Inspection on 05/05/05 for Wyngate Rest Home

This inspection was carried out on 5th May 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

Wyngate Rest Home 07/06/07

Wyngate Rest Home 23/06/06

Wyngate Rest Home 24/02/06

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 Lincolnshire LN12 1PX Lead Inspector Kima Sutherland-Dee Unannounced 5 May 2005 09.45 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. Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Wyngate Rest Home Address Alford Road Mablethorpe Lincs LN12 1PX 01507 477531 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 Stephen John Croudace Mrs Stephen John Croudace Care Home 26 Category(ies) of Older Person (OP) - 26 registration, with number of places Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 16th February 2005 Brief Description of the Service: Wyngate is a 26 bed residential home providing personal care for older people, it is situated just outside the small town of Sutton On Sea. All the communal rooms and bedrooms are on the ground floor. There are communal gardens. There is a mini bus that is wheelchair accessible for trips out and health appointments. Mr and Mrs Stephen Croudace own the home and Mr. Croudace is the registered manager. Mr. Croudace has now moved offices and is based in a separate part of the building. At the time of the inspection there were 17 residents at the home. The home does offer respite care. Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 7 hours. It consisted of talking with 5 of the residents, 3 members of staff and the manager/ owner, as well as reviewing a sample of the documents and records. The inspection was combined with a complaint investigation following an anonymous complaint and the details are included in the relevant sections of this report. What the service does well: What has improved since the last inspection? What they could do better: The home needs to improve the overall management including the supervision of the staff, and the way the manager receives and deals with complaints, both those viewed as serious and those seen as minor. Residents and staff have a right to complain and it would be seen as helpful if the registered manager spent more time in the home speaking with both the staff and the residents, and managing the care manager. If the manager held regular staff meetings then staff would understand why decisions are taken and they would have an opportunity to express their views. This is especially important because no staff are formally supervised, therefore they do not have the opportunity to discuss issues with their manager, or to reflect on their own working practices. Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 Stage 4.doc Version 1.30 Page 6 Medication needs to be ordered in time to prevent stock running out, and the homes policies must be followed to prevent administration errors. Any incidents that affect the wellbeing of the service users must be reported to the Care Standards Commission. The manager must improve the recruitment procedures to protect the welfare of the residents. 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 C53 C04 S2481 Wyngate V2255198 050505 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 Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 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) 1 The information on which prospective residents, current residents and visitor’s can make choices about the home is not up to date and therefore it would not allow people to make informed choices about the home. EVIDENCE: The last inspection report, which is displayed in hallway and available to residents and visitors, was dated June 2003. The latest report was not displayed and the previous complaint report was not displayed. The manager said that things went missing but they were unaware of the lack of up to date information. Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 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) 8,9,10 The staff provide kind and caring personal care for the residents. The home cannot meet all of the residents health care needs until the medication is administered according to the home’s own policies and received frequently enough to maintain the correct stock. EVIDENCE: The medication policies are available to the staff and they have received training. The communication book states on 3 occasions between the 23rd April and the 4th May 2005 that medication ran out and on 1 occasion double doses of paracetamol were given to a resident over a period of 4 days. The book records that two days later the manager has asked all staff to re read the medication policy to prevent mistakes. No errors have been reported to the commission, as they must be under regulation 37. One member of staff said that some staff had been refusing to administer medication as although they received training they were told that the course they completed was not to administer medication. Other staff on duty had been willing to administer medication. The residents said that G.Ps had been called when necessary and they had received help to access healthcare. Notes were kept about any medical appointments and the follow up treatment. Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 Stage 4.doc Version 1.30 Page 10 The residents were complimentary about the staff, they said they were kind and caring and that they were treated with respect. The staff were observed carrying out care tasks and they were respectful to the residents. Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 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) 12,13,14 The home is unable to meet the entire social and care needs of the service users with the current staffing level and the way staff are deployed throughout the day. The residents therefore have restricted choices and control. The home is not offering a range of activities suited to the preferences of the residents, or ensuring that the residents remain part of the local community. EVIDENCE: The home displays a programme of bus trips, which start in June 2005. The residents said that although the home organises occasional entertainment there are few activities of the sort they want to participate in. At the last inspection there was a list in the office and the staff room stating that staff should be carrying out activities with the residents every afternoon. At this inspection that list was no longer displayed and staff were clear that they were unable to carry out activities due to lack of staffing numbers. They stated that when there are 2 staff on duty they do not have time to undertake activities and meet the basic care needs of the residents. One resident said they would like to go into town and would need staff help to do so, the staff had never offered. The manager said there was a driver available and if the residents asked any trips could easily be arranged. Staff stated that on occasions they have to ask residents to wait for care such as baths or going to bed, because of lack of staff on duty. The residents said Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 Stage 4.doc Version 1.30 Page 12 that although the staff were good they knew they were busy and some care had been forgotten or delayed. Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 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 Residents and staff will be unable to use the complaints procedure until the information is available in the home. Although the manager states that they are approachable they spend little time in the home talking to the residents and staff. There are a minority of the staff who have little confidence in the managers acting on concerns brought to them. Not all complaints have been recorded correctly or passed on to the manager for action. EVIDENCE: An anonymous complaint has been received at the commission and part of this inspection was spent investigating the elements of the complaint. The complaints policy was seen along with the whistle blowing policy. Both had out of date information. The manager printed the new versions but was unaware as to why these had net been put in the home files. Part of the complaint states that there is little confidence in the manager, the care manager or the providers acting upon complaints although they are all approachable. The manager strongly disagreed with this view and said that although they had little time to spend in the home, they were available in the office or by telephone and happy to discuss concerns. One member of staff said that they had previously raised concerns but nothing had been done as a result. Two members of staff said that the manager had only been around the home in connection with the new kitchens and occasionally asked staff in passing if ‘everything was O.K’. They also said that if notes were left for the care manager they were not responded to, although they recognised that they were busy and could ‘forget things’. The complaints procedure does not record the actions taken or the outcome of complaints. The staff understood that if the complaint was minor it should be Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 Stage 4.doc Version 1.30 Page 14 recorded in the communications book and not the complaints record. The manager stated that this is incorrect and all complaints should be recorded in the complaints log. The manager was not able to produce records to show if any complaints had come directly to them and what actions had been taken. Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 Stage 4.doc Version 1.30 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 standard(s) 19,22,23,25,26 The temperatures of the heating and water do not currently meet the needs of the residents. The residents are not able to call for assistance in some areas of the home, therefore the staff are unable to maintain their safety. The residents do have the adaptations and equipment that is needed, however a small number of these are difficult to use due to the hall carpets. The kitchen does have an impact on the home and the noise was intrusive. EVIDENCE: The home is well furnished with comfortable seating and the bedrooms contain the resident’s own possessions. Domestic staff keep the home clean and odour free. Part of the complaint relates to the temperature in the home. Residents said they were cold particularly at night. One radiator in a resident’s bedroom had the thermostat turned on but no heat was coming out. Another resident said that they were either too hot or too cold and the staff also said that heating and water temperatures were not satisfactory. There were also two occasions when complaints about the temperature and the lack of hot water were recorded in the communications book. The corridors had heating but the Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 Stage 4.doc Version 1.30 Page 16 windows were open, creating cold drafts. Other residents mentioned that they were cold during the manager and inspector touring the home. The staff also said that when the catering staff carry food boxes through the front door drafts are a problem. The manager said that this would be stopped and all food should be carried through the side entrance. During the inspection there was considerable noise from the kitchens that could clearly be heard in the home especially when the door was opened, including catering staff swearing and arguing, crockery clashing and a constant hum from the ovens. The manager stated that they were in the early stages of re locating the kitchens to other premises. The staff also talked about the call bell system saying that they had to swap bells from room to room to use working ones, that the bells did not reach the en suite bathrooms. The communication book states that a service user was heard knocking on the wall from their bathroom and there were concerns. The manager said that if a bell was broken the staff should report this and it would be fixed. The complaint referred to the thickness of the carpets in the corridors, saying that residents found it hard to push their walking aids and the staff found it difficult to carry out the duties. The carpets are good quality and they have underlay fitted for heavy use. The residents said that although it may have been difficult at first the carpets were O.K except one person who said it was very difficult for the staff to push the wheelchair. The tea trolley is difficult to push along the long corridors. Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 Stage 4.doc Version 1.30 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 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) 27,29,30 The resident’s physical and social needs are not being fully met because of the numbers and the deployment of staff. In one instance the recruitment procedures of the home endangered the welfare of the residents and did not meet the requirements of the commission. EVIDENCE: The staff and the residents commented on the lack of staff and how they are deployed during the day. Although there are 17 residents at the home, there are very long corridors and 2 staff cannot meet the care needs and the social needs of the residents. A resident and a member of staff said that a notice had been put up for staff saying that ‘the resident’s do not want to hear about the staff moans about lack of staff’. Out of 39 recent shifts with 3 shifts on each day there were 2 staff on 9 occasions, there are other occasions after this period where 2 staff are on the rota to be on duty. Staff said that when the manager is on duty they are in the office but they do try and help with the care. The manager has been on the duty rota and counted as care staff. The manager stated that staff shortages were due to a recent staff dismissal. One member of staff said that staff offer to do extra shifts and that they arrange these between them often without the managers involvement in order to meet the needs of the residents. A staff file was seen that did not contain a current application form or any references. The manager said that this person had previously been employed by the home and then left, when they were re-employed the usual checks were not carried out. Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 Stage 4.doc Version 1.30 Page 18 Training has not been offered to staff that have been promoted, in order that they can carry out their new role with confidence. Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 Stage 4.doc Version 1.30 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 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) 32,36, The registered manager was open and helpful during the inspection. Staff are not supervised to carry out their jobs and there is a lack of direct management from the registered manager. EVIDENCE: Staff do not receive formal supervision and the last records available date from 2003. Staff stated that they have not had supervision, and that they only see the registered manager in connection with the kitchens. The staff also said that they have not had staff meetings for about a year and they have requested them. The residents said they rarely see the owner/manager but they do have positive contact with the care manager. The manager said that a number of the concerns in the complaint book could have been put right but that the staff and the care manager may not have been reporting these issues. Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 x COMPLAINTS AND PROTECTION 3 x x 2 2 x 2 3 STAFFING Standard No Score 27 2 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x 2 x x x 1 x x Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 Stage 4.doc Version 1.30 Page 21 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 OP1 Regulation 5(1)(d) Requirement The latest inspection reports and any additional reports in response to a complaint must be displayed in the home and available. Medication must be obtained and administered according to the homes policies and for the wellbeing of the residents. Residents needs must be met, including their physical and social needs. The residents must be offered opportunities to remain part of the community. The updated complaints procedure must be distributed to all the residents and made available to the staff. The manager must endeavour to improve the relations between the managers and a minority of the staff team. The heating in the home must be regulated to suit the needs of the residents. The water supply must be available at all times at a safe heat but warm enough to suit the needs of the residents. Staff must be on duty at all times in numbers to meet all of the needs of residents. Timescale for action By 30th May 05. 2. OP8 & OP9 13(2)(4)( c) 12(1)(a) (3) 16(2)(m)( n) 22(2)(5)( 7)(a)12(5 )(a) By 30th May 05. By 30th June 05. 3. OP12& OP13& OP14 OP16 4. By 30th June 05. 5. OP23 OP25 23(2)(j)(p ) By 30th June 05. 6. OP27 18(1)(a) By 30th June 05. Page 22 Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 Stage 4.doc Version 1.30 7. 8. OP29 OP36 19(1)(a)( b)(c) 18(1)(a)( 2) Recruitment procedures must always be followed in order to protect the residents. Staff must be supervised and supported to carry out their roles. By 30th May 05. By 30th June 05. 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 OP22 Good Practice Recommendations The equipment used by the residents must be suitable and not prevent their independence. This relates to the wheelchairs that are difficult to push in the corridors. Wyngate Rest Home C53 C04 S2481 Wyngate V2255198 050505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unity House, The Point Weaver 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. 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