Care Home: Wyndham House

What the care home does well We looked at two of the recruitment files and these show that appropriate checks have been carried out prior to the staff starting work at the Home. What the care home could do better: We looked at the medication records and the care notes for a particular resident with regard to a recent episode of ill health. The Manager also provided additional information via email later on the day of our visit. The records are not clear as the medication administration records are not always consistent with the care notes relating to the medication for this particular resident. It is not easy to audit what medication the resident was given and what she refused or was too poorly to take. The records show that the GP was called but did not come to visit until after the pharmacy that the Home uses was closed. Due to previous problems with staff making changes to the medication administration record it had been recommended that they do not do this and so the residents medication was not obtained from an out of hours pharmacy but staff waited until the next day to obtain it from their usual pharmacy. This meant that the resident was not able to start their course of medication until the day after the GP prescribed the medication. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Wyndham House Manor Road North Wootton Kings Lynn Norfolk PE30 3PZ zero star poor service 30/09/2008 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Lella Hudson Date: 1 6 0 2 2 0 0 9 Information about the care home Name of care home: Address: Wyndham House Manor Road North Wootton Kings Lynn Norfolk PE30 3PZ 01553631386 01553631105 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Eaglecrest Care Management Ltd care home 44 Number of places (if applicable): Under 65 Over 65 44 dementia Conditions of registration: 0 Admission to additional places can only begin following an improvement in the service level rating for the home Date of last inspection Brief description of the care home Wyndham House is a large detached building in North Wootton, close to the town of Kings Lynn. The Home was originally a Victorian house, which has been extensively extended. The Home provides care for up to thirty six older people who have dementia. There are twenty six single rooms and five shared rooms on the ground and first floors. The majority of the bedrooms are en suite. The fees for this home range from #380.00 to #597.74 2 1 1 1 2 0 0 8 Care Homes for Older People Page 2 of 12 What we found: We carried out this Random Inspection following a concern raised to us about medication relating to a particular resident. We also wanted to look at staff recruitment files and talk to the Manager about the current admission process. The Manager said that there are currently 21 residents at the Home. She said that she is aware that Norfolk Social Services are still not placing residents at the Home and that she tells prospective self funding residents this when they make enquiries about the Home. She confirmed that she is carrying out pre admission assessments for self funding residents with a view to admitting them to the Home. The Manager said that she has employed four new staff although they have not all started work yet as she is still waiting for references and Criminal Records Disclosures for some staff. The Manager said that she has recently employed a deputy manager to work at the Home to provide additional management support into the Home. She confirmed that the staffing levels are maintained at five staff in the morning and four in the afternoon. She also said that, on some nights, there are three waking night staff on duty but that there are usually two on duty. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 3 of 12 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 3 17 The service must retain 30/10/2008 records, in accordance with schedule 3 and 4, relating to people living in the home for any period of time. This is so that the service can show information relating to individuals health and care needs and how they have been met. 2 3 14.1(2) People who use the service 17/07/2008 must have their needs assessed prior to admission so that the home can assure people they have the capacity to meet their needs. This requirement made at the last inspection on the 17/07/08 has not been met. Enforcement action is now being considered. 3 7 15.1 People who use the service 17/07/2008 must be assured that their needs are properly assessed and written into care plans so that their holistic needs can be met. This requirement made at the last inspection on the 17/07/08 has not been met. Enforcement action is now being considered. Page 4 of 12 Care Homes for Older People Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 4 8 13.4 People who use the service must be assured that risks associated with daily living are assessed and action taken to minimise or eliminate risk so that they are safeguarded from harm. This requirement made at the last inspection on the 17/07/08 has not been met. Enforcement action is now being considered. 17/07/2008 5 8 12.1(a) People who use the service 17/07/2008 must be assured their nutritional needs are accurately assessed and met so that their health is safeguarded. This requirement made at the last inspection on the 17/07/08 has not been met. Enforcement action is now being considered. 6 9 12 The non-availability of 29/10/2008 medicines must be avoided at all times. Medicines must be promptly obtained so they can be given to people at the home as prescribed. Repeat requirement 08/08/08 This is so peoples health and welfare is safeguarded. 7 9 13 Medicines must be 29/10/2008 Care Homes for Older People Page 5 of 12 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action administered to people living at the home by staff who follow safe procedures for their administration at all times. Repeat requirement 08/08/08 This is so that peoples health and welfare is safeguarded. 8 9 13 Medicines no longer in use for people prescribed them must not be retained at the home. timescale 14 days This is so that peoples health and welfare is safeguarded. 9 9 13 Medicines must be given to 29/10/2008 people at the home in line with prescribed instructions at all times. This must be demonstrated by the homes record -keeping practices . Repeat requirement 08/08/08 This is so that peoples health and welfare is safeguarded. 10 9 13 Medicines prescribed for 29/10/2008 external application must be safely and securely stored so that people at the home are not at risk of accidental harm . Repeat requirement 08/08/08 This is so peoples health and welfare is safeguarded. 29/10/2008 Care Homes for Older People Page 6 of 12 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 11 9 13 Full and accurate records for 29/10/2008 the administration of medicines (including external medicines and those prescribed with variable doses) must be completed by staff at all times. Repeat requirement 08/08/08 This is so that peoples health and welfare is safeguarded. 12 10 12 The service must ensure that 29/10/2008 peoples privacy and dignity is promoted at all times. This is so that peoples health and well being is promoted. 13 12 16 The service must ensure that 30/10/2008 people living in the home have the opportunity to exercise choice in relation to all aspects of daily life. This is so that peoples health and well being is promoted. 14 15 16 The service must ensure that 30/10/2008 people are provided with a nutritious diet that is presented in a way that meets their physical and cognitive abilities. This is so that peoples health and well being is promoted. 15 22 23 The premises must be 30/10/2008 designed in a way that meets Care Homes for Older People Page 7 of 12 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action the needs of people with demenia. This is so people are supported to orientate independently around the building and to enhance well being. 16 26 23.2(d) People who use the service 17/07/2008 must be assured that the home will be kept hygienic, odour free and in a good state of repair and redecoration. This requirement made at the last inspection on the 17/07/08 has not been met. Enforcement action is now being considered. 17 27 18.1(a) People who use the service 17/07/2008 must be assured that suitably qualified competent and experienced staff will be available in sufficient numbers at all times. This requirement made at the last inspection on the 17/07/08 has not been met. Enforcement action is now being considered. 18 30 18.1(c) People must be assured the 17/07/2008 home will provide staff who have been trained to carryout the duties they are expected to perform. This requirement made at the last inspection on the 17/07/08 Care Homes for Older People Page 8 of 12 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action has not been met. Enforcement action is now being considered. 19 33 24 The service must have systems in place to monitor the quality of the service. This is so that the service can identify any shortfalls and make improvements where necessary to promote the health and welfare of people living in the home. 30/10/2008 20 37 17.2 The home must keep an 17/07/2008 accurate up to date record of staff on duty each shift to ensure they know who is on duty and that staffing levels can be accurately monitored. The service must retain records relating to people who live in the home. This is to safeguard the health and welfare of people living in the home. 30/10/2008 21 37 17 22 38 13 The service must have a robust risk management system in place. This is so that people living in the home are safeguarded. 30/10/2008 23 38 37 The service must report all 30/10/2008 serious incidents occuring in the home in accordance with regulation 37. Care Homes for Older People Page 9 of 12 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action This is so that the handling of serious incidents can be monitored to ensure the protection of people living in the home. Care Homes for Older People Page 10 of 12 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 11 of 12 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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