard(s) 12 and 15 The gradual increase in the number and type of activities is appreciated by residents and helping them to remain alert and occupied. Residents feel their daily routines are flexible, and are pleased with the very good choice and quality of meals. EVIDENCE: More than half of the residents who gave their views of activities, either during the inspection or in completed questionnaires, said that there were “sometimes” enough activities. The manager described progress in introducing activities, and staff seemed enthusiastic about becoming involved. The home is moving towards a fuller programme of activities which, when developed further, should record and reflect preferences and the assessed social needs of individual residents. Some staff members have attended a brief dementia training session. Further training for all staff, with a good focus on care practices and suitable activities, will help the home to achieve good outcomes for those people who have some level of confusion or dementia. It is important for the home to demonstrate that all residents are being offered the range of activities that meet their needs, and better records are needed in care plans to achieve this. Wingates has employed the same chef for a number of years. He remains consistent in maintaining good standards of meals and has a good rapport with Wingates Residential Home F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 Page 12 residents. Residents consulted confirmed that they are asked about their likes and dislikes, that they are offered choices at mealtimes, and that they enjoy their meals as a result. Special diets are catered for and good consideration is taken of particular needs. For example, the chef made a ‘birthday trifle’ for a resident who was unable to manage cake due to having a soft diet. The kitchen is well organised. There are plans to increase the space available in the dining room. Staff were seen to assist residents sensitively during the meal when required. Prior to the meal however, two care staff were heard to ask residents very loudly if they wished to use the toilet. This practice was also commented on by a resident who said “they need to stop shouting about going to the toilet”. In order to maintain the dignity of residents, staff must be discreet and sensitive when assisting residents with their personal care needs. Wingates Residential Home F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 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 standard(s) 16 and 18 Residents and relatives are provided with information about the complaints procedure, and feel that the manager would listen and respond to any concerns they may have. Staff training has raised awareness of protection issues. Current guidelines are needed to ensure that the correct action is taken should any protection issues arise. EVIDENCE: Since the last inspection, the complaints procedure has been revised. It is clear in terms of the process to be followed, the contact details for the CSCI, and the timescales for responses. The procedure is included in the new service users’ guide provided to all residents. Questionnaires received indicate that relatives have been made aware of the complaints procedure. Residents and staff spoke about the approachability of the new manager, and of their view that she will address issues that need to be addressed. Staff at the home have attended a training course about abuse and protection, and the home’s policy and procedure file includes an abuse procedure. However, the procedure is not consistent with the Bolton Metro Vulnerable Adults multi-agency policy and procedure. Training on this procedure is offered by Bolton Social Services. It was stressed to the manager that she and staff must apply to attend this training as Bolton Metro guidelines have to be followed whenever an allegation is made. Wingates Residential Home F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 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 standard(s) 19 and 26 The ongoing redecoration and refurbishment programme at Wingates has resulted in a more comfortable and suitable living environment for residents. There are good standards of cleanliness and hygiene. EVIDENCE: There have been positive and significant changes in the environment since the last inspection. Unsuitable seating has been replaced with comfortable armchairs. Alterations to the use of communal areas are being implemented to create brighter lounge areas and a more suitable dining room. A ground floor bathroom has been converted to a shower room and is being used frequently by residents. There is an ongoing programme for redecoration of bedrooms and corridors and the replacement of carpets. Residents said they are pleased with the changes and also commented that the cleaner is “very efficient” and the home is always clean. Regular safety checks are carried out, including the testing of electrical, gas and fire safety equipment. Wingates Residential Home F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 The home is making progress towards ensuring that suitable staffing arrangements are in place, that recruitment procedures protect residents and that staff have the right training to carry out their roles competently. EVIDENCE: The rota indicates that the manager and 3 or 4 care staff are on duty during the day. The home also employs a cleaner, handyman and chef. Staffing levels appear sufficient to meet the needs of residents. There are vacancies at present resulting in other staff, and sometimes the manager covering shifts at times. This, in turn, affects her ability to carry out the range of management tasks that need addressing so that all the requirements from the last inspection can be met. For example, some progress has been made in providing individual supervision meetings for some, but not all staff. CRB checks have been applied for. However the manager must check that referees for staff are the most recent employer. One reference seen was not suitable in this regard. Photos of staff members are required on staff files. The manager would also benefit from up to date information about CRB / POVAFirst checks, available on the internet, to ensure that recruitment practices are robust and correct and that she is familiar with POVA listing guidelines. It is recognised that there has been notable progress in this set of standards since the last inspection where major shortfalls were identified, and plans are in place to address training needs of staff. However, requirements have been carried forward in respect of priority areas to be addressed so that compliance can be monitored. Wingates Residential Home F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 Page 16 Wingates Residential Home F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 and 33 Better management arrangements are resulting in some positive changes in the environment and care practices, in ways that improve the quality of life for residents. The home seeks the views of residents and needs to develop a plan that shows how the service is being improved. EVIDENCE: The home has employed a new manager since the last inspection. The manager has introduced a number of necessary changes in order for the home to progress towards meeting the required standards. Of the four staff members consulted, 3 spoke positively about the changes and could see the benefits for residents. They were enthusiastic, understood the purpose of the changes, and were supportive of the manager who they considered to be competent and approachable. Residents also spoke positively about the manager. One commented that she “can be trusted if you need to talk about anything”. Progress has been made in meeting standards and requirements since the last inspection, but it is recognised that further work and time is needed to ensure Wingates Residential Home F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 Page 18 that the whole staff group is committed and to address the remaining shortfalls. The home has developed a range of questionnaires to gather views about the home. The manager was advised to use a range of methods to gain opinions. For example, a specially devised questionnaire for district nurses may elicit useful information about what they expect from the home, and be used to improve professional working relationships for the benefit of residents. 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. It would clearly be useful for the manager to have ready access to a computer to help with this, with care planning and with the need to access current guidelines on a range of issues. Wingates Residential Home F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 x 2 x x x x x Wingates Residential Home F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 Page 20 Yes Are there any outstanding requirements from the last inspection? 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 7 Regulation Requirement Timescale for action 3 October 2005 2. 8 3. 12 4. 18 5. 29 13, 14, 15 The registered person must ensure that all assessed needs are recorded and that staff understand how to meet them. All care plans must be detailed, comprehensive, reviewed at least monthly and updated to reflect changes. (Previous timescale of 30.12.04 not met). 13, 14, 15 The registered person is required to ensure that specific and detailed records are kept in respect of residents with, or at risk of developing, pressure sores and that care staff receive training in this area. (Previous timescale of 30.11.04 not met) 12,14,15, The social and recreational needs 16 of each resident must be recorded and met within a written activity programme, to include suitable activities for people with dementia. 12,13,18 The registered person is required to ensure that staff understand and enrol for training in the multi-agency protection procedures. 18, 19 The registered person is required to implement robust recruitment procedures, to include suitable F56 F06 S9309 Wingates V222327 090605 Stage 4.doc 3 October 2005 3 October 2005 3 October 2005 29 July 2005 Page 21 Wingates Residential Home Version 1.30 6. 30 and 36 18 7. 33 24 references. (Previous timescale of 30.11.04 not met.) Comprehensive induction, training and supervision arrangements must be in place, and an individual training and development profile in place for each staff member. (Previous timescale of 30.1.05 not met) Staffing arrangements must take account of management tasks to be completed. The quality monitoring system must be developed to inform an annual development plan for the home. (Previous timescale of 28.2.05 not met) 3 October 2005 5 December 2005 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 31 Good Practice Recommendations It is strongly recommended that IT equipment is in place to enable the registered manager to carry out her role and readily update herself on new developments, in line with current expectations. Wingates Residential Home F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich Bolton, Lancashire 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 F56 F06 S9309 Wingates V222327 090605 Stage 4.doc Version 1.30 Page 23 - 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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