The unannounced inspection took place on 09 November 2015. At the last inspection on the home had an overall rating of Requires Improvement. Wingates Residential Home is situated on a main road in the Westhoughton area of Bolton. It is on a bus route to the town centre, and is close to the motorway network. The home provides accommodation for 36 people, all in single rooms. There is a car park, a garden, and a patio area.
There was a manager at the home who was in the process of registering with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
On the day of the inspection there were 35 people residing at the home.
We looked at staffing levels on the day and at staff rotas and found they were of concern. Two apprentices were working on the day of the inspection and we questioned whether they should be performing the same tasks as care staff. The lounge was sometimes left unsupervised and we saw that people required assistance. Recruitment of staff at the home was robust.
Safeguarding and whistleblowing bullying policies were in place and staff demonstrated an understanding of the issues. The home had CCTV in communal areas and had a policy in place for this. There was a sticker in the window advertising that CCTV was in place but this should also have been referred to in the information given to people about the service to ensure they were aware of it.
Medicines policies were in place and we saw that medicines were ordered, stored, administered and returned safely.
We observed the meal time experience, which could have been improved with the addition of table mats, condiments and pictorial table menus. The environment could have been made more appropriate for people who live with dementia with the addition of better lighting, more signage and more appropriate pictures on the walls. There were a number of notices pinned to the walls in the home, which we asked the manager to remove as they were inappropriate.
The staff induction process was thorough and training had been undertaken by all staff. The new manager was in the process of collating information around staff training to ensure the new training programme was appropriate. Supervisions had not been undertaken for some time but the manager had begun to put these into place.
Consent for interventions was sought throughout the day. The home worked within the legal requirements of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS).
We observed care in the home throughout the day and saw it was delivered with kindness and compassion by care staff. People’s privacy and dignity was respected, there was a dedicated treatment room where people could receive treatment in privacy. If it was their wish people could receive treatment in their own bedrooms.
The home produced a quarterly newsletter and had a service user guide, which was in need of updating with details of new legislation and the new manager details.
Staff at the home had undertaken the Six Steps end of life training so that people could be cared for in the home environment at the end of their lives if this was their wish.
Care plans included some information about people’s preferences, likes and dislikes but were in the process of being updated to make them more person centred.
Choices were given regarding what and when people chose to eat and whether people stayed in their rooms our spent time in communal areas. However, people had not been given the choice of having a key for their rooms, which would have afforded them more privacy.
A range of activities was on offer at the home, including arts and crafts, trips out, religious services and entertainment. However, a significant number of people spent most of the day sitting in the lounge with little stimulation.
There was a complaints policy in place and this was displayed in the reception area and outlined in the service user guide. We saw a number of compliments received by the service.
People who used the service, visitors and staff felt the manager was approachable. The manager was aware of what was needed at the service, had put an action plan into place and had already completed some actions.
The home maintained good links with the local community.