4 May 2023
During an inspection looking at part of 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.