Inspection on 04/10/05 for The Wheel House

This inspection was carried out on 4th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Wheel House 03/07/08

The Wheel House 26/03/08

The Wheel House 29/10/07

The Wheel House 31/05/06

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 The Wheel House Linden Hill Wellington Somerset TA21 0DW Lead Inspector David Kidner Announced 4 October 2005 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Wheel House Address Linden Hill Wellington Somerset TA21 0DW 01823 669444 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr William Gilbert Gillespie Mr Michael Beale Care Home 6 Category(ies) of 1. Learning disabilities. registration, with number of places The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection First Inspection Brief Description of the Service: The Wheel House is situated on the outskirts of Wellington but has close access to all local amenities and facilities. The home is currently registered to provide a service for six service users with a Learning Disability. It is expected that this will rise to a total of ten service users once building work commences. The home currently has one lounge, a large kitchen/dining room, six single bedrooms, four of which have full en-suite facilities. The other two bedrooms have a toilet and wash basin and share one bathroom that is on the same landing. There are extensive grounds with mature gardens and large patio areas. The home also has facilities on site for woodwork, gardening and arts and crafts. The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Wheel House opened in May 2005. There are currently three service users living at the home. The home has been admitting service users on a very gradual basis. One service user moved to the home in May 2005 and another service user moved to the home in July 2005. The last service user to be admitted to the home was in September 2005. It is expected that the staff team will increase in size as more service users are admitted to the home. This was the first inspection that has been conducted at The Wheel House. As a result of this Inspection the home may have a number of requirements and recommendations. It is expected that the number of these should drop at the next inspection when the provider has had the opportunity to address these issues. However, not all standards were assessed at this Inspection. The Registered Manager is Mr Michael Beale. At this inspection the Inspector was only able to speak to two staff members. Another staff member was taking a service user to the local shops and other activities. The Inspection was conducted over one day (8.0hrs). The Inspector viewed all parts of the home, records in relation to care and support plans, staff recruitment files, health and safety records and medication records. The Inspector spoke to the three service users and was shown around the home by one of the service users. Two service users completed the comment cards and the Inspector was able to speak to the three service users, two in private. The comments received were all very positive in relation to the support that they receive. Three comment cards were received from parents/relatives. Again comments were very positive. One comment received was that following a few minor worries at the beginning the parent stated that these minor worries were dealt with “quickly and efficiently by the manager” and that they have “excellent communication with the staff at all times and they are doing everything possible”. The inspector did not receive any comments form Care Managers, Placing Authorities or Health Care Professionals. As a result of this Inspection the home has five requirements and nine recommendations. What the service does well: The Wheel House provides very homely accommodation that is of a high standard. The home is very individual in its style of accommodation as it has The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 6 undergone refurbishment and redecoration and has retained some of its original features. It was evident at the time of the inspection that the service wishes to promote service user involvement and empowerment. The home employs a Consultant Specialist in Autism to support the home. The Registered Manager and staff team strive to provide a high quality service. Staff that the Inspector spoke to appeared very professional and motivated. Service users commented that they liked living at the home, liked the staff, the food, activities and their bedrooms. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 2 3 4 5 The home has a detailed Statement of Purpose and Service User Guide that informs all interested stakeholders of the services that are provided. The home completes detailed pre-admission assessments and individualised transition plans. EVIDENCE: The Wheel House has a Statement of Purpose and a Service User Guide. These documents are readily available to all interested stakeholders. The Statement of Purpose contains all items as listed in Schedule 1 of the Care Homes Regulations 2001. The Commission for Social Care Inspection (CSCI) request that an up to date copy of the statement of purpose be forwarded to the local office. The fee structure does not include charges in relation to hairdressing, toiletries, magazines, newspapers and entrance fees for activities. Service Users are supplied with the service users guide that clearly states the services that are provided. The home employs a consultant who has specialist knowledge in Autism and Autistic Spectrum Disorder who conducts a detailed assessment prior to being admitted to the home. The Responsible Individual and the Registered Manager are involved in the assessment process. The Inspector viewed the preadmission assessment for the service users that have been admitted to the home. These were very detailed. The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 9 The Inspector was advised that transition plans are based on individual service users need. The Inspector was advised that staff have visited service users in their previous home prior to moving to The Wheel House. Service users and their parents/carers have visited The Wheel House prior to making a decision to move to the home. All service users have a three-month trial period and individual written contracts. The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 7 9 10 The home has developed care plans for all services users. However, these need to be reviewed to ensure that they contain detailed information as to ensure that they identify the specific care needs and how these should be addressed. Risk assessments need to be more robust. EVIDENCE: The Inspector viewed three care plans. The care plans contained appropriate documentation in relation to the service users individual care and support needs including risk assessments and records of appointments with health care professionals. The care plans were also supported by monthly summaries that are written by the key worker. The Inspector had lengthy discussions with the Registered Manager and Responsible Individual in relation to the details of the care plans. It was not very clear in some of the care plans as to how specific areas of need were to be addressed by the care team. Due to the needs of the service users it is important that there is a continuity and consistency of care. It is recommended that the care plans be further reviewed to ensure detailed The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 11 information is given to the care team so as to promote this. It was noted that the care plans had not been signed. Discussions also took place in relation to how the care plans are constructed and where information is held. It is recommended all records pertaining to care plans are located in one main file. The Inspector spoke to the service users and the staff on duty at the time of the inspection. The home promotes the use of Somerset Total Communication (STC) and there are photographs around the home to assist service users who use STC. The Inspector observed staff offering service users choices in many aspects of daily living. Risk assessments are conducted as needed. The Inspector viewed some of the risk assessments that had been conducted. Following discussion with the Registered Manager and Responsible Individual it is recommended that the risk assessment format be reviewed to ensure that detailed assessments have been recorded that follow a systematic approach, that clearly identifies the risk and the control measures that have been implemented. Review dates should be set. All records at the home are stored securely and service users have access to their records if so wished. The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 13 14 15 16 17 The Wheel House supports and encourages service users to access a variety of activities both in the local and wider community and at the home. The home encourages contact with families and friends, if so wished. The Wheel House provides a very individualised menu. EVIDENCE: The home is fully aware of the activities that the service users previously took part in prior to moving to the home. One service user has an avid interest/ hobby and the home are continuing to support and promote this activity. Currently, one of the service users is accessing a college-based activity/course at the local college. No service users are able to access paid employment at present. The service users spoken to confirmed that they are able to access the local community facilities with support. The home strives to maintain a friendly relationship with the neighbours. The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 13 Service users spoken to confirmed that they are encouraged and supported to access a variety of activities. The staff rota is amended where needed to ensure service users can access activities at various times of the day. Each service user has a weekly activities programme that has been agreed with the service users. The home provides opportunities for arts and crafts, computers, woodwork and gardening skills. The Registered Manager confirmed that family and friends are welcome at the home at any time. Visitors can be met in private. One service user confirmed that their family visits when they can. The service users that the Inspector spoke to stated that their privacy and dignity is respected and that staff knock on bedroom doors and bathroom doors before being invited to enter. Service users have a key to their bedroom. The Inspector witnessed staff interacting with service users in a professional and inclusive manner. Service users have unrestricted access to the home. One service user confirmed that they are involved in cooking and cleaning tasks. At the time of the inspection one service user was involved in meal preparation and cooking. The home displays the weekly menu in the kitchen. Service users likes and dislikes are fully taken into account and as there are only three service users currently accommodated, the meal times and menu are very flexible. Service users that the Inspector spoke to confirmed that they can choose what they wish to eat and that they can have an alternative meal. The menu appeared to be nutritious and varied. The food cupboards, fridge and freezer were well stocked and fresh fruit was readily available. Currently there are no special diets required. The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 19 20 The home offers a high degree of privacy. The home ensures that service users have access to appropriate healthcare professionals. Medication at the home is stored securely, however, some processes need to be addressed to ensure that the service users are not placed at unnecessary risk. EVIDENCE: There are no set times for getting up and going to bed and staff encourage service users’ individuality and personal identity. This is evident in how the staff support service users in choosing clothing, hairstyles and make up. However, service users are able to make such decisions but may need some advice and support from time to time. All staff were observed to be interacting with service users in a very professional manner. Some staff use STC and there is a photo board of all staff and photos in some areas of the home. The home operated the key worker system. The care plans that were viewed contained documentation of the visits made to health care professionals. These included visits to the GP, dentist, chiropodist, optician, speech and language therapist, physiotherapist and Consultant Psychiatrist. Records are kept of all visits and consultations. The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 15 The home operates the Monitored Dosage System. The Inspector viewed the arrangements in relation to the storage and administration of medicines. Hand transcribed MAR charts were not signed and dated at the time of writing. The Registered Manager should contact the supplying pharmacy to ask if they can provide printed charts. Although the return of medicines and with a few exceptions the administrations are recorded, the receipt of medicines into the home is not recorded so compromises the home’s ability to audit the medication stock. All staff administering medication has training planned and the Registered Manager carries out assessment of competence to administer, with records kept. The home keeps a file for staff information in relation to the medication used at the home and the side effects. The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 23 The home has a Complaints Policy but needs to develop a complaints log. The home must ensure that behaviour management guidelines are developed to address challenging behaviours and to ensure that staff receive training in physical intervention. This will promote health and safety for service users and the staff team and ensure that service users are protected. EVIDENCE: The home has a Complaints Policy. The home has not received any complaints. Following discussion a complaints log must be introduced. This was discussed with the Registered Manager at the time of the inspection. The home has a Whistle blowing Policy and a policy relating to the Safeguarding of Vulnerable Adults. The Inspector had lengthy discussions with the Registered Manager and Responsible Individual in relation to the need to develop Behaviour Management Guidelines for service users whose behaviour may challenge the service. This will provide staff with detailed information as to how to respond to such episodes in a consistent manner. However, the home does keep ABC charts and body maps and will make referrals to psychology services for advice and support. There were discussions around the use of physical intervention. Some of the challenges that are presented may necessitate the use of some form of physical intervention/breakaway technique. The Inspector was advised that one staff member will be attending Non Abusive Physical and Psychological Intervention Trainer Course (NAPPI) and will then be able to instruct other team members. This must be viewed as a priority for the home. Records must be kept of the agreed physical intervention for individual service users and of all interventions that are used. The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 17 For the protection of vulnerable service users, the home ensures that a POVA first is applied and a CRB disclosure is received for each staff member. The Registered Manager stated that the home does not manage the finances for any of the service users who are currently living at the home. The home will keep small amounts of money for service users if needed. Records and receipts are kept for all transactions. Theses records were not inspected at this inspection. The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 25 26 27 28 29 30 The Wheel House appears to be very homely. On the day of the inspection the home was very clean and hygienic. EVIDENCE: The Wheel House provides a very homely environment. It is currently providing accommodation to three service users. The shared space is very comfortable and homely in appearance. There is a large lounge, kitchen/diner and extensive gardens to the rear. The gardens are very well maintained and provide a high degree of privacy and security. There is also a large ornamental pond and fountain. One service user wanted to point this feature out to the inspector, as they had been involved in its construction. To the front and rear of the home there are also large patio areas. All bedrooms are of single occupancy and all but two of the bedrooms have full en-suite facilities. The two other bedrooms have a toilet and washbasin and share a bathroom that is situated on the same landing area. There is a toilet on the ground floor with hand washing and drying facilities. The Inspector viewed the three bedrooms that are occupied. All three bedrooms were decorated and furnished to reflect the individual service users’ needs and The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 19 preferences. Service users stated that they were very happy with their bedrooms. They contained personal items such as TV, DVD, hi-fi, radio and personal hobby items. There were pictures of family and friends. The home is fully accessible to the current service users. Presently, no service users have difficulty in their mobility and no specialist aids and adaptations are needed. However, when the home has further building work completed it will be able to provide a service, to service users with mobility needs. On the day of the inspection the home was very clean and tidy. The home has adequate laundry facilities. This area was very well maintained. Service users are involved in the cleaning of the home and managing their own laundry. All cleaning agents are stored securely. The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 33 34 The Inspector did not assess all standards at this Inspection. The home has been open since May 2005. The Registered Manager is assessing the training needs of the staff team and is developing a Training and Development Plan. The home recruitment process files were not adequate and did not hold the appropriate documentation. EVIDENCE: The Inspector noted that Job Descriptions were held in each staff personnel file. The Registered Manager confirmed that all staff have job descriptions. The service users are supported by staff on a 1:1 basis. Where needed two staff will support one service user. Staff that the inspector spoke to stated that they felt that they had adequate staff on duty at all times. The home has a duty rota and also keeps a record of all staff that have worked at the home on a day-to-day basis. The Inspector noted that some staff had also received some training in Somerset Total Communication (STC). The Registered Manager stated that the home would be registering all staff that need to be enrolled on the Learning Disability Awards Framework and to commence NVQ qualification. Mandatory Training is currently receiving priority attention. Staff that the Inspector spoke to stated that they have received The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 21 training in Autism, medication, first aid, and fire awareness and key worker training at Induction. These matters will be followed up at the next inspection. The Inspector viewed the recruitment files of the most recently appointed staff members. The Inspector noted that the filers did not contain all the documentation as listed in Schedule 2 of the Care Homes regulations 2001. This must be addressed. The Inspector was advised of POVA first checks the Inspector is aware that Enhanced CRB Disclosures have been obtained prior to staff commencing work at the home. The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 40 41 42 The home does not have all the policies and procedures as needed and should develop quality assurance and quality monitoring systems. This will provide important feedback in light of the home recently opening. The home strives to promote all matters relating to health and safety. There are some areas that need further attention. EVIDENCE: The Inspector had discussions with the Registered Manager in relation to quality assurance and quality monitoring systems. It is recommended that the home develop a policy to address this. It is acknowledged that the home has only been open for a few months. However, it would be good practice for the home to seek feedback from all interested stakeholders. This also includes an annual development plan for the home. The home was displaying the notice of inspection and service users were aware of the Inspector visiting. The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 23 The home has a large number of Polices and Procedures, however, the Registered Manager should ensure that there are polices and procedures at the home as listed in Appendix 2 of the National Minimum Standards Care Homes for Adults (18-65). The Inspector viewed the home’s records in relation to fire safety. The home regularly checks the fire alarm system and emergency lighting and keeps records of such checks. Staff have received fire training and have undertaken regular fire drills. The home has a Fire Risk Assessment. The fire alarm system was service on 27.05.05 and the fire extinguishers were serviced on the 15.09.05. The home must conduct checks on the home’s torches as discussed with the Registered Manager with records kept. The Gas Safety Certificate is dated 24.05.05. The Electrical Hardwiring Certificate is dated 27.04.05. Portable Appliance Testing has not been conducted, as all the equipment is brand new. The Registered Manager is aware that all portable appliances will need to be tested annually. The home should ensure that it keeps records of the regular testing of the hot water outlets. The home has fitted thermostatic valves to all hot water outlets. All windows are restricted where needed and wardrobes are secured. This promotes health and safety. The home has conducted a number of environmental in-house risk assessments and has employed an outside service to complete a detailed risk assessment of the home/environment. This was conducted on the 15.06.05. The Inspector recommends that the Registered Manager ensure that all risk assessments are dated and that a risk assessment is completed on the pond/water feature to the rear of the property. The home keeps records of all accidents at the home. These are stored correctly and in line with the Data Protection Act 1998. The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 x 3 1 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Wheel House Score 3 3 1 x Standard No 37 38 39 40 41 42 43 Score x x 2 2 3 2 x D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 25 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13 (2) Requirement The home must maintain a record of all medication received in the home. This may be recorded on individual MAR charts. All medicines that are administered must be signed for to confirm administration. The home must ensure that all staff receive training in physical intervention/breakaway techniques. Behaviour Management Guidelines must be developed to ensure that no service user is subject to physical restraint unless to secure the welfare of that or any other service user. Records must be kept of agreed interventions and when these have been used. The home must ensure that staff recruitment files contain all the documentation as listed in Schedule 2 of the Care Homes Regulations 2001. The Registered Manager must ensure that records are kept of the maintenance of the homes torches. Timescale for action 21.10.05 2. YA23 13 (6) 31.01.06 3. YA23 13 (7) (8) 25.10.05 4. YA34 19 21.10.05 5. YA42 23 (4) 21.10.05 The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard YA6 YA6 YA6 YA9 YA20 YA40 Good Practice Recommendations Care plans should be reviewed to ensure they contain detailed information as to how the care team are to meet complex needs. Care plans should be signed by the Registered Manager, service user and/or other interested stakeholders to confirm the agreed package of care. The format that the care plans are presented should be reviewed. The format for the risk assessments should be reviewed to also include review dates. The Registered Manager should ensure that all hand transcribed medication is supported by two staff signatures. It is strongly recommended that the Registered Manager ensures that there are polices and procedures at the home as listed in Appendix 2 of the National Minimum Standards Care Homes for Adults (18-65). The home should develop an annual development plan and quality assurance and quality monitoring systems. The home should ensure that it keeps records of the regular testing of the hot water outlets. The Registered Manager should ensure that all risk assessments are dated and that a risk assessment is completed in relation to the pond/water feature to the rear of the property. 7. 8. 9. YA39 YA42 YA42 The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 27 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier, Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Wheel House D53_D02 S63400 The Wheel House V244864 041005 Stage 4.doc Version 1.40 Page 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. 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