This inspection took place on 24 and 31 May 2018. The inspection was unannounced. This meant the provider and staff did not know we would be attending. This was the first inspection of the care home since it was registered under the new legal entity of Anchor Care Homes Limited.Wynyard Woods is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The care home accommodates up to 50 people in one adapted building across two floors. One of the floors specialises in providing care to people living with a dementia. At the time of our inspection there were 46 people using the service.
The home had a registered manager. 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.
During our inspection we found a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – Good Governance. We found records were not accurate and up to date. Staff administered people’s oral medicines in a safe manner. However, we found there were gaps in the record for people’s topical medicines (creams applied to the skin) and we could not be reassured people were in receipt of their prescribed topical medicines. Food and fluid charts were incomplete and did not show people were getting the right nutritional intake according to their assessed needs. People’s needs were assessed before they began to live at Wynyard Woods. The home provided a service to people who needed respite care. We found one person who had been admitted for a further period of respite care whose records had not been updated. We found audits used to monitor the quality of the service failed to identify the deficits we found in the service.
The service had received accreditation from the provider due to the work they had achieved on providing care to people with dementia. We found the environment of the home was not conducive to supporting the independence of people living with dementia.
We carried out observation of a mealtime and found staff did not engage people in meaningful conversations. Staff were task centred and people’s experience of mealtimes could be improved. We recommended the provider carry out a review of mealtimes.
The provider used a dependency tool to measure the numbers of staff on duty. We found the staff on duty matched the outcome of the dependency tool. Relatives told us there did not always appear to be enough staff on duty. We recommended the provider review the deployment of staff.
There were differing opinions between staff and relatives regarding the provision of meaningful activities for people. People were supported to go out and attend activities if they wished. Relatives spoke with us about the long hours in the home with no provision of activities. We recommended the provider review the activities on offer for people using the service.
Regular checks were carried out on the home to make sure people lived in a safe environment. These included for example, fire and water checks and window restrictors.
Accidents and incidents were recorded by staff and reviewed by the management team to ensure actions were taken to prevent a reoccurrence.
Staff were trained in how to safeguard people who used the service. Staff told us they felt able to raise concerns.
Pre-employment checks were carried out on staff before they began working in the home. This ensured staff were suitable to work with people who needed support. Staff were provided with an induction and training to carry out their roles. They had regular supervision meetings with their line manager.
The provider had a complaints process in place. We saw relatives had complained about the length of time it took to fix the lift. A stair lift had been put in place. The lift had now been repaired.
Cleaning was carried out throughout our inspection. We drew to the attention of the management team areas of the home which required further cleaning. These areas were addressed during our visits to the home.
Kitchen staff were given information about people’s dietary requirements and understood people’s needs. A menu was on display in the reception area. People told us if they did not like what was on the menu alternatives were available.
Systems were in place to promote good communication between staff. These included handover records were pertinent information was passed between shifts to enable staff to be up to date with people’s care needs.
People and their relatives were given the opportunity to engage with the service. A resident and relatives meeting was held on a regular basis.
Staff respected people’s dignity and privacy. Personal care took place behind closed doors and staff knocked on people’s bedroom doors to seek permission to enter.
The home was a part of the community and used by local services to support local people.
The provider carried out an annual survey of the home. The provider was open and transparent regarding the results of the survey and had put them on their website
You can see what action we told the provider to take at the back of the full version of the report.