Inspection on 23/01/09 for East Wheal Rose Farmhouse

This inspection was carried out on 23rd January 2009.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

East Wheal Rose Farmhouse 08/02/07

East Wheal Rose Farmhouse 08/12/05

East Wheal Rose Farmhouse 05/07/05

East Wheal Rose Farmhouse 06/01/05

East Wheal Rose Farmhouse 06/07/04

East Wheal Rose Farmhouse 30/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Honeybourne House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: East Wheal Rose Farmhouse St Newlyn East Newquay Cornwall TR8 5JD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ian Wright     Date: 2 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: East Wheal Rose Farmhouse St Newlyn East Newquay Cornwall TR8 5JD 01872510750 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): mail@dcact.org Spectrum Name of registered manager (if applicable) Mrs Sharon Waterton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home East Wheal Rose Farmhouse provides accommodation and personal care for up to three adults with autism / aspergers syndrome. The registered provider is Spectrum. Spectrum employs a manager and a team of staff to run the home on a day-to-day basis. The home is situated on the outskirts of the village of St. Newlyn East, in a very rural location, but within a short driving distance of Newquay. The home is set in its own grounds. Spectrum supplies vehicles to enable people living at the home to make full use of community facilities. The house is a spacious, two-storey building. People are provided with single bedrooms. There are two bathrooms. Downstairs there is a kitchen, large lounge / dining room. Each person also has their own separate lounge. There is also an office. The property has gardens at the rear of the building. There is ample car parking space. The home does not have specific access facilities for people Care Homes for Adults (18-65 years) Page 4 of 28 care home 3 Over 65 0 0 3 3 Brief description of the care home with physical or sensory disabilities although there is some scope for adaptation of the building if required. The range of fees at the time of the inspection was from £4790 per week. A copy of this inspection report should be available from the registered provider or from the CSCI website at www. csci.org.uk Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: How we carried out this inspection: This key inspection took place in seven hours in one day. All the key standards were inspected. The methodology used for this inspection was: (1)To case track two people using the service. This included inspecting their records. (2) Discussing care practices with management. (3) Inspecting records and the care environment. (4) Surveying staff and people who use the service regarding their views. Other evidence gathered since the previous inspection, such as notifications received from the home (e.g. regarding any incidents which occurred), was used to help form Care Homes for Adults (18-65 years) Page 6 of 28 the judgements made in the report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information provided to people who use the service (e.g. regarding services offered) is good. For example all people who use the service (and /or their representatives ) receive a statement of terms and conditions of residency or contract when they move in. This ensures people are aware of their rights and responsibilities. Pre admission assessment procedures are satisfactory and ensure the registered persons check they can meet the persons needs before admission is arranged. Evidence: We inspected a copy of the homes statement of purpose and service user guide. These contain satisfactory information about the service. The registered provider outlined a satisfactory assessment procedure. For example prospective clients and their families visit the home before admission is arranged. Senior staff visit the person to meet them as part of the assessment process. We were able to inspect contracts / statements of terms and conditions of residency for people using the service. Information inspected was satisfactory. Care Homes for Adults (18-65 years) Page 10 of 28 Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Satisfactory care planning procedures are in place. There is satisfactory opportunity for people to participate in making choices and be involved in decision making. Staff enable people using the service to take an appropriate level of risk so they can pursue as independent a lifestyle as possible. These measures ensure the needs of people who use the service are met, and they are given the opportunity to make choices how they lead their lives. Evidence: A care plan was contained on the file for each person we case tracked. There is evidence care plans are reviewed. Care plans are accessible to staff. There is a review process in operation, and people who use the service (and / or their representatives) are invited to meetings which occur. From discussion and observation, people who use the service are as much as possible involved in making decisions about their lives, and how the home is run. For example Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: people have some involvement in cleaning, laundry etc. Where restrictions are in place, these are recorded. Restrictions in place appear appropriate considering peoples needs. Suitable risk taking seems to take place to enable people using the service to live as independent lifestyle as possible. The home has its own transport, which enable people to participate in community activities. Suitable risk assessments are kept on file, and reviewed as necessary. There is a suitable approach to helping people to manage their monies. Money is managed by staff on behalf of people using the service. Money is held securely. Suitable records are kept recording any expenditure. Management have appropriate systems to ensure records are checked. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered persons ensure people living in the home can live a lifestyle which meets their needs and wishes. Evidence: People using the service have the opportunity to pursue a range of activities such as going horse riding, attending work placements, going bowling etc. Social and shopping trips are organised according to the wishes and needs of individuals. People have opportunity to visit friends and relatives. Relatives and friends also visit the home. We spoke to relatives who regularly visited the home. They said they felt welcome when they visited. There is suitable space for people using the service to receive visitors in private. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: From our observation, and discussion with staff and relatives, people using the service can get up and go to bed when they wish. Routines in the home seem appropriate according to individual needs. People can spend their time in the part of the home where they wish. The relatives of one person said the food provided is to a good standard. Suitable records of food eaten are kept and these show a varied and nutritious diet. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal and health care needs of people living in the appear to be satisfactorily promoted and met. The management of medication is satisfactory. Evidence: We observed people using the service receiving suitable care and support from staff. Documentation regarding how care tasks are completed is satisfactorily documented in care plans. People living in the home appear to have their personal hygiene needs met. Relatives we spoke to also said that their sons care needs are met to a good standard, and were very complementary about staff support. People living in the service have suitable access to health care professionals such as GPs, dentists, district nurses, chiropodists, opticians etc. We inspected the medication system. The medication policy seems satisfactory. Medication is stored appropriately in locked cupboards within two offices. Medication is administered via a monitored dosage system supplied by a local pharmacist. Staff have received appropriate training regarding handling medication. Administration and Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: recording of medication seems satisfactory. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered persons have satisfactory complaints and adult safeguarding procedures. This should help to ensure any concerns, complaints and safeguarding allegations are investigated appropriately. Evidence: Copies of the complaints and adult safeguarding procedures were inspected and are satisfactory. Any complaints or concerns received by the registered persons appear to have been investigated and responded to appropriately. The Commission for Social Care Inspection has not received any complaints during this inspection period. We would advise the registered provider to include information regarding access to the social services complaints procedure within their procedure and /or within individual service user guides. People who are funded by local authorities have a right to use this procedure if they are funded by social services, and subsequently they should be made aware of this. The registered providers adult safeguarding procedure is satisfactory. Most staff have received training regarding adult safeguarding, and the management team will ensure other staff receive this training as it becomes available. Relatives of people who use the service who we spoke to, said they had no concerns regarding staff attitudes or care practices. There has been one adult safeguarding alert since the last inspection, this has been investigated, and the concern was unsubstantiated. Care Homes for Adults (18-65 years) Page 18 of 28 Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. East Wheal Rose provides a suitable facility for the people living there. Evidence: The building was inspected. Two people are currently accommodated at the home, and there are no plans to accommodate a further person. There is a lounge / dining area. There is suitable toilet and bathing facilities. Water temperatures are checked when people bathe. Each person has their own bedroom, and also a lounge where they can spend time. However these rooms are not for exclusive use, as one is also used for storage and the other for staff sleep in accommodation. There are imminent plans to refurbish the home. One person will spend time at alternative accommodation for the duration of the work, while the other person will remain at East Wheal Rose. There was a delay in informing the commission of this move, although the alternative accommodation which will be used appears satisfactory. It is advisable thermostatic valves are fitted to all bath and shower facilities when the Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: refurbishment occurs to limit the risk of scalding. The manager said people using the service have been involved chosing decorations for the home. The home has suitable garden areas which are accessible to the people living in the home. There is suitable car parking areas available. The home is situated in a rural area, but the registered provider has transport so people can move around the community. The home was clean, warm and light enough on the day of the inspection. The kitchen was clean. Laundry facilities are satisfactory. The outside of the building and the gardens were maintained to a satisfactory standard. A relative stated maintenance arrangements needed to be improved; for example there had been occasions when there had been unsatisfactory delay in the organisation responding to maintenance requests. The registered provider has said they are trying to improve their maintenance service. There is a noisy water pump which the registered provider said would be fixed / insulated during the forthcoming works. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels appear satisfactory to meet the needs of people currently accommodated at the home. Recruitment checks and staff training are to a good standard. These measures ensure people who use the service are supported by suitably knowledgeable and skilled staff. Evidence: On the day of the inspection there was six members of staff on in the morning and afternoon. Sleep in staff are provided. Personnel records were inspected for the staff on duty for the morning of the inspection. These were satisfactory.Staff employed had two references, a Protection of Vulnerable Adults First check (POVA First) , a Criminal Records Bureau check (CRB) , a completed application form and evidence of identification. We inspected training records for the same sample group of staff. By law staff require the following training: * Regular fire training in accordance with the requirements of the fire authority. * There must always be at least one first aider on duty (at appointed person level) *All staff must have manual handling training- for example if people using the service need assistance in this area. *All staff must have basic training in Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: infection control. * Staff who handle food receive food hygiene training. * All staff must have an induction and there needs to be a record of this. * Awareness training regarding the needs of people accommodated. The delivery of training is good. The registered provider offers staff a comprehensive staff induction which covers the majority of the elements required by law. Staff subsequently attend follow up training which covers the areas more comprehensively. Many of the staff need to attend the follow up training. This is because they have only been in post for less than 6 months. Staff should receive the appropriate training within a satisfactory timeframe. People using the service currently do not require assistance with moving and handling. However staff should receive basic moving and handling training i.e. of inanimate objects, in line with the law. There is good opportunities for staff to obtain a National Vocational Qualification in care. When staff have received an NVQ 2 there is the opportunity to obtain an NVQ 3 in care if this is deemed by management as appropriate. A relative said there had been quite significant staff turnover. We looked into this matter and it appeared that people had either been promoted, moved to other homes operated by Spectrum or left the organisation. It is quite difficult to retain staff in what can be a challenging environment, and we think the organisation is doing what it can to support staff and minimise staff turnover where possible. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered provider and the homes management team are effective in ensuring the service is managed to a good standard. Quality assurance procedures apprear satisfactory. Health and safety procedures and checks are to a good standard and should ensure people working and living in the home are kept safe. Evidence: The registered provider is Spectrum, a registered charity supporting people with autism / aspergers syndrome. The manager has submitted an application to be registered with the Commission for Social Care Inspection, and is due to be interviewed by CSCI on Monday 26th January 2009. The home seems to operate to a good standard, and the management group seem competent to manage the home. The registered provider has a satisfactory approach to quality assurance. For example surveys have been completed regarding whether people who use the service think the service they receive is satisfactory. Representatives of people who use the service have also been surveyed. Some concerns have been raised regarding maintenance Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: arrangements, and the registered persons should monitor this to ensure improvement. The registered provider has supplied the commission with their Annual Quality Assurance Assessment (AQAA) (an annual dataset, and self assessment required by CSCI). This was completed to a good standard. Any notifications, required by the commission (e.g. regarding untoward incidents) appear to have been received by us. The registered provider has a health and safety policy. There is also a fire risk assessment. Testing of fire extinguishers and the fire system appear to have been completed appropriately by external contractors. Internal checks on the fire system appear to have been completed appropriately by staff (e.g.emergency call points and emergency lighting). Health and safety risk assessments are have been completed. Suitable records regarding accidents are kept. Portable electrical appliances have been tested and appear satisfactory. The electrical hardwire circuit was tested when building work at the home was completed. The test results were satisfactory. Moving and handling equipment has been serviced and deemed safe. Gas appliances have recently been serviced. We were shown a receipt to show this work has been completed, and the manager said the home is awaiting a gas certificate from the contractor. An up to date certificate of insurance is displayed. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 24 27 Monitor maintenance systems to ensure they improve. Fit thermostatic valves to bathing facilities Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!