Wingates Residential Home provides accommodation for 36 people, all in single rooms. The home is situated on a main road in the Westhoughton area of Bolton. It is on a bus route to the town centre, and is close to the motorway network. There is a car park, a garden, and a patio area.

The inspection took place on 02 March 2017 and was unannounced. At the time of the inspection there were 30 people living at the home. The last inspection was undertaken in November 2015 where the service was given an overall rating of Requires Improvement due to concerns around staffing levels, the dining experience, lack of staff supervisions and lack of person centred care plans.

There was a registered manager in place. 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.

People told us they felt safe at the home. There was a robust recruitment procedure, which helped ensure staff were suitable to work with vulnerable people. Staffing levels were sufficient to meet the needs of the people who used the service. Staffing was flexible to respond to changing needs.

Safeguarding and whistle blowing procedures and guidance were in place and staff we spoke with demonstrated a good understanding of the issues. Health and safety measures were in place and records complete and up to date.

There was an appropriate medicines policy and procedure in place. We saw that the medication systems were effective and medicines were ordered, stored, administered and disposed of safely.

The induction programme was thorough and included all mandatory training. There was an on-going training programme and refresher courses were accessed as necessary.

The décor of the premises and some of the furniture and fittings, such as beds, duvets and curtains were in need of replacing and updating. The lighting was poor in some areas of the home and required attention.

The home was working within the legal requirements of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS).

People told us staff were kind and caring and we observed friendly and respectful interactions throughout the day. People’s privacy and dignity was respected. Information given to families and potential users of the service was informative and appropriate.

People’s wishes for when they were nearing the end of their lives were respected. Care given at this time was delivered well in conjunction with other professionals.

People were given choices and their wishes, likes and dislikes were recorded and adhered to by the service.

There were a number of activities on offer at the home as well as entertainers and celebrations of special occasions. People were supported to follow their own interests.

Complaints and concerns were dealt with appropriately and the service had received a number of compliments. Regular feedback was sought to help the service continually improve the delivery of care and support.

People who used the service, relatives and staff members felt the registered manager was approachable and supportive. Staff supervisions were undertaken regularly and there were regular staff meetings, which all helped offer support to staff.

A number of audits and checks were carried out regularly. The results of these were analysed to help drive improvement to the service.

The unannounced inspection took place on 09 November 2015. At the last inspection on the home had an overall rating of Requires Improvement. Wingates Residential Home is situated on a main road in the Westhoughton area of Bolton. It is on a bus route to the town centre, and is close to the motorway network. The home provides accommodation for 36 people, all in single rooms. There is a car park, a garden, and a patio area.

There was a manager at the home who was in the process of registering with the Care Quality Commission. 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.

On the day of the inspection there were 35 people residing at the home.

We looked at staffing levels on the day and at staff rotas and found they were of concern. Two apprentices were working on the day of the inspection and we questioned whether they should be performing the same tasks as care staff. The lounge was sometimes left unsupervised and we saw that people required assistance. Recruitment of staff at the home was robust.

Safeguarding and whistleblowing bullying policies were in place and staff demonstrated an understanding of the issues. The home had CCTV in communal areas and had a policy in place for this. There was a sticker in the window advertising that CCTV was in place but this should also have been referred to in the information given to people about the service to ensure they were aware of it.

Medicines policies were in place and we saw that medicines were ordered, stored, administered and returned safely.

We observed the meal time experience, which could have been improved with the addition of table mats, condiments and pictorial table menus. The environment could have been made more appropriate for people who live with dementia with the addition of better lighting, more signage and more appropriate pictures on the walls. There were a number of notices pinned to the walls in the home, which we asked the manager to remove as they were inappropriate.

The staff induction process was thorough and training had been undertaken by all staff. The new manager was in the process of collating information around staff training to ensure the new training programme was appropriate. Supervisions had not been undertaken for some time but the manager had begun to put these into place.

Consent for interventions was sought throughout the day. The home worked within the legal requirements of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS).

We observed care in the home throughout the day and saw it was delivered with kindness and compassion by care staff. People’s privacy and dignity was respected, there was a dedicated treatment room where people could receive treatment in privacy. If it was their wish people could receive treatment in their own bedrooms.

The home produced a quarterly newsletter and had a service user guide, which was in need of updating with details of new legislation and the new manager details.

Staff at the home had undertaken the Six Steps end of life training so that people could be cared for in the home environment at the end of their lives if this was their wish.

Care plans included some information about people’s preferences, likes and dislikes but were in the process of being updated to make them more person centred.

Choices were given regarding what and when people chose to eat and whether people stayed in their rooms our spent time in communal areas. However, people had not been given the choice of having a key for their rooms, which would have afforded them more privacy.

A range of activities was on offer at the home, including arts and crafts, trips out, religious services and entertainment. However, a significant number of people spent most of the day sitting in the lounge with little stimulation.

There was a complaints policy in place and this was displayed in the reception area and outlined in the service user guide. We saw a number of compliments received by the service.

People who used the service, visitors and staff felt the manager was approachable. The manager was aware of what was needed at the service, had put an action plan into place and had already completed some actions.

The home maintained good links with the local community.

We carried out this unannounced inspection under Section 60 of the Health and Social Care Act 2008 on 21 October 2014 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. At the last inspection in November 2013 the home was found to be meeting all the regulatory requirements.

Wingates Residential Home provides residential care for 36 people. At the time of the visit there were 36 people resident at the service, though one person was in hospital.

There was a registered manager at the home. 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.

We found the home to be clean and homely, although the environment offered little stimulation or support to people living with dementia conditions.

People who used the service were well presented and relationships between them and the staff were friendly and comfortable. People told us they felt safe living at the home and were able to speak to staff or the manager about any issue or concern.

People’s dignity and privacy were respected and they were given choice in many areas of their life. Meal choices could have been made clearer and menus more accessible to people with confusion or living with dementia.

There were a range of activities on offer at the home and people were encouraged to participate if they wished to do so. The home had good links with the local community, enabling people to feel part of a wider society.

Staff, visitors and people who used the service said the manager had an open door policy and was approachable. Quality assurance arrangements were in place at the home.

We visited Wingates Residential Home on 5 November 2013 and saw people who used the service were well presented. The home was clean, tidy and free from malodour. Staff were seen to be polite and friendly towards people who used the service.

People who used the service and their relatives were kept informed of news and events via newsletters and regular meetings. They were invited to put forward suggestions and raise concerns through questionnaires, at the meetings or by speaking with staff.

Care plans were clear and easy to follow. They contained health and personal information which was relevant and up to date.

We spoke with three people who used the service and three visitors. One person who used the service told us, “I love it, they are my family. You can have a good laugh and they listen to you”. Another person commented, “They are all very kind and good”.

A visitor said, “I have two relatives here, I brought my X because the care was so good”. Another told us, “I am always made welcome and my X is looked after well".

People’s nutritional and hydration requirements were adhered to. Weight and nutritional intake charts were completed and referrals to appropriate professionals were made.

Staff at the home were suitably qualified and training and development was on-going.

There was a complaints procedure in place and regular audits and checks were completed to help ensure the care delivered was of a high quality.

We visited Wingates Residential Home on 5 February 2013 and found that the premises were clean, tidy and warm. The people who used the service were well presented and we saw that staff interacted with them politely and with respect. We saw that care was delivered in a timely and efficient way.

We spoke with four people who used the service and they were all positive about the care they received. One person said “We are very well looked after, the food is excellent, we want for nothing here.”

We also spoke with three relatives and two professional visitors. One visitor said “I have peace of mind, I know X is fed well and warm and looked after. My life is easier and X is supported.” A professional visitor said “The end of life care is excellent, communication is great, they respond quickly to suggestions and comments made.

We looked at a sample of six care plans and found them to contain up to date, relevant medical and health information as well as records of care needs. We saw that these were person centred and individualised to incorporate people’s choices and preferences.

We observed that relevant policies and procedures were in place within the home and staff were aware of them. We saw evidence of training undertaken by staff and encouragement of staff members to continually develop their knowledge and skills.

We saw that there was a complaints procedure in place and noted that complaints were taken seriously and followed up appropriately.

People told us that they had choices around their daily activities. Activities were arranged every day, and one person said they liked the quizzes while another said they liked to join in the singing. We heard, “It’s just like a hotel. The staff are first class” and “The home is comfortable and homely, the staff are kind and caring to residents and relatives.