At our last inspection on 3 March 2017 our overall assessment of the service was ‘Good’. However, we found that improvements were needed to ensure that the service was consistently safe. At this inspection we found that the improvements we had identified as being needed had been made. We have therefore revised our rating of this aspect of the service to 'Good.'

•People received safe care and were protected from avoidable harm, discrimination and abuse. There were sufficient staff to meet people’s needs and safe staff recruitment procedures were in place and used.

•People received their prescribed medicines safely and these were managed in line with best practice guidance.

•People lived in a clean and hygienic environment and were given appropriate support to manage their lifestyles and behaviours in the least restrictive way.

•People’s needs were assessed, monitored and reviewed and staff had the knowledge and skills to provide the right care and support for people.

•People were enabled to have maximum choice and control over their lives and the approaches to care delivery supported this practice.

•Staff were well supported to carry out their roles and had developed positive relationships with the people they cared for.

•Staff understood people’s needs, preferences, and what was important to them. People were supported to maintain and develop their interests and to enjoy a varied social life.

•There was an open, transparent culture within the service and care was personalised for each individual.

•People were encouraged to give their views about how the service was run and there were systems in place to monitor and keep improving the quality of the service provided.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

Good (report published February 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remained rated good overall.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

We inspected Wyngate Residential Care Home on 1 December 2015. This was an unannounced inspection. The service provides care and support for up to 26 people. When we undertook our inspection there were 22 people living at the home.

People living at the home were older people. Some people required more assistance either because of physical illnesses or because they were experiencing memory loss.

There was a registered manager in post. 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.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of our inspection there was no one subject to such an authorisation.

We found that there were sufficient staff to meet the needs of people using the service, but at times they were not deployed correctly to ensure people’s needs could be met. The provider had not taken into consideration the complex needs of each person to ensure their needs could be met through a 24 hour period.

We found that people’s health care needs were assessed, and care planned and delivered in a consistent way through the use of a care plan. People were involved in the planning of their care and had agreed to the care provided. The information and guidance provided to staff in the care plans was clear. Risks associated with people’s care needs were assessed and plans put in place to minimise risk in order to keep people safe. However, these were not always kept up to date when people’s needs changed.

Checks took place to ensure the environment was a safe one to live and work in. However, repair works took a long time to complete, so hindering the safety of individuals.

People were treated with kindness, compassion and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home. The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence and control over their lives.

People had a choice of meals, snacks and drinks. And meals could be taken in a dining room, sitting rooms or people’s own bedrooms. Staff encouraged people to eat their meals and gave assistance to those that required it.

The provider used safe systems when new staff were recruited. All new staff completed training before working in the home. The staff were aware of their responsibilities to protect people from harm or abuse. They knew the action to take if they were concerned about the welfare of an individual.

People had been consulted about the development of the home and quality checks had been completed to ensure services met people’s requirements.

When we visited the service in November 2013 we asked the provider to make improvements in staffing levels. This visit was to look at those improvements.

On the day of our visit 24 people were living at the home. The majority of people experienced some memory loss.

We spoke with two people who lived in the home, a visiting relative, two members of care staff and the manager of the service.

The provider had sent us an action plan telling us what they were going to do make the improvements required. We found improvements to the staffing levels in the service had been made for working during the daytime.

At night time a member of the home’s bank staff was always available to go to the home at short notice should they be required.

The people we spoke with told us there was sufficient staff on duty to meet all of their needs. One person told us, “The staff respond quite quickly when I push the bell.”

When we visited 21 people were living in the home. We spoke with 10 people who lived there as well as members of care staff and a visiting healthcare professional.

A senior carer was in charge on the day of our visit as the manager was not available. We looked at records and observed how staff supported the people living in the home.

We saw before people received any care or treatment they were asked for their consent. Staff spoke about making sure people gave their consent to help them get up in the mornings or have their personal hygiene needs met.

People told us they were very happy living in the home. One person said, “I think I’m cared for very well. You’d have to go a long way to find a better home.”

People told us the staff did not have time to talk to them and felt there were not enough staff on duty sometimes to care for them. On person told us, “At night time they could do with another member of staff, especially if someone is taken really poorly when it needs two staff to look after them."

The provider had a system to regularly assess and monitor the quality of service people received although this could be more robust.

The provider had sent us an action plan telling us what they were going to do to make sure they were compliant with the two standards we had set compliance actions against when we visited in August 2012. The first was to improve their quality assurance systems and the second was to improve their record keeping.

We spoke to people using the service very briefly. This was because we were mainly checking records and speaking with staff.

The home had a log of complaints they had received and the actions they had taken to resolve them. The manager had received training on how they should audit the services they provided to people and we saw the audits they had undertaken since our last visit. This included medication and care records.

Care records had improved since we visited in August 2012 and reflected all the care needs of people in the home. A member of staff told us the care records showed how they needed to care for people.

The people we spoke with told us they felt respected and involved with their care. We saw they were able to make choices about what they did during the day and had personalised their rooms. One person told us, “I have choices about everything here and that includes when I get up and go to bed.”

We were told by people they thought the care was very good and the care staff were kind to them. One person told us, “They’re marvellous, they’ve answered my every prayer.”

People said they felt safe in the home. One person we spoke with said, “If I didn’t feel safe I would tell the staff and they would help me.”

People felt supported by knowledgeable staff. One person told us, “Oh yes, they know what they’re doing.”

People knew how to complain if anything was wrong and felt confident it would be put right. The home’s systems to ensure continuous quality of care needed to be improved.

People’s care plans were not always comprehensive especially for people admitted to the home for short periods.