Care Home: Wyngate Rest Home

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What the care home does well The manager and staff provide the people with friendly and thoughtful care, which is appreciated by all the people living at the home. The activities organised and provided are varied, suitable and enjoyed by many of the people to keep them occupied. We were told, "Proof of Wyngate`s value for money can be seen by the amount of respite care admissions that return to Wyngate and often become permanent." People confirmed that they never regretted their choice to live at Wyngate. The staff training is comprehensive and supports staff with the knowledge and ability to care safely and well for the people. What has improved since the last inspection? An activity organiser has been employed. The activities now provided engage the people fully and are what they want. The manager has recruited some new staff since the last inspection so that the staff numbers now enable a good shift rota system to be sustained. The manager and business staff have improved the surveys and questionnaires they send out to "service users and their relatives and also to fellow professionals to elicit their views, and concerns". They have also improved the way they collect and feed back the results to improve the care for people. Staff now have regular one-to-one meetings with the manager and feel better supported in their work. What the care home could do better: We set no requirements or recommendations at this visit. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Wyngate Rest Home Alford Road Mablethorpe Lincs LN12 1PX     The quality rating for this care home is:   two star good service 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. Lead inspector: Vanessa Gent     Date: 1 8 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Wyngate Rest Home Alford Road Mablethorpe Lincs LN12 1PX 01507477531 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) : info@wyngatecarehome.co.uk Mr Stephen John Croudace care home 26 Number of places (if applicable): Under 65 Over 65 26 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Wyngate is a privately-run, purpose-built, single storey care home providing personal care, both long-term and respite, for up to twenty-six people of either sex over the age of 65 years. It is 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 shopping facilities are available in surrounding towns. The home has a wheelchair accessible mini bus, for trips out and residents health appointments. The accommodation consists of twenty-four single rooms, ten of which have a toilet and washbasin in them, and one ensuite shared room. All rooms not ensuite have a washbasin. Communally, there are two lounges, a large dining room, four toilets, three bathrooms, two of which have shower cubicles and a shower wetroom The garden provides a tranquil outdoor area for people to sit in although landscaping is not complete. There is ample car parking at the front of the home. The homes business offices are housed in an adjoining building but are operated separately from the home. Care Homes for Older People Page 4 of 26 Brief description of the care home The weekly fees charged are between £351 and £486. People pay for their own extras such as hairdressing and chiropody charges, personal newspapers and magazines. Information about these costs as well as the day-to-day operation of the home can be found in the statement of purpose and service user guide. These documents and a copy of the last inspection report are available to people who live there and for those interested in coming to live at the home. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. An unannounced visit was made to the home as part of our key inspection. It started at 12.05 and lasted five hours. As part of our review and assessment of the service the owner completed a selfassessment questionnaire called the Annual Quality Assurance Assessment (AQAA). The information we received, as well as that which we hold about the service, was used to plan the visit and produce this report. Care Homes for Older People Page 6 of 26 The main method of inspection we used was called case-tracking. This involved choosing certain residents, and checking the care they receive through looking at their records, chatting with them, the care staff, any visitors and observing care practices. Our visit to the home focused on whether key standards had been met and how people felt about the service provided. The care received by three people was followed in detail to check that their health, safety and welfare needs were fully met and that they were supported to maintain their dignity, autonomy and choice. We spoke with the manager, staff on duty and several people in the lounge and their own rooms, including those whose care we were following closely. People talked about their experience of living at the home. Any comments we received are mentioned in the main body of this report. Some personal records, known as care plans, general house records and staff records were looked at, and the way care was given to the people was noticed. We saw some areas of the home and watched the lunch meal being served to and taken by the people who live there. The manager was present throughout our inspection visit. What the care home does well: What has improved since the last inspection? 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 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have enough information to help them decide if they want to live at the home. The initial assessment process helps the care team to know they can meet each new persons individual needs. Evidence: The statement of purpose and service user guide we saw were comprehensive documents that people told us gave them the information they needed when deciding whether to come to live at the home. They said they were given a copy and the manager explained any further details they needed to know. Peoples care plans showed us that the manager or a senior staff member had visited the person and assessed whether they could meet the needs and wishes of the person wanting to live at the home. People confirmed that when someone visited them, they asked lots of questions. Care Homes for Older People Page 10 of 26 Evidence: The manager does not offer an intermediate care service at the home. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and wishes are met by clear care plans, close liaison with healthcare professionals and others and safe medication practices. They are looked after with dignity and respect by a caring and thoughtful staff team. Evidence: The care plans we looked at were comprehensive and told staff how to care for the people who live there. We were told, People are assumed to have full capacity, unless proved otherwise, to make their own choices and decisions when implementing their plan of care. People told us that that they knew what their care plans were and that they were asked for their input when they first moved in and regularly when they were reviewd by their key-worker. At the last review of the service, the manager told us that care plans are reviewed regularly and involve the residents and their representatives where possible. We saw signatures in care plans that confirmed this. A relative told us, I am always notified straight away if my relative needs me for any reason or if they are poorly. Care Homes for Older People Page 12 of 26 Evidence: People told us, the staff are really good. Nothing is too much trouble for them. Theyre very good at caring. They always look after me really well when Im poorly. They call the doctor straight away. A doctor said that the manager and staff are very good at liaising. They always call us appropriately and follow instructions well. They give very good care. Staff told us that they have had training in diabetes care and are booked onto a training session to update their knowledge for safely giving out medicines. The manager told us, and records confirmed, that the supplying pharmacist regularly looks at the staffs procedures and practices for giving medications and that it keeps people safe. Their last report showed that there have been no outstanding issues relating to how the staff order, store or give the medications to the people. The manager told us, Within our staff induction and training, staff are taught to respect service users choice, dignity and privacy and to encourage and promote service users independence. and All service users are treated equally through the Policies and Procedures within the home e.g. Right to Respect, The Right to Complain and The Right to Dignity. We were told that people felt that staff treated them with respect and dignity. Theyre really lovely with all the residents. They speak lovingly to us. Theyre so kind. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have varied activities, full autonomy and flexible choice in their lives. The food provided is nutritious and provides a well-balanced diet. Evidence: People told us that the activities are what they want and that there are enough of them. We saw the activity programme in place and being followed. The manager told us that the feedback she got from asking the residents some survey questions was put into action to implement into the activity programme. The manager said, Wyngate has its own mini bus for outings which incorporates a tail lift for wheelchair users and is utilised for group/personal outings. People confirmed that they were taken out in the bus and enjoyed the trips. They said they went to garden centres, the seaside and shopping. To ensure that they meet peoples diverse cultural needs and wishes, services are arranged and held at the home and several service users at this present time enjoy Holy Communion in their room as a group once a week, attended by some family members. People confirmed that their individual wishes are known and respected. Care Homes for Older People Page 14 of 26 Evidence: Although no visitors came during our visit, relatives had told us previously that they were always made very welcome and that the manager and staff always spoke with them as they came into the home to welcome them. People told us they are always consulted on their choice and wishes for every aspect of the home. They have their own meetings which are documented and where people can discuss issues, express their opinions and have their say in the running of the home. The manager said, The home offers three nutritious meals together with snacks and drinks throughout a 24-hour period. People told us the food is ok and fine. The meal we saw served to the people had fresh and frozen vegetables and the pudding was homemade. We saw that drinks were available and provided throughout the day, both at the mealtimes and in between. A person previously told us, every effort is made to present [the meals] in an appetising way. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel able to voice any concerns, are taken notice of, and are protected by staff who are trained to prevent abuse and who are committed and caring. Evidence: People told us they were very happy with the quality of care and attention they received from the manager and staff. One person told us, They treat us well. They are lovely, excellent. People told us they would always tell the manager or staff if they were not happy with any aspect of the service provided. Previous comments received from a relative included, I have never had to raise any concerns but I know they would respond appropriately if it was necessary. Another relative said, We are very happy with all aspects of care provided. Neither we nor the manager had received any complaints since the last main inspection. Previously, when one concern had been raised, we had documented that it was addressed appropriately by the manager and staff and responded to by the provider. People said they felt safe and well-cared for. Staff told us they are trained, from induction onwards, to keep the people safe. Their induction and training records confirmed this and they demonstrated how they keep people safe by their approach to and handling of the people during our visit. Care Homes for Older People Page 16 of 26 Evidence: People individually told us that if they were not happy with another staffs practices, they would not hesitate to talk with the manager about it. But they all told us they have a very good staff team and they are got on well together; that there was no disharmony at all. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in clean, comfortable, homely accommodation that is well-maintained and where they feel safe. Evidence: People told us that the housekeepers always keep the home clean and tidy. A relative told us previously that it always smelt pleasant whenever they visited. The people said they liked their rooms, which they could personalise and were cosy. We saw, in the rooms of the people whose care we looked at especially, that person items were evident. People told us that the garden has not changed much over the past few years and is still in need of landscaping to provide the people with somewhere pleasant and attractive to sit out in good weather. The large hole that was dug out for a pool was never been finished but is sealed off from access by people who live at or visit the home, to keep them safe. The manager told us that they have purchased new patio furniture since our last visit. The Fire Safety Officers report found that everything pertaining to fire safety was satisfactory. The Environmental Health Officer, on 16/04/08, assessed that there were no issues and that their hygiene practices were satisfactory. Care Homes for Older People Page 18 of 26 Evidence: Staff told us and we saw that the chemicals and other items were kept securely locked away at all times. The maintenance records showed that the maintenance man visited regularly, that repair tasks were done within a reasonable timescale and signed when completed. The manager, in her self assessment, said, Staff are provided with suitable protective clothing to reduce the risk of cross infection. In the past twelve months, we were told, a specialised bath has been installed and work is progressing on adding two ensuite bathrooms to existing rooms. We confirmed this during our visit. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are in safe hands with enough well-recruited and trained, caring staff always on duty to ensure their comfort and well-being is maintained and to give them time to receive the attention they need. Evidence: People told us that they were never kept waiting for staff to come when they used their call bells. They also said they felt there were always enough staff on duty at all times. Staff told us that although they were kept busy, they were able to accomplish their tasks without rushing round and had time to chat to the residents whilst working. People told us the staff were lovely and were smiling and cheerful. Staff told us, and the manager confirmed, that at least half of them have passed or are taking nationally-recognised qualifications to help them care better and more safely for the people who live at the home. A recently-employed staff member said that they felt they had been safely recruited, with all the checks made to ensure they would keep the residents safe from the risk of harm. They said that their induction had lasted long enough and they had shadowed other staff, to make sure they would care appropriately and safely for the people living in the home. Care Homes for Older People Page 20 of 26 Evidence: Staff told us and the training matrix and their certificates showed that they are well supported in their learning to improve their knowledge in caring for the people. Staff said that the training was plentiful and appropriate; we have loads of training. Staff also spoke knowledgeably about how well they know the people to whom they give care and their needs and how to meet their needs. Staff told us they had staff meetings regularly and felt able to voice their opinions and any concerns. They said that they could get their points across and discuss any problems. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run for the benefit, enjoyment and safety, and in the best interest of the people who live there and the staff. Evidence: The manager has recently achieved the top level in a nationally-recognised qualification in care and is soon to start her training for the Registered Managers Award. She told us that she attends every training session that the other staff attend. She recently attended a course on the new law about people having mental capacity and staff are also booked to attend the course. People told us she is often seen around and chats with them all. A resident told us, If ever there was an angel sent from heaven, Ann is that angel. She even came in specially when I was really poorly and gave up her whole weekend just to sit with me. The manager said that she and the business staff sent out surveys and questionnaires Care Homes for Older People Page 22 of 26 Evidence: to service users and their relatives and also to fellow professionals to elicit their views, and concerns. She told us the surveys are collected to analyse and feed the results back for the care to people to be improved on an ongoing basis. She said this is an improvement since the last main inspection. We confirmed this as being done. The business administrator supported some people to manage their own finances. We saw the financial records of people whose care we were monitoring. They were handled and recorded appropriately with two signatures and receipts being recorded for each transaction. Staff confirmed that they now met regularly one-to-one with the manager and felt well supported. Records showed that health and safety in the home is monitored and maintained. The reports from the Fire Safety and Environmental Health officer and the servicing and maintenance checks we saw in relation to fire equipment, gas appliances and electrical installation to keep the home safe and hygienic confirmed this. Some of the people who have visited their relatives whilst they were living at Wyngate have written notes of appreciation, some of the comments which included,we would just like to say a sincere thankyou for taking care of our dad; I would like to compliment all your staff for the care and consideration they have given [the resident] whilst in their care. All are very polite and courteous and tend to the needs of their clients with respect. Your care home is one of the best I have visited for cleanliness and freshness. Would you pass on my thanks for doing a wonderful job with such caring and dedication. A very, very Big Thank You for your caring, thoughtfulness, help and sensitivity whilst Mum was in your care. Mum couldnt have had better care anywhere else, but WYNGATE, thank you so very much. We cant thank you enough for looking after Mum over the past few years. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 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, Care Homes 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 25 of 26 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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