Wykewood

Updated 4 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors, a medicines inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Wykewood is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Wykewood is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since it was registered. We received feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

We spoke with 2 people and 8 relatives about their experience of the care and support provided. We also spoke with 11 staff members, including the registered manager, clinical nurse lead, nurses, care staff and other members of staff who worked in the home. We reviewed a range of records. This included 3 peoples care records in detail including supplementary daily notes, and a sample of 2 other people’s care records. Multiple medication records were reviewed.

We looked at 3 staff files in relation to recruitment and induction and a variety of records relating to the management of the home, including training records, audits and policies.

Updated 4 July 2023

About the service

Wykewood is a care home providing personal care and nursing care to up to 40 people. The service provides support to people living with a range or physical, neurological, and mental health issues, including brain injury and dementia. At the time of our inspection there were 14 people using the service. 3 out of the 4 units were being occupied and used in the home. The fourth unit was not in use.

People’s experience of using this service and what we found

Systems were in place to keep people safe from abuse. We found medicines were being managed safely however we recommended the provider reviewed the process for administering medication covertly with prescribing professionals. Risk assessments were in place which linked with care plans however we found not all risks to people were being effectively monitored. We found examples where people were not on ABC charts despite having some behaviours which challenge and could pose a risk to themselves or others. Staffing levels according to the dependency tool were sufficient however we made a recommendation for staff deployment to be reviewed to ensure there were always enough staff to complete the 15-minute observations required. We saw evidence of lessons learnt where things had gone wrong.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service did not always provide sufficient choices of nutritious food for people, we saw a lack of vegetables and choice offered on the day of inspection. We recommended the service review this as well as reviewing the availability of foods to meet people’s specific dietary requirements. Pre assessments done prior to people being admitted to the home were detailed and specific. People were supported by staff who had received sufficient training and support to fulfil their roles.

The service was responsive to people’s needs and requirements. Care plans were detailed and contained person centred information and guidance for staff. The provider had assistive technologies to meet people’s specific communication needs. We saw evidence of activities and excursions for people which were planned specifically to meet their preferences and interests. Staff were trained to deliver end of life care and care plans were completed in line with these requirements.

Many of the shortfalls identified on the last inspection had been improved or rectified by the registered manager. The provider had effective audit systems in place which were driving the quality in the service. The registered manager was completing daily audits, walk arounds, and oversight in the service had improved. The provider was engaging with people, relatives and staff through a range of different methods to gain feedback on ways to improve the service. Staff told us the management team were supportive and visible on the units.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 1 November 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations

At our last inspection we recommended the provider reviews staffing arrangements to make sure staff are available, at all times, to meet people's needs. We also recommended the provider reviews catering arrangements to make sure people have choice in how and when they receive their meals. At this inspection we found the provider had acted on these recommendations and improvements had been made.

This service has been in Special Measures since 1 November 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 16, 21, 28 September 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, medicine management and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective, responsive and Well led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Inadequate to Good. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wykewood on our website at www.cqc.org.uk.