CQC report explained · a nursing home
What the CQC found at Wykewood
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Risk assessments and medicines systems had improved, but behaviour and weight monitoring was not always effective. Staffing deployment did not always ensure that 15-minute observations were completed by staff on the unit.
- Effective?
- Good
- People received care from trained and supported staff. Mental capacity and DoLS records were up to date, and healthcare professionals were involved where needed, although food choices and some care planning records needed improvement.
- Caring?
- Good
- This key question was not covered by this focused inspection, so no new rating was given in this report.
- Responsive?
- Good
- Care plans were detailed and activities were arranged around people's interests. Some care plans did not fully reflect people's current needs.
- Well-led?
- Good
- Managers had effective audits, reviewed incidents and sought feedback from people, relatives and staff. Inspectors found improved oversight and a more open management culture.
What inspectors found, July 2023
Rated Good and no longer in special measures; inspectors found kind, organised care, but safety still requires improvement.
This was an unannounced focused inspection on 04 May 2023. Inspectors spoke with people, relatives and staff, and reviewed care records, medicines records, staff files and management records.
The home had improved since the previous inspection. Medicines were managed more safely, care planning and staff support had improved, and managers had better checks in place. People were supported with activities, communication and end-of-life planning.
Some safety issues remained. Monitoring of behaviour and weight was not always effective, staffing deployment did not always support 15-minute observations, and food choices did not always meet people's needs. The overall rating is Good, but Safe is rated Requires Improvement.
Improved management checks
The provider had regular audits and action plans to identify and address shortfalls. Inspectors could see evidence of improvements and lessons learned.
“The provider had effective audit systems in place which had identified some shortfalls in the service.” from the report
Detailed care planning
Care records gave staff detailed information about people's needs, preferences and risks. Relatives said they could see up-to-date care plans.
“Care plans were detailed and contained person centred information and guidance for staff.” from the report
Activities and communication
The home provided different types of activities and used communication aids, including boards, pictures and information in a person's preferred language.
“On the day of inspection, we saw multiple activities occurring during the day, with 1 on 1 activities, small groups and larger groups all organised.” from the report
Trained staff
Staff had induction, ongoing training and regular supervision. Inspectors found good compliance with required training.
“People were supported by staff who had received sufficient training and support to fulfil their roles.” from the report
Behaviour and weight monitoring
seriousSome people did not have ABC charts to monitor behaviour. One person lost weight and regularly refused food, but no effective action or oversight followed.
“We found examples where people did not have antecedent behaviour charts (ABC) in place to monitor and review people's behaviours for triggers and changes in behaviours.” from the report
Staff deployment for observations
seriousOn one unit, staff deployment did not always ensure that 15-minute observations were completed. Staff sometimes asked colleagues from another unit or visiting relatives to watch someone.
“When we go on break then we have to ask a staff member from another unit to complete our observation, or if family members are here, we will ask them to watch over the person we are observing.” from the report
Food choice and dietary needs
needs fixingThere was limited food choice at lunch, and high-calorie snacks were not consistently offered. Suitable food was not always available for a person's medical dietary needs.
“We recommend the provider reviews the choices of nutritious food available for people in line with the specific dietary requirements of people to ensure people's needs and preferences are met.” from the report
Some care plans out of date
needs fixingAlthough care plans were reviewed regularly, some did not fully reflect people's current needs. The manager said these details would be reviewed.
“However, some care plans were not always fully reflective of people's current needs despite them being reviewed regularly.” from the report
- 01What has changed on the unit where inspectors found that 15-minute observations were not always completed by staff on that unit?
- 02How do you now identify and respond when someone loses weight or regularly refuses food?
- 03How are ABC charts used for people whose behaviour may put themselves or others at risk?
- 04How do you make sure high-calorie snacks and suitable foods for medical dietary needs are offered consistently?
- 05How have instructions for crushed or covert medicines been reviewed by appropriate healthcare professionals?
This was a focused inspection of Safe, Effective, Responsive and Well-led; Caring was not covered, and ratings for any key questions not inspected carried over from the previous inspection. This explanation was written from the published report of 4 July 2023 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, November 2022
Rated Inadequate; inspectors found serious safety and management failures, despite kind care from staff.
This was the home’s first inspection. Inspectors visited without notice on 16, 21 and 28 September 2022. They spoke with people, relatives and staff, and checked care plans, medicines, staffing, incidents and management records.
The overall rating was Inadequate. Safe and well-led were also Inadequate. Inspectors found missed observations, serious incidents, missed medicine doses, unsafe medicine records and weak checks by managers. They were also not confident that staffing was always enough.
Caring was rated Good. People and relatives generally described staff as kind and respectful. Effective and responsive were Requires Improvement because records, training, food choices, activities and personalised care were not always good enough.
Kind and respectful staff
People and relatives spoke positively about the staff. Inspectors found that people were treated with dignity and respect.
“People and their relatives were complimentary of the staff and of the care they received. They were treated with respect.” from the report
Clean home
The home was clean, and inspectors were assured that infection control systems were effective.
“We were assured that the provider had effective systems in place to minimise the spread of infection within the service.” from the report
Care planning involvement
Relatives said they had been involved in assessments, care planning and reviews. Care plans were generally detailed and personalised.
“Relatives told us they had been involved in the initial assessment of their family members needs and subsequent reviews.” from the report
Complaints handled
Complaints were investigated and answered. In one case, the home arranged a meeting with the family and other professionals to agree actions.
“Complaints made to the service had been investigated, responded to and contact had been made with the complainant to confirm they were happy with the actions taken.” from the report
People were not always safely observed
seriousStaff did not always provide the required level of one-to-one observation. Inspectors found missing observation records and staff who were unsure what support people needed.
“Staff had failed to maintain the levels of observation required to make sure people were safe which had resulted in serious incidents.” from the report
Medicine management failures
seriousSeven people missed some prescribed doses because medicines were not in stock. Records, storage and instructions for when-required medicines were not always safe.
“Seven people missed some doses of their prescribed medicines because there was no stock available in the home for them.” from the report
Staffing was not assured
needs fixingInspectors could not be confident that enough staff were available at all times, particularly when people needed one-to-one support. Staff and relatives also raised concerns about absences and turnover.
“However, we could not be assured that staffing levels were appropriate to meet the needs of people using the service.” from the report
Records and legal safeguards were unreliable
seriousDoLS information did not always match the position for people living at the home. Some care, nutrition and risk records also conflicted or were incomplete.
“Failure to maintain accurate records is a breach of Regulation 17(2) of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Limited food choice and activities
needs fixingPeople did not always have enough choice about meals, portion sizes or meal times. Activities were limited and were not consistently based on individual interests.
“People did not have activity programmes which were planned around their individual interests.” from the report
Management checks did not find problems
seriousThe provider carried out audits, but they did not reliably identify or correct serious issues with safety, medicines and records. Actions promised after earlier concerns were not always completed.
“Systems to assess, monitor and improve the service were not sufficiently robust.” from the report
- 01How do you now make sure every person receives the correct level of one-to-one or other observation, including overnight?
- 02What has changed to prevent people missing medicines, and how are medicine stocks, records and fridge temperatures checked?
- 03What staffing levels are in place on each unit and at night when people need one-to-one support?
- 04How have you corrected inaccurate DoLS, care, nutrition and observation records?
- 05What individual activities and meal choices are now available, and how do you check that people receive them?
This was the first comprehensive inspection of the newly registered home and covered all five key questions, including infection prevention and control. This explanation was written from the published report of 4 November 2022 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 Wykewood
2 rated inspections over a year: the service has improved, from Inadequate to Good.
- July 2023Goodcurrent ratingup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2022InadequateSafe: InadequateEffective: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- May 2021
Registered with the Care Quality Commission on 27 May 2021.
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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