This was an unannounced inspection, which took place on the 25 November 2014. Wingham Court Care Centre is a BUPA care home which provides long-term nursing care and short stay care for up to 73 younger people. The service offers specialist support for those who have a brain injury or for those who have challenging behaviour. It is registered for up to 73 people. At the time of our inspection there were 71 people at the service.
The service is split into four areas on two floors. Rexley one and Rexley two are for people who have a physical disability and is on the ground floor. On the first floor is YPD one and YPD two which is for people living with a cognitive impairment or have an acquired brain injury.
At the time of inspection there was no 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 and associated Regulations about how the service is run.
People and their relatives told us that they felt they were safe. Not all staff had received updated safeguarding adults training but had knowledge of the safeguarding procedures and what to do if they suspected abuse. In addition not all staff had received up to date training in moving and handling and health and safety. This meant that staff may not have the most up to date guidance.
There were not always enough staff to safely meet people’s needs. This meant that sometimes people did not receive personal care in a timely way or at all. People did not always have their medicine on time and were sometimes woken late at night to have their medicine.
There were processes in place in relation to the correct storage and audit of people’s medicines. All of the medication was administered and disposed of in a safe way. Although there was a risk, due to lack of staff, that people may not get their medication in a timely way.
Pre-employment checks for staff were completed. For example in relation to their full employment history and reasons why they had left previous employment. This meant that only suitable staff worked there.
There was a risk of cross infection. Some areas of the service were clean. However there were certain aspects to the infection control that needed improvement. People’s rooms, the corridors and some of the living areas were not clean. Staff were not always using the correct procedures where bedpans were cleaned and sterilised.
Some people thought the food was good and felt that their needs were catered for. People were encouraged to make their own decision about the food they wanted. Other people felt that the food was not good and that they didn’t always get what they had asked for. We saw that there was a wide variety of fresh food and drinks available for people.
Some staff knew about the Mental Capacity Act 2005. However we saw that mental capacity assessments had not taken place in relation to one of the units. The unit had a key pad lock in place that some people were unable to access.
People thought that the staff were caring and that they were treated with dignity and respect. They also felt that if they needed privacy then this would be given. Staff communicated with people in a meaningful way however there were times where people were left for long periods of time without any interaction with staff.
People did not always feel that staff understood their care needs. One person said that they felt that staff did not understand their specific health needs. People had access to other health care professionals as and when they required it.
Some activities were available. We saw that some people enjoyed an activity on the day of the inspection. However there were not enough activities provided for people specific to their needs.
People did not always understand how to make a complaint and did not always feel comfortable to do so. There was a copy of the complaints procedure for everyone to see in the reception area. All of the complaints were logged and an action plan was written to resolve the complaint where possible.
People, relatives and staff were asked for their opinion and feedback on what they thought of the service. However these comments were not always used to make improvements. For example in relation to improving the environment.
People and staff did not feel that there was the management support in place in the service. The audits that took place were not effective and improvements had not been made as a result of the audits. For example in relation to the cleanliness and care plans. People were regularly asked for their feedback on the service through meetings and surveys. Information from these were used to make improvements.
We found several breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.
You can see what action we told the provider to take at the back of the full version of the report.