Wyndham Manor Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last inspection we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Records did not always evidence that an effective system was in place to assess people’s needs. There were shortfalls relating to medicines management, nutrition, mental capacity, distressed behaviours and continence care.

The provider had already identified many of the issues we found. They had introduced a new electronic care management system which provided tools to help staff effectively assess people’s needs. It was not possible to check how effective this new electronic care management system was since it had just been introduced and was not yet embedded into practice.

Records did not always evidence that care and support was delivered in line with best practice guidance and legal requirements. There were shortfalls relating to continence care, mental capacity, nutrition, medicines management and the assessment of people’s distressed behaviours.

The provider had already identified many of the issues we found. They had introduced a new electronic care management system which provided tools to help staff document how they delivered evidence-based care and support. It was not possible to check how effective this new electronic care management system was since it had just been introduced and was not yet embedded into practice.

An effective system was not fully in place at the time of our inspection to ensure staff teams worked together well. Prior to our assessment, staff meetings had not been carried out as planned. However, meetings were now taking place and a new electronic care management system had been introduced, which included tools to help communication and the coordination of care.

A new handover recording system had been introduced; whilst this proforma included more detailed information, it was not always accurate and not every person was recorded on the prepopulated handover record. In addition, there was no evidence of management oversight. Senior management staff told us this would be addressed.

Records did not always evidence how people were supported to live healthier lives. There were shortfalls relating to continence care, nutrition, supporting people who displayed distressed behaviours and medicines management. Assessments relating to the risk of malnutrition and choking were not always accurate and advice from the speech and language therapist could not always be located.

The provider had already identified many of the issues we found. They had introduced a new electronic care management system which provided tools to help staff document how they supported people to live healthier lives. It was not possible to check how effective this new electronic care management system was since it had just been introduced and was not yet embedded into practice.

Records did not fully demonstrate that staff monitored and improved people’s outcomes. We identified shortfalls relating to continence care, nutrition, supporting people who displayed distressed behaviours and medicines management.

The provider had already identified most of the issues we found. They had introduced a new electronic care management system which provided tools to help staff document how they monitored and improved people’s outcomes. It was not possible to check how effective this new electronic care management system was since it had just been introduced and was not yet embedded into practice.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met.

Records did not always demonstrate how staff followed the principles of the MCA. This meant there was a risk that people received care which did not uphold their rights.

DoLS applications had been submitted to the local authority for authorisation, if people’s plan of care amounted to a deprivation of liberty. However, CQC had not been notified of the outcome of some of these applications which was not in line with legal requirements.

The provider was organising additional staff training in relation to the MCA. They had introduced a new electronic care management system which provided tools to help staff document capacity assessments, best interests decisions and consent. It was not possible to check how effective this new electronic care management system was since it had just been introduced and was not yet embedded into practice.