CQC report explained · a nursing home
What the CQC found at Wyndley Grange Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, appropriate medicines support and staff who understood safeguarding and risks. An incident involving concerns about neglect, verbal abuse and moving and handling was being investigated during the inspection.
- Effective?
- Good
- Staff had the skills and training needed to support people. People's consent, best interests, nutrition and access to health professionals were appropriately considered.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff promoted independence, offered choices and supported people to maintain important relationships.
- Responsive?
- Good
- Care plans contained personalised information and were reviewed regularly. People could choose activities and knew how to raise complaints.
- Well-led?
- Good
- Inspectors found approachable managers, clear staff responsibilities and quality checks. Feedback from people, relatives and staff was gathered and used to improve the service.
What inspectors found, January 2018
Wyndley Grange Nursing Home was rated Good; inspectors found significant improvements, with one safety investigation still ongoing.
This was an unannounced inspection on 18 and 19 October 2017. Inspectors spoke with people living in the home, relatives, staff and health professionals. They observed care and checked care records, medicines records, recruitment files, complaints and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines support, kind care, suitable training, personalised support, activities and systems for handling concerns.
The previous inspection in November 2016 rated the home Requires Improvement overall, including Safe, Responsive and Well-led. Inspectors found significant improvements in these areas. They also noted that an incident involving concerns about neglect, verbal abuse and moving and handling was being investigated by another organisation at the time of this inspection.
Improved safety systems
The home had improved checks for people who could not use call bells and had introduced assessments for bed rails. Instructions for as-required medicines were clearer and more personalised.
“At this inspection we found the provider had made significant improvements in these areas.” from the report
Kind and respectful care
People told inspectors that staff were kind and caring. Observations showed respectful support, including during personal care and transfers.
“We saw that staff were attentive and had a kind and caring approach towards people and spoke to them affectionately.” from the report
Choice and independence
People were offered choices about daily care, meals and where to eat. Staff encouraged people to do things for themselves where possible.
“Throughout the day we saw staff supporting people to make decisions for them, where practicable, regarding what they wanted to do and promoting their independence.” from the report
Activities and personal interests
The home offered group and individual activities, including reminiscence activities for people with dementia. People's suggestions were recorded and used to plan activities.
“We saw that there were reminiscence activities for people with dementia, which families were involved in talking about people's life history.” from the report
Open management
People, relatives and staff felt able to approach the managers. Staff understood their roles and the home had systems for gathering feedback and reviewing quality.
“People we spoke with were confident about approaching the managers if they needed to.” from the report
Safety investigation
seriousAt the time of the inspection, another organisation was investigating concerns about neglect, verbal abuse and moving and handling. Inspectors did not report that these concerns were evident in staff practice during their visit.
“At the time of our inspection there was an incident being investigated by one of our partner organisations regarding concerns of neglect, verbal abuse and moving and handling of people” from the report
- 01What was the outcome of the incident investigation involving concerns about neglect, verbal abuse and moving and handling?
- 02How do you check that staff use hoists and other equipment safely when moving people?
- 03How will you assess and review my relative's risks, including whether they can use a call bell or need regular checks?
- 04How are as-required medicines explained to staff and checked to ensure they are given correctly?
- 05How will you involve my relative and our family in care reviews, meals and activities?
This was an unannounced comprehensive inspection covering all five key questions and the overall rating. This explanation was written from the published report of 12 January 2018 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, December 2016
Requires Improvement; inspectors found kind and effective care, but concerns about medicines, records, risk management and leadership.
This was an unannounced inspection on 3 and 8 November 2016. It was brought forward after concerns that people's care needs were not being met. Inspectors spoke with people living in the home, relatives and staff. They observed care and checked care records, medicines records, complaints and audits.
Inspectors found that people were treated kindly and with dignity. Staff had training and understood safeguarding. People were supported with healthcare, choices and decisions about their care. These areas were rated Good.
However, medicines were not always given as prescribed. Some risk assessments and health monitoring records were incomplete. Care information was held across two systems and was not always up to date. Staff reported feeling unheard, and quality checks had not found the problems. Safe, Responsive and Well-led were rated Requires Improvement.
The overall rating was Requires Improvement. The previous inspection in September 2015 rated the home Good. The provider had agreed with other agencies to stop new placements temporarily while improvements were made.
Kind and respectful care
People were treated with compassion and respect. Staff checked people's choices before providing care and promoted privacy and independence.
“We saw that people were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.” from the report
Trained staff
Staff had training and supervision and showed knowledge of people's care needs. They understood safeguarding responsibilities.
“Staff spoken with had a good understanding about their safeguarding responsibilities and was confident about their role in keeping people safe.” from the report
Healthcare support
People were supported to see healthcare professionals and referrals were made when needed. Inspectors found examples of prompt action when someone's health changed.
“People told us told us they were supported to see their GP, attend hospital appointments, or appointments to see other healthcare professionals such as the dentist or chiropodist.” from the report
Medicines were not always safe
seriousSome as-needed medicines did not have enough instructions for staff. One medicine was given regularly even though it was prescribed only when needed. Refrigerator temperatures were also outside the safe range without appropriate action.
“People did not always receive their medication as prescribed.” from the report
Risks were not consistently managed
seriousSome bed rail risk assessments were missing. Records did not always show checks for people who could not use their call bells, and staff did not always consider possible causes when someone was found in an unusual position.
“However we saw that where bed rails were in place risk assessments had not been completed for the use of bed rails to ensure that the risk to the person were managed.” from the report
Care records were incomplete
needs fixingFluid charts were not consistently completed. Instructions from visiting health professionals were not always added to care records, and staff were using two care record systems.
“Some of the care records showed that information was not updated when other visiting professionals gave instructions, so current information was available for staff to ensure people's care needs were met.” from the report
Weak quality checks
needs fixingThe provider's audits had not identified several shortfalls. A satellite kitchen had dirty equipment and no cleaning schedules, although it was closed and cleaned during the inspection.
“The providers systems to monitor the quality of care provided had not identified this shortfall.” from the report
Staff felt unheard
needs fixingSome staff reported feeling devalued, intimidated or unable to raise concerns. The report linked this to a lack of an open and transparent culture and increased use of agency staff.
“This showed that there was not a clear, transparent and open culture in the home where staff felt valued and able to raise concerns.” from the report
- 01What has been changed so as-needed medicines are given only when prescribed, with clear instructions for staff?
- 02How are medicine refrigerator temperatures checked and acted on when they fall outside the required range?
- 03How do you make sure care records include the latest instructions from doctors, nurses and other health professionals?
- 04How are fluid charts and other monitoring records checked for completeness each day?
- 05What has been done to improve staff communication, reduce reliance on agency staff and make it easier for staff to raise concerns?
This was an unannounced inspection covering all five key questions and the overall rating, after the inspection was brought forward because of concerns about people's care needs. This explanation was written from the published report of 30 December 2016 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 Wyndley Grange Nursing Home
3 rated inspections over 2 years: the service has held its Good rating throughout.
- January 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2016Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 January 2011.
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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