CQC report explained · a nursing home
What the CQC found at Wingham Court Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, suitable risk plans and safe infection control. They noted unclear medicine records for three people and unsafe storage of sharps in one medicine room, both of which were addressed during the inspection.
- Effective?
- Good
- People received care based on their needs and staff had suitable training and supervision. Health professionals, therapists and other services worked together to support people's health and rehabilitation.
- Caring?
- Good
- People and relatives described staff as kind, caring and respectful. People were involved in care decisions, supported to remain independent and able to make choices about their daily routines.
- Responsive?
- Outstanding
- Care and activities were highly tailored to people's interests, abilities and past lives. Staff supported people to keep relationships, follow hobbies, communicate in different ways and take part in unusual community activities.
- Well-led?
- Good
- Inspectors found effective leadership, quality checks and open communication. Care plans were more accurate than at the previous inspection, although information about care was still held in several places and was not always easy to follow.
What inspectors found, April 2020
Rated Good, with Outstanding responsiveness; inspectors found kind, safe care and highly personalised activities, but some records needed clearer organisation.
This was an unannounced, planned inspection on 28 February 2020. Inspectors spoke with seven people, six relatives, 14 staff and a healthcare professional. They observed care and checked care, medicine, training and management records.
The home was rated Good overall. Safe, Effective, Caring and Well-led were rated Good. Responsive was rated Outstanding. Inspectors found enough staff, safe medicines systems, kind staff, suitable training and strong support for people's health, independence and choices.
The home had improved from Requires Improvement at the previous inspection. It had previously breached two regulations about consent and governance. Inspectors found enough improvement had been made and there were no current breaches.
Inspectors identified some issues during the visit. Medicine administration records for three people were not always clear, sharps were not stored safely in one medicine room, and care information was spread across different records. The management team acted on some issues straight away or said they would address them.
Highly personalised activities
The home supported people to pursue creative interests, hobbies and personal ambitions. Activities gave people purpose and helped them stay connected with the community.
“People were supported with activities that gave structure and a purpose to their life.” from the report
Kind and respectful care
People and relatives said staff were caring and respectful. Inspectors saw staff supporting people warmly and helping them keep important family relationships.
“People and relatives told us that staff were kind, caring and respectful towards them.” from the report
Support for independence
Staff encouraged people to do what they could for themselves and involved them in decisions about their care and routines.
“People were supported and encouraged to remain as independent as possible and were involved in decisions around their care.” from the report
Good specialist support
The home used therapists, nurses, a clinical psychologist and other health professionals to support people with neurological conditions and rehabilitation.
“There were teams at the service consisting of care staff, nurses, therapists and a clinical psychologist specialising in care for people with an acquired brain injury.” from the report
Improved staffing
Staffing had increased in the areas where the previous inspection found improvement was needed. Inspectors saw people receiving support quickly.
“Since the previous inspection there had been an increase in staff on the units where we had identified that improvement was needed.” from the report
Unsafe sharps storage
seriousSharps were not stored safely in one medicine room. The management team removed them during the inspection.
“Sharps were also not being stored in one of the medicine rooms in a safe way.” from the report
Care information was spread across records
needs fixingInspectors could not always easily see exactly what care had been provided because information was kept in several folders. Management said it would streamline the records.
“It was not always easy to navigate through exactly what care had been provided to a person.” from the report
Short-term prescriptions needed clearer dates
needs fixingSome short-term medicines prescribed by the GP did not state how long they should be given. The clinical lead said this would be addressed in future.
“Prescriptions for short-term medication prescribed by the GP did not always have the length of time it should be given.” from the report
- 01How do you now make sure medicine administration records are clear and checked for errors?
- 02What arrangements are in place to store sharps safely in every medicine room?
- 03How have you streamlined the different care notes so staff can find the latest information quickly?
- 04How do you make sure short-term prescriptions state clearly how long each medicine should be given?
- 05How will you continue the improvements made since the previous Requires Improvement inspection?
This was a planned inspection based on the previous rating and covered all five key questions, including both the premises and the care provided. This explanation was written from the published report of 10 April 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2019
Wingham Court Care Home was rated Requires Improvement; inspectors found caring and responsive support, but concerns about consent, records and staffing.
Inspectors visited the home without notice on 7 February 2019. They spoke with nine people, staff, a health professional and, after the visit, a relative and other professionals. They reviewed care records, medicines records, audits and other documents.
People generally said they felt safe and were treated kindly. Inspectors found good relationships between staff and people, personalised activities, suitable health support and safe medicines systems. However, staffing deployment needed improvement in two areas during afternoons.
The main concerns were about legal consent decisions and care records. Capacity assessments were not always completed when needed, including where people's movement was restricted. Some care plans and daily records were inaccurate, out of date or lacked enough detail.
The overall rating fell from Good at the previous inspection, published in October 2016, to Requires Improvement. Caring and Responsive were rated Good. Safe, Effective and Well-led were rated Requires Improvement.
Kind and respectful care
People and relatives described staff as caring. Inspectors observed warm relationships, respectful communication and support for people's independence and faith.
“People were treated in a caring and dignified way. They were involved in decisions about their care.” from the report
Personalised activities
The home offered activities, outings and hobbies based on people's interests. Inspectors saw staff encouraging participation and arranging meaningful experiences.
“Staff took into account people's interests and wishes and wants when arranging activities and trips.” from the report
Health and clinical support
People received support from relevant health professionals, including physiotherapists, doctors, dieticians and speech and language therapists. Staff followed professional guidance.
“People's care records showed relevant health and social care professionals were involved with their care.” from the report
Medicines and risk management
Inspectors found suitable systems for storing and giving medicines. Care plans included risk assessments covering issues such as falls, choking, nutrition and safe evacuation.
“There were appropriate systems in place to ensure the safe storage and administration of medicines.” from the report
Staff availability
needs fixingIn two of the four units, staff were sometimes busy elsewhere or taking breaks during afternoons. One person had little staff interaction for 90 minutes, and another could not attract staff for over ten minutes.
“In one lounge people had very little interaction from staff for a period of 90 minutes.” from the report
Consent and restrictions
seriousCapacity assessments were not always completed for important decisions. Inspectors found that one person's movement was restricted during lunch without the required assessment, best-interest decision or application.
“This was restricting the person's movements without any MCA capacity assessment, best interest decision or DoLS application being in place” from the report
Care records
seriousSome care plans contained conflicting or out-of-date information. Daily notes did not always explain how staff responded to distress or behaviour, making it harder to understand the right support.
“As records were not always accurate, complete and contemporaneous in relation to people's care delivery this is a breach of regulation 17” from the report
Language about one unit
minorSenior staff and others used terms such as “challenging behaviour unit” and “secure unit”. Inspectors said this contributed to a more hospital-like feeling and asked the manager to consider the terminology.
“This use of language contributed to this unit having more of a hospital feel where people were being 'detained.'” from the report
- 01What has been done to ensure capacity assessments and best-interest decisions are completed before restrictions or other care decisions are used?
- 02How do you now make sure staffing is sufficient and visible in the two units during afternoon breaks and busy periods?
- 03How are care plans checked and updated when people's needs change or outside professionals give new advice?
- 04How do daily records explain what staff did when someone was anxious, agitated or showing behaviour that challenged?
- 05What language is now used to describe the unit that was referred to as the “challenging behaviour unit” or “secure unit”?
This was an unannounced inspection covering all five key questions and the overall rating, following a previous Good rating published in October 2016. This explanation was written from the published report of 13 March 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Wingham Court Care Home
6 rated inspections over 5 years: the service has improved, from Inadequate to Good.
- April 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- March 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2015Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- April 2015Inadequatestayed InadequateSafe: InadequateResponsive: Inadequate
- February 2015InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- October 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 12 November 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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