Inspection on 26/04/05 for The Wheelhouse

This inspection was carried out on 26th April 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Wheelhouse 09/08/06

The Wheelhouse 27/09/05

The Wheelhouse 18/10/04

The Wheelhouse 11/05/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Wheelhouse 15 Old Roar Road St Leonards-on-Sea East Sussex TN37 7HA Lead Inspector Jeanette Denereaz Unannounced 26 April 2005 09:00 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 Wheelhouse Version 1.10 Page 3 SERVICE INFORMATION Name of service The Wheelhouse Address 15 Old Roar Road St Leonards-on-Sea East Sussex TN37 7HA 01424 752061 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) The property is owned byFerguson Care Limited with is a wholly subsidiary of Craegmoor Healthcare Ltd Care Home 5 Category(ies) of Learning disability (LD) 5 registration, with number of places The Wheelhouse Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum service users to be accommodated is 5 2. Service users should be aged between 18 and 50 years of age Date of last inspection 18 October 2004 Brief Description of the Service: The Wheelhouse is registered to accommodate five adults with learning disabilities, however only four males are resident at the present time. The property is a two storey-detached house located in a residential area on a private road on the outskirts of Hastings. The property is owned and managed by Craegmoor Healthcare. The service users accommodated have very complex needs, and three of the four service users have very limited communiction skills. The Wheelhouse Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1st 2005 to March 31st 2006. The visit lasted from 9.00 until 13.00. The home currently has four service users in residence, with one service user occupying a double room. The visit was spent talking directly with the recently appointed manager and with one service user privately. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of the service in the report. Some judgements about quality of life and choices were taken from direct conversation with the service user and observations of the other three service users who have limited verbal communication skills. There was discussion with the manager and evidencing of records held at the home. A tour of the premises was undertaken. What the service does well: What has improved since the last inspection? The Wheelhouse now has a manager in post, and she has made application to the CSCI to become the registered manager. A new walk-in shower has now been installed, and the lounge has new sofas. The dining room has been rearranged and the dining chairs have been recovered giving a more homely feel. All service users are now eating in the dining room and staff now dine with them. There is a planned programme for re-decorating the home. The Wheelhouse Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Wheelhouse Version 1.10 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 Wheelhouse Version 1.10 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 The home has a comprehensive policy and procedures for the admittance of new service users. However, the policy and procedures were not followed with the admittance of the most recent service user, and this is placing him and others at risk. EVIDENCE: It is was unclear how the home had assessed the care needs of one service users prior to him moving into the home. The service user stated, “I feel I was dumped here”. The manager confirmed that his placement at The Wheelhouse was not the home allocated to him when he came to live within the Craegmoor organisation. The regime in place to secure his placement raises concerns regarding other service users safety and the individual’s quality of life. His privacy, dignity and independence are severely comprised whilst living at The Wheelhouse. The Wheelhouse Version 1.10 Page 9 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) 7 & 8 The service offered to three service users is at an acceptable standard. However, one service user is totally misplaced in this home and is not compatible with the other service users. The service user is restricted within the home; he is isolated in his room for many hours without staff interaction. The home is therefore not ensuring that all the people living there are safe and well cared for. EVIDENCE: The Inspector interviewed the service user addressed above and he stated that he is lonely in the home, and wants to move so he can communicate with other service users. The service user has a restricted regime 1:1 staffing during the day, but at 21.00 he must go to his bedroom until 7.30 in the next morning. During the tour of the home the service user’s bedroom was viewed, the room was very untidy, and it was discovered that he has been trying to re-design his en-suite bathroom. Tiles had been removed and decorating materials were in the room. The manager was unaware that this activity had taken place. There were not risk assessments or planning to support him to undertake this activity. The evidence drawn from this that the service user is undertaken ‘risky’ activities and is not supervised or supported when in his room. Therefore the home is not meeting its duty to care for this service user. The Wheelhouse Version 1.10 Page 10 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 & 17 Service users generally are helped to learn and keep practical skills they need each day to the best of their abilities. They have access to the local area with staff support. Food served by the home was found to be adequate and includes individual choices and requirements at each meal. EVIDENCE: The service user with good communication spoke to the Inspector, and told her he goes out everyday with a member of staff and has many interests. He did express his concern he wants to move to another residential setting so he could talk to other people and wants to be more independent. All service users require full staff support within the local community. This was fully evidenced through conversation and both verbal and body language from service users. The home does encourage family links. Good example was observed during the inspection with a telephone call from a service user’s sister from Paris, arranging a visit to his mother who also lives abroad. The Wheelhouse Version 1.10 Page 11 Service users require full support from staff in preparing of meals and beverages due to limited ability and health care needs. Service users are encouraged to take part in the purchasing of the food. The home shops at the local supermarkets and one service user at a time goes with the staff. The menu records evidenced varied and balanced meals, including special dietary needs of one service user. The Wheelhouse Version 1.10 Page 12 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 It was apparent that three service users’ healthcare needs were being managed and staff were aware of the additional support individuals require. However, one service user has his support dictated by a set of regimes, which restrict his lifestyle. The home is not meeting this service user’s physical and emotional health needs. . EVIDENCE: Talking to one service user privately, it was evident that he wants to move to a residential setting where he would be able to communicate with other people. He said, “I want to live with people I can talk to, staff and other residents.” The Wheelhouse other residents have limited communication skills. One bedroom has en-suite facilities, and the other service users have a choice of a bath or shower, this is indicated by service users going to the bathroom of their choice and staff supporting them with their personal hygiene. Medication practices described and seen during this inspection are adequate, and safely administered. The medication is stored securely and safely and a monitored dosage system is used. The Wheelhouse Version 1.10 Page 13 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 Service users are supported to raise concerns, and the home has a comprehensive complaints policy and procedures in place. EVIDENCE: The service user spoken with clearly understood who to talk to if he wishes to make a complaint. He has a computer and often writes to Craegmoor management when he feels aggrieved. He had a letter to give to the Area Manager during this visit regarding the minibus and that it continuously breaks down. Since the last inspection there have been no complaints from service users. One service user did go missing from the home recently, but was found safe. Security procedures are now in place including magnetic doors and keypad on the front door. The manager has reviewed the security and safety of service users throughout the home and details of the individual’s safety is in stated in his care plan. The Wheelhouse Version 1.10 Page 14 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) 24,25,28 & 30 Service users live in a homely environment, and their bedrooms reflect their taste and interest. But the home was found not be clean or hygienic in the kitchen and other communal areas. The lack of cleanliness and with cleaning products not locked away the home is not ensuring the service users are living in a safe environment. EVIDENCE: There was a general lack of cleanliness throughout the home. Wall and skirting were in need of cleaning. The kitchen area was not in a hygienic standard. The service users bedrooms and bathrooms were found to be clean with the exception of one room. It was evident that the service user had no supervision when in his bedroom. The lounge area has improved since the last inspection with new sofas, and the dining room had undergone improvements, which included the recovering of the dining chairs. Also the home now has a walk-in shower, this has improved the access and movement for service users and staff during supported showering. The Wheelhouse Version 1.10 Page 15 There is a separate laundry room, with washing machine and tumble dryer. However, on the day of the Inspection there was cleaning chemical, washing powder and conditioner in this room, and the COSSH cupboard was unlocked. The Wheelhouse Version 1.10 Page 16 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) 31,34 & 36 Service users now benefit from a more stable staff team, and a manager in post. The manager, through supervision with staff have identified training needs which include report writing and care planning. EVIDENCE: The home has in the past year experienced a high turnover of staff including a change in manager. Since the last inspection the home has recruited new staff including the manager. All staff files held in the home evidenced today had the required administration checks undertaken through the recruitment process. The new manager has introduced regular supervision for all staff every eight weeks. The manager is also supervised by the Area Manager every eight weeks. Supervision notes were seen on this inspection. The home has also introduced return to work interviews for staff. The Wheelhouse Version 1.10 Page 17 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) 37,38,40 & 42 The new manager is motivated and full of enthusiasm, but lacks the experience to lead an inexperienced staff team in this challenging home. She has a sound ethos and her priority is the well being of the service users. However, certain staff practices need to improve which include the reviewing of the smoking policy, break times for staff and set duties to maintain the health, safety and welfare of the service users. EVIDENCE: The home had no cleaning rotas, the manager was leaving the cleaning for the staff to organise and undertake. There was no evidence that the staff were cleaning on a regular basis. The Overall cleanliness of the home reflected the inefficiency of the management to direct staff, and therefore putting service users at risk. The Wheelhouse Version 1.10 Page 18 It was evident that since the last inspection the staff had made the garage area into an unofficial staff room, with sofas with evidence that it was a smoking area. The daily log had an entry that stated a service user had been asked not to disturb staff when in the garage. The manager was asked if the home had a smoking policy and what were the procedures for staff breaks. She informed the Inspector that there was a no smoking policy within the home, and staff do have breaks away from service users, when people do smoke, but there were no set times allocated. It was unclear if the home had ‘no go’ areas for service users, and no recorded rotas for staff breaks. The manager must review the smoking policy of the home, and justify ‘no go’ areas within the home for service users. The Wheelhouse Version 1.10 Page 19 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 2 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 2 2 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 1 x x 3 x 1 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x x Standard No 31 32 33 34 35 36 Score 3 x x 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 1 x x Standard No 37 38 39 40 41 42 43 Score 2 3 x 2 x 1 x The Wheelhouse Version 1.10 Page 20 Are there any outstanding requirements from the last inspection? YES 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 YA2 Regulation 14(1) See Schedule 3(1)(a) Requirement It is required that new service users are admitted to the home only on the basis of a full assessment undertaken by people competent to do so. The procedures undertaken to evidence that the home can met the individuals care needs. It is required that the manager must reiewed the risk assessments and care plans for the individual service user and the resitrctions placed upon him within the home. Also to include risk assessments on his D.I.Y. activities in his room at night. It is required that the manager must ensure that the limitations placed on the individual service user is made only in the persons best interest, consistent with the purpose of the service and the homess duties and responsibilities under law. It is required that the manager must ensure that all service users living within the home received sensitive and flexible personal support to maximise the service users privacy, dignity, independence and Version 1.10 Timescale for action 1/07/05 2. YA3 12(4)(a) 13(4) 18 See Schedule 3 1/07/05 3. YA7 20 (3) 1/07/05 4. YA18 & YA19 12 (4)(a) 1/07/05 The Wheelhouse Page 21 control over their lives. 5. YA25 23(2)(f) It is required that the manager must ensure that the service users are supported to maintain useable floor spece sufficient to meet individual needs and lifestyle. The service user to be encouraged to clear the room at regular intervals It is required that the manager must ensure the home is kept clean, hygienic and free from offensive odours. To put in place cleaning systems to control the spread of infections. It is required that the home has a Registered Manager in post that is qualified, competent and experienced to run the home. It is required that the manager must ensure so far as is reasonably practicable the health, safety and welfare of service users and staff including the hygience within the home, understanding and practice of measures to prevent spread of infection. It is required that the manager must ensure the health and safety of the service users and staff with the safe storage of hazardous substances and the COSSH cupboard is locked when not in use. It is required that the manager must ensure that there is sufficient staff on duty, day and night and during staff breaks to support service users assessed needs at all times 1/07/05 6. YA30 13(3) 16(2)(j) (k) Immediatel y 7. YA37 8&9 1/07/05 8. YA42 12 37(1)(e) Immediatel y 9. YA42 13(4)(a) Immediatel y 10. YA33 18(1)(a) 30/06/05 The Wheelhouse Version 1.10 Page 22 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. Refer to Standard YA40 Good Practice Recommendations It is recommended that the manager should go through the homes policies and precedures to ensue that they are applicable and adhered to within the home. The Wheelhouse Version 1.10 Page 23 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Wheelhouse Version 1.10 Page 24 - 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!