Inspection Reports for Wellington House

The complaint investigation substantiated physical abuse of Resident #1 by multiple staff members and failure to report and protect residents. The facility neglected to report the abuse to the Administrator for four days and failed to notify the Health Care Personnel Registry about involved staff. Staff E and Staff F were suspended and later terminated.

The facility failed to protect residents from physical abuse by staff, including hitting a resident with a shower head and hairbrush and throwing ice at residents. The facility also failed to report the abuse timely and did not complete required Health Care Personnel Registry reports. These failures resulted in a Type A1 and a Type A2 violation.

The complaint investigation was substantiated as the facility failed to supervise Resident #1, who had dementia and wandering behaviors, allowing her to elope and be found 4.2 miles away, resulting in physical harm and hospitalization.

The facility failed to provide adequate supervision for a resident with dementia who eloped from the facility, resulting in substantial risk of physical harm. The resident was found several miles away and required hospital treatment for low blood pressure and dehydration. The facility did not ensure proper supervision and security measures to prevent elopement.

Complaint investigations were initiated by the Gaston County Department of Social Services on 01/20/22 and 01/28/22. The investigation found residents were not dressed due to positive resident COVID cases and residents staying in their rooms, leading to failure in maintaining residents' rights.

The facility failed to ensure that 5 of 9 sampled residents in the Special Care Unit were treated with dignity and respect due to not being dressed in a timely manner. Observations and care plan reviews showed residents were dependent on staff for dressing but were left undressed due to positive COVID-19 cases and residents staying in their rooms.

The complaint investigation included a desk review from August 6-7 and August 10-14, 2020, and an onsite COVID-19 focused Infection Control survey on August 10, 2020, with a telephone exit on August 14, 2020.

The facility failed to implement a physician ordered laboratory test for one resident and failed to maintain CDC, NC DHHS, and local health department COVID-19 infection control guidelines, resulting in residents with positive and negative COVID-19 test results sharing rooms. Additionally, the facility failed to accurately document medication administration for one resident, including insulin and other medications.

A deficiency was not corrected; specifically, at least two staff were unaware of the location or use of the required central emergency release switch for the special magnetic locking on all exit doors, indicating a failure in staff training for emergency evacuation procedures.

Deficiencies related to the original complaint were not corrected and further action is required. The inspection was a follow-up to verify correction of these deficiencies.

Deficiencies related to the original complaint were not corrected, requiring further action. New deficiencies were found regarding the Special (magnetic) Locking system on all exit doors, which failed to operate as required by the NC State Building Code, including failure to unlock on fire alarm activation and emergency release switch activation. Additionally, most staff were not aware of the location or use of the required central emergency release switch, indicating a need for proper staff training.

The complaint was partially substantiated based on observations during the survey.

The complaint was partially substantiated with deficiencies cited related to failure to meet NC State Building Code requirements for emergency release switches on locked doors, corridor obstructions blocking exit access, exposed electrical wiring hazards, incorrect exit signage, and lack of documentation for monthly inspections of the range hood fire suppression system.

The complaint investigation was initiated by the Gaston County Department of Social Services on May 23, 2019, following reports of alleged sexual assaults involving two residents at the facility.

The facility failed to respond immediately to an alleged sexual assault involving Resident #1 by not sending her to the hospital for medical evaluation until the next day, and failed to immediately notify local law enforcement after an alleged sexual assault involving Resident #2. These failures resulted in substantial risk for harm and neglect of the residents.

The facility failed to provide adequate exhaust ventilation in certain areas, specifically the laundry room and Blue Spa, as mechanical exhaust fans were not exhausting interior air in these locations.

Complaint investigation was initiated by the Gaston County Department of Social Services on October 24, 2017, related to failure to schedule a cardiology referral appointment for Resident #3.

The facility failed to assure a referral appointment was made for 1 of 5 sampled residents (#3) with a cardiology referral following two visits to the emergency department. Despite discharge instructions and follow-up recommendations, no cardiology appointment was scheduled for Resident #3.

The facility was found deficient in meeting the NC State Building Code and adult care home physical plant requirements, including lack of adequate fire detection devices, unfastened wood trim presenting a hazard, incomplete fire protection in electrical ceiling penetrations, and failure to provide proper exhaust ventilation in specified areas.

The followup survey revealed that all deficiencies had not been corrected. Deficiencies included failure to maintain current sanitation and fire safety inspection reports, loose hand grips in bathrooms, improper use of bathrooms for storage, unsafe outside premises, inadequate housekeeping and furnishings, hazards in HVAC and plumbing systems, malfunctioning emergency lighting, impaired fire sprinkler escutcheon plates, breaches in fire-resistance-rated construction, non-latching corridor doors, and inadequate exhaust ventilation in specified rooms.

The facility was found to have multiple deficiencies including unclean and poorly maintained furniture in activity areas, failure to assure follow-up on laboratory orders for two residents, failure to provide residents with at least one outing every other month, and failure to clarify incomplete medication orders related to additional sodium in residents' diets.

Multiple physical plant deficiencies were identified including lack of current fire safety inspection reports, unstable hand grips in bathrooms, improper use of bathrooms for storage, unsafe outside premises, housekeeping and maintenance issues, inadequate fire extinguisher maintenance, incomplete fire safety rehearsal documentation, unsafe building equipment and electrical systems, and insufficient exhaust ventilation.