We carried out a review of the data available to us about Wyvern Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Wyvern Lodge, you can give feedback on this service.
People's experience of using this service and what we found
There had been significant improvements following the inspection of 3 and 4 December 2019. Positive changes had been made to safely manage the water temperatures within the home. Thermostatic mixing valves had been fitted to taps to safely regulate water temperatures. Temperatures were tested of each tap regularly. The upstairs bathroom had been replaced since the last inspection, which was clean. Changes had been made to infection control procedures at the home. The home was clean and tidy throughout with no shortfalls identified. Statutory notifications were appropriately submitted to the CQC where concerns had been shared with the local safeguarding team and when the police had been called to the service.
People were supported to remain safe. Staff were trained in safeguarding and understood their responsibility to protect people from avoidable harm and abuse. Safe recruitment and selection processes were followed. Risks to people's health and safety were assessed with guidance for staff to follow. Medicines were administered safely to people. Accidents and incidents were reported and recorded with audits in place to help identify any trends or patterns.
Staff were enthusiastic and happy in their work. They felt supported within their roles. Staff described working together as a team, they provided person-centred care and helped people to achieve their potential. The home was well-led by a registered manager who was committed to improving people's quality of life. The home had a clear management and staffing structure in place and staff worked well as a team. The registered manager was aware of their duty of candour. Effective quality assurance systems were in place to monitor the quality and safety of care. Audits had improved which helped to identify any shortfalls.
Rating at last inspection
The last rating for this service was Requires Improvement (published 4 March 2020). At our last inspection we found people were at risk from scalding because water temperatures exceeded safe ranges. Areas in the home also posed a risk of infection. Statutory notifications had not always been sent in line with requirements. At this inspection we found improvements had been made.
Why we inspected
We carried out an inspection of this service on 3 and 4 December 2019. We rated the service requires improvement in Safe and Well Led due to the shortfalls, which we identified. 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.
We undertook this focused inspection to check the provider 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 and Well-led.
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 Requires Improvement to Good. This is based on the findings at this inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wyvern Lodge on our website at www.cqc.org.uk.
People were not always protected from the risk of harm; water temperatures exceeded the safe ranges identified in the provider’s policy. Quality assurance checks had not always been used effectively to identify shortfalls. For example, that water temperatures were not being checked in line with the provider’s policy and that water exceeded safe temperature ranges.
The provider could not always be assured people were protected from the risk of infection. Areas in the home were visibly dirty and could not always be cleaned effectively because they had not been adequately maintained. The provider had approved for maintenance work to commence in April 2020. Statutory notifications were not always submitted to the commission when required.
Staff had access to personal protective equipment [PPE], such as gloves and aprons. People were protected from the risk of potential abuse. Staffing levels were sufficient to meet the needs of people and staff were recruited safely.
The provider engaged with people and their relatives. The registered manager had built strong links with the local community. People, relatives and staff spoke positively about the registered manager.
People’s needs were assessed, although assessment for oral healthcare was not always completed in line with published guidance about best practice. We did see some evidence people were supported to access the dentist. Staff were supported in their roles with relevant training and support.
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.
People were supported to access meaningful activities and opportunities for work and development. People felt proud about what they had achieved. People received personalised care and support that was responsive to their needs. People’s end of life care preferences were explored and recorded.
People told us they were supported by kind and caring staff, our observations confirmed this. People’s dignity and privacy was respected and maintained. People were supported to be involved with decisions about their care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published June 2017).
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wyvern Lodge on our website at www.cqc.org.uk.
We have identified breaches in relation to the inconsistent submission of statutory notifications and safe care.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
At the last inspection, the service was rated Good.
At this inspection we found the service remained Good.
Why the service is rated Good:
People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
Risks to people were assessed and where required a risk management plan was in place to support people manage an identified risk and keep the person safe.
Staffing numbers were sufficient to meet people’s needs and this ensured people were supported safely. People told us they felt safe living at the service.
The provider ensured that new staff completed an induction training programme which prepared them for their role. Training was completed in essential matters to ensure staff and people at the service were safe. Staff were supported through a supervision programme. Supervision is where staff meet one to one with their line manager to discuss their work and development.
People were supported to maintain good health and had access to external health care professionals when required.
Staff were caring towards people and there was a good relationship between people and staff. Staff demonstrated an understanding of the needs and preferences of the people they cared for.
Support provided to people met their needs. Supporting records highlighted information about what was important to people and how to support them. People were involved in activities of their choice.
There were systems in place to assess, monitor and improve the quality and safety of the service. Staff described the registered manager as supportive. Comments from people confirmed they were happy with the service and the support received.
Further information is in the detailed findings below.
Wyvern Lodge is a care home which provides accommodation and personal care for up to eight people with mental health needs. At the time of our inspection eight people were living at Wyvern Lodge.
This inspection took place on 23 January 2015 and was unannounced.
There was a registered manager in post at the service. 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 and associated Regulations about how the service is run.
People who use the service and their relatives were positive about the care they received and praised the quality of the staff and management. Comments from people included, “Staff are really good. They don’t just do things for you like in hospital” and “You can talk to staff here, they try to understand you”.
People told us they felt safe when receiving care and were involved in developing and reviewing their support plans. Systems were in place to protect people from abuse and harm and staff knew how to use them.
Staff understood the needs of the people they were supporting. People told us staff provided support with kindness and compassion.
Staff were appropriately trained and skilled. They received a thorough induction when they started working for the service. They demonstrated a good understanding of their roles and responsibilities, as well as the values and philosophy of the service. The staff had completed training to ensure the care and support provided to people was safe and effective to meet their needs.
The service was responsive to people’s needs and wishes. People had regular group and individual meetings to provide feedback and there were robust complaints procedures. One person told us; “Complaints are dealt with positively. I am able to talk to staff and issues will be dealt with”
The registered manager assessed and monitored the quality of care. The service encouraged feedback from people and their relatives, which they used to make improvements.
There was a relaxed and friendly atmosphere in the home. People appeared very comfortable with the staff who supported them. Everyone we asked said that they felt safe at the home. One person said 'There is no problem. I always feel safe here.' Another person said 'All the staff are kind and respectful.'
People told us they were very happy with the care and support they received. One person said 'They help you and are always there for you.' Another person told us 'I'm a much more confident person since I have been here and that helps with everything.'
People were very complimentary about the staff who supported them. Comments included; 'Staff are kind and always there to help you' and 'Staff are lovely and encourage you to do the things you want to do.'
Staff personnel files gave evidence of a robust recruitment process which ensured that new staff had the relevant skills and were of good character. The recruitment procedure also minimised the risks of abuse to people who lived at the home by making sure that all staff were thoroughly checked before beginning work.
There were systems in place to effectively monitor the quality of care and to identify and minimise risks to people.
We observed staff had a very close and friendly rapport with people. We saw people were encouraged to make their own decisions about daily activities and staff supported them once the decision was made.
We found that people consented to their care and treatment, both in writing and verbally on a daily one to one basis.
We saw care planning was person centred and agreed with the individual. Regular reviews were carried out and also involved the individual.
We found the receipt, storage and administration of medication was managed safely within the Royal Pharmaceutical Society guidelines.
Staff confirmed they were given the opportunity to build on their skills and received appropriate support from the manager. The provider had an effective complaints system available.
People who use the service told us that they feel that wyvern lodge is a supportive place to live, one person told us, 'the staff are really supportive and helpful'.
The people we met feel they are well supported by the staff to regain independence in their daily lives. We saw the staff team spending time helping people, listening to them and talking to them in a way that conveyed respect and sensitivity to their needs.
People who use the service each have a detailed, informative care plan written with their involvement that sets out what sort of support they require with their range of mental health needs. Care plans are a record to guide staff and explain what care and support a person needs. We found the information in the care plans was helpful and detailed enough to guide staff to provide effective support to people with their mental health needs. We also read useful information in the care plans about how to encourage people to develop more independence in their daily lives.
We found that people who use the service are supported to buy, prepare and cook the meals they like to eat. People are supported by the staff with training and guidance, so that they understand how to eat a healthy well balanced diet.
We saw that people who use the service live in a homely and comfortable environment. The environment is enhanced because people are able to choose the colour of the paint for the walls in their bedrooms. We also saw art works created by people who live at the home on display in communal areas.
We found that people benefit because they are supported by staff who are effectively monitored and supervised in their work and practise.
We saw evidence that staff do regular training courses and update themselves in their knowledge about a range of subjects relevant to the needs of the people who use the service. This training for staff in a range of subjects relevant to the care of people who use the service, helps ensure staff understand how to give them the support they need.
We saw that people who use the service are involved in monitoring the quality of service and care they receive. We also saw that the manager and the staff act on the views of people who use the service to improve overall outcomes for them even more.
People benefit from the way that complaints about the service will be addressed. When complaints are made there is an easy to follow procedure that means complaints have to be properly responded to and resolved where possible, to the satisfaction of the person making the complaint.