Inspection on 24/02/06 for Wyngate Rest Home

This inspection was carried out on 24th February 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Wyngate Rest Home 07/06/07

Wyngate Rest Home 23/06/06

Wyngate Rest Home 05/05/05

Wyngate Rest Home 16/02/05

Wyngate Rest Home 15/09/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Wyngate Rest Home Alford Road Mablethorpe Lincs LN12 1PX Lead Inspector Vanessa Gent Unannounced Inspection 09:30 24 February 2006 th 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 Wyngate Rest Home DS0000002481.V276828.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. Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wyngate Rest Home Address Alford Road Mablethorpe Lincs LN12 1PX 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) 01507 477531 Mr Stephen John Croudace Mrs Sharon Jane Barnett Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 05/05/05 Brief Description of the Service: Wyngate is a privately-run, structurally modern, single storey residential care home situated on a main road and bus route, outside the seaside town of Mablethorpe. There are no shopping facilities within walking distance of the home but retail, leisure and commercial facilities are available in surrounding towns. The home owns a minibus with wheelchair access to transport residents on trips and to appointments. The home provides personal care, both long-term and respite, for up to twenty-six people of both sexes over the age of 65 years. The home has twenty-five single and one ensuite shared rooms. Six of the sinlge rooms are ensuite. Communally, there are two lounges, a large dining room, four toilets and three bathrooms, two of which have shower cubicles. The home is pleasantly decorated throughout. The well-kept garden provides a tranquil outdoor area for all residents. There is ample car parking at the front of the home. The home’s business offices are housed in an adjoining building but operated separately from the home. Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook this inspection in seven hours. The main method of inspection used is called case-tracking, which involves selecting a proportion of residents, and tracking the care they receive through the checking of records, discussion with them, the care staff and observation of care practices. Four service users’ assessments and care plans were examined. Three of the four staff on duty, four of the sixteen residents and three relatives were interviewed during the inspection. Several other residents spoke informally with the inspector. One comment card was received from relatives. What the service does well: What has improved since the last inspection? A statement of purpose with a copy of the latest report is kept on display and is available for visitors or residents to read. Pharmacy procedures and practices have been ‘tightened up’ and now follows the home’s policies and procedures to ensure that residents receive their medications safely and correctly. Hot water was available in all parts of the home at a temperature safe for residents to use and no-one complained that the home was not warm enough. Staff numbers are better than at the previous inspection but the four staff on duty in the mornings include the new acting manager, who then does not have the time to administrate, supervise and support staff as well as act in a caring Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 6 role. Staff have suggested a way to increase the staff numbers later in the evening, when both staff and residents feel there is a shortfall. Staff files seen demonstrate that recruitment procedures are followed and are adequate to safeguard the residents. 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. Wyngate Rest Home DS0000002481.V276828.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 Wyngate Rest Home DS0000002481.V276828.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): 1, 3, 4, 5 The home produces a statement of purpose and service user guide that indicate what is practiced to ensure the health, welfare and comfort of the residents. The home’s admissions procedure does not fully assure residents that their needs will be met. EVIDENCE: The home’s statement of purpose was displayed in the foyer and a service user guide is given to each resident on admission. Before admission, to assess each prospective residents and determine if the home can meet their needs, the general manager or senior carer visits the person in their own environment, either at hospital or at home. The acting manager needs to confirm in writing that the home can meet the needs of the prospective resident. Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 9 The prospective resident is welcome to visit the home, as confirmed by a resident spoken with. A month’s trial stay is offered to ensure that the resident is happy with the home, wishes to stay long-term and that the home can indeed meet their needs. Wyngate Rest Home DS0000002481.V276828.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 Care plans indicate that the holistic needs of the residents are clearly defined. Good contact with healthcare professionals and the monitoring of health issues ensure that the health and personal needs of residents are met although their social needs are not. EVIDENCE: A new care plan format, which is to be put in place and was seen at the inspection, is adequate to clearly identify and describe the resident’s needs and how to meet them. This needs to be used without delay to ensure that staff are better equipped to care for the residents safely and adequately. The care plans seen are reviewed monthly. Staff spoken with were knowledgeable of the residents’ needs and the contents of the care plans. They said that they read the care plans, get good handovers, are able to follow the care advised and that there is good communication between them. Residents say they feel safe and well-cared for. Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 11 Contact between staff and healthcare professionals, such as GPs, district nurses, tissue viability advisors, chiropodists and optician, was confirmed in the care plans and measures are in place, such as the use of pressure-relieving equipment, to put good care practices into action. All staff who administer medications have been trained but update training is now necessary for safe practice. Pharmacy procedures and practices appear to have been improved to enable residents to receive their medications safely and correctly. Wyngate Rest Home DS0000002481.V276828.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, 15 Although residents are satisfied with the car they receive, limiting their choices and not asking for their preferences, for example as far as activities or food is concerned, means that their wishes are not known or catered for at all times. Relatives are welcomed when visiting the home. EVIDENCE: Although the pre-inspection questionnaire listed a variety of games and activities, none of these are actually on offer as there is still no activities organiser. Some residents feel that there are not enough activities and life at the home is boring; that their lives are not varied enough to ensure they are occupied in the way they want so they have become disinterested. They feel staff do not have enough time to concentrate on things other than basic caring. Staff say they do not have enough time to provide activities as well as fulfilling their caring roles. A minibus with wheelchair access, which is owned by the home, is available to take residents out but they say it is not used during the winter months and not Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 13 often in the summer, except to take residents to medical appointments, etc. Residents say they are not asked what they would like to do or where they would wish to visit or go. No evidence was seen of communal activities being brought into the home, except for the occasional communion service. One resident said that they had been told that “entertainers near the seaside wanted too much money for performing so that’s why they didn’t have them very often”. Visitors say they are encouraged & feel welcome and are offered refreshments when they arrive. Residents say they have choice in most but not all aspects of their lives, such as activities and food. Residents say the food is very good, but that there is not enough choice. One resident said “the food is very good but you don’t have to be a fussy eater”. One resident says that “if we don’t like the food, we just leave it and don’t bother to ask for anything else”. The three-week sample menus provided do not list a choice of main courses at lunchtime. The senior cook says that choices are available throughout the day but the resident has to ask for an alternative rather than two choices being offered each day. Wyngate Rest Home DS0000002481.V276828.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, 18 All complaints, however minor, are taken seriously, but the recording of the complaint, investigations and outcome is not adequate to maintain individual confidentiality. Residents feel safe and comfortable in the home. Staff have been trained and are aware of how to protect residents from the risk of harm or abuse. EVIDENCE: A copy of the complaints procedure is displayed in the foyer and is written into the statement of purpose and service user guide. One resident said, “ I haven’t had any complaints but I would mention to the staff if I had any concerns”. The complaints record book needs updating to improve the complaint process – from the date of receipt and acknowledgement of a complaint to how the complaint is managed, what the outcome is and whether the timescale is met. Five minor complaints were received within the past year but were all recorded one after the other on the same sheet of paper. Each complaint should be recorded and managed on one page per complaint to ensure confidentiality is maintained. Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 15 Systems and policies for protecting vulnerable adults are in place and staff training has taken place for most staff. Staff say they know how to protect residents from abuse and harm and who to take any concerns about the care of the residents to. Residents say that they feel safe at the home and the “staff are lovely”; Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 16 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): 21, 22, 24, 25 The home provides a comfortable, clean, warm environment for those living there to feel ‘at home’ but not all adaptations or facilities have been provided for the less mobile residents’ physical needs to be catered for. The hot water in the home is of an adequate temperature for comfortable usage but most of the radiators are unguarded and too hot to ensure that residents are safeguarded from risk of harm. EVIDENCE: Six of the single bedrooms and the double room are ensuite. There are sufficient communal toilets and bathrooms to meet the needs of the residents. Two of the three bathrooms have a shower cubicle. There are communal toilets close to the lounge and dining room. Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 17 There are no grab rails along any of the corridors. Residents spoken with say “this causes problems for those who are unsteady on their feet and need the support of a rail they can hang on to from time to time”. One resident said, “This is a good home; I have been thrilled with it. My room has a good view of the garden and it is always warm”. Residents’ rooms inspected were personalised and pleasantly decorated although some residents say that the furniture is now rather looking ‘dated’ and worn. Two visitors spoken with said, “we have visited four or five other homes and this one is excellent: it is clean and they use plenty of air fresheners around and it smells nice. The carpets in the corridors are lovely.” All residents spoken with said they were warm enough and the home felt warm throughout the inspection, except for the manager’s office which is very draughty because the window is ill-fitting and needs replacing. The home is light and airy. The hot water in the residents’ rooms was appropriate for their personal needs. However, radiators, especially those in communal areas such as the lounges and dining room, have not been risk assessed, were very hot to touch and were all uncovered except in the bathrooms. There is a risk of being burnt should a resident fall against one and not be able to move away from it or use it to steady themselves in the corridor. Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 18 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, 30 There are not enough staff on duty to ensure that all aspects of the residents’ needs are being fully met. Recruitment measures and training undertaken are adequate to safeguard residents. EVIDENCE: Overall, there appears to be adequate numbers and skill mix of staff on duty at any time. However, the new acting care manager does not have any supernumery hours so there are administrative issues that are not being addressed, there is no activities organiser and the residents say they are not getting stimulation or variety in their lives, and staff say they have only enough time to give basic care and nothing else. Three staff files were seen and contained all the information as required, including a photo of the staff, evidence of identity, two references and checks made with the appropriate authority to safeguard the residents. Induction is thorough & a checklist completed. A staff spoken with confirmed that the induction process lasted for up to twelve weeks and that she was wellsupported until she felt able to care safely for the residents. Staff spoken with feel well-trained, competent & confident in their care practice. Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 19 All staff have had training in the mandatory areas but most are now due for renewal and updating. The new general manager is in the process of getting new dates for all training. Staff say they feel confident that their care practices are safe and residents say they are happy with the quality of care provided. One residents said, “they are all good carers but there’s not enough communication between the staff and the residents”. Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 20 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): 32, 33, 35, 36, 37, 38 The new managers of the home are poised to put fresh and appropriate practices into place to improve the conditions of the home, the lives of the residents and the working practices of the staff and give direction to the home after a lack of management at the previous inspection. EVIDENCE: The registered manager has recently left so the provider wants to set up new system - a general manager over the two homes owned by the company and a care manager for each home. The new general manager says that the acting care manager for Wyngate is respected by the residents and staff; has a good sense of humour and a sense of good fun; knows her limitations but she is willing to learn; is nervous but capable. Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 21 The new acting manager for Wyngate states that she has intentions to put more robust measures in place that will provide better care for the residents. There are aspects of the administration and caring practice that need reassessment to improve the care provided, such as putting the new care plans into use and supervising staff. No questionnaires or resident surveys have been issued recently and residents say that staff do not ask for their views or wishes. Residents’ opinions & wishes need to be made known & audited to ensure they get the care & attention they require. Residents’ finances, taken care of by the business administrator, are monitored and administered appropriately with two signatures and receipts being recorded for each transaction. No supervision has taken place since there has been no manager in place but the new general manager and acting care manager showed that they have plans in place to start with staff supervisions from this inspection. According to the pre-inspection questionnaire, all the policies and procedures were implemented in April 2002 and reviewed in January 2005. The new acting manager needs to have enough supernumery time to devote to making sure that all record-keeping and staff support is in place to ensure that the home runs smoothly, for the safety of the residents and those who work in the home. Health and safety measures are mostly in place in the home to safeguard the residents. However, grab rails in the corridors would improve the safety margin and make unsteady residents feel more self-assured and confident. Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 22 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 3 X 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X 3 2 X 3 2 X STAFFING Standard No Score 27 2 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 2 X 3 2 3 2 Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 23 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 OP4 Regulation 14.1.d Requirement The provider must inform prospective residents in writing that their needs can be met by the home after their admission. Activities must be provided that are varied and accord with the wishes and needs of the residents. Community involvement in the home must be provided and encouraged for residents to participate in. The registered person must ensure that the layout of the premises meets the needs of the residents to enable them to move confidently around the home. The provider must seek the advice of the Environmental Health Officer to ensure that the radiators are safe for the residents living in the home. Staff numbers and skill mix must be adequate to maintain a safe care practice for the residents at all times. The residents’ views must be obtained and taken into account DS0000002481.V276828.R01.S.doc Timescale for action 31/03/06 2 OP12 16.2.n 30/04/06 3 OP13 16.2.m 30/04/06 4 OP22 23.2.b 30/04/06 5 OP25 23.2.a,5 30/04/06 6 OP27 18.1.a 31/03/06 7 OP33 24.1,3, 26.4.a 31/05/06 Wyngate Rest Home Version 5.1 Page 24 8 OP36 18.2 9 OP37 17 10 OP38 23.2.a in all aspects of their lives in the home. Staff must be supervised 31/05/06 regularly to ensure they are supported by the manager and provider and their care practice is safe. Records, as required in Schedule 30/06/06 4. 1-16, must be kept up-to-date and policies and procedures reviewed as necessary to ensure safe practices for the residents. Health and safety practices, such 31/03/06 as fitting grab rails throughout communal areas, must be provided to keep residents safe at all times. 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 OP36 Good Practice Recommendations It is recommended that staff supervisions should take place at least six times per year. Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Wyngate Rest Home DS0000002481.V276828.R01.S.doc Version 5.1 Page 26 - 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!