CARE HOME ADULTS 18-65
The Wheelhouse 15 Old Roar Road St Leonards-on-sea East Sussex TN37 7HA Lead Inspector
Jeanette Denereaz Unannounced Inspection 27th September 2005 10:00 The Wheelhouse DS0000021268.V258340.R01.S.doc Version 5.0 Page 1 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 The Wheelhouse DS0000021268.V258340.R01.S.doc Version 5.0 Page 2 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 Stationery 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 DS0000021268.V258340.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service The Wheelhouse Address 15 Old Roar Road St Leonards-on-sea East Sussex TN37 7HA 01424 752061 01424 752061 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ferguson Care Limited Vacant Care Home 5 Category(ies) of Learning disability (5) registration, with number of places The Wheelhouse DS0000021268.V258340.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The maximum service users to be accommodated is 5. Service users should be aged between 18 and 50 years on admission. Date of last inspection 26th April 2005 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 the service users have very limited communiction skills. The Wheelhouse DS0000021268.V258340.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second in the year running from April 1st 2005 to March 31st 2006. The inspection took place between 10.00 and 13.00. The overall focus of the inspection was on meeting with the manager and reviewing the progress of the requirements from the previous inspection, and a full tour of the home. Time was spent meeting the manager, inspecting a number of records, policies, procedures and other documentation. As this report was made following the second unannounced visit, and does not cover all the standards, therefore for the reader to make a judgment about the home, it is recommended that a copy of the last inspection report of the 26th April 2005 also be obtained to have a clearer picture of the home. What the service does well: What has improved since the last inspection?
Since the last inspection the manager and staff have worked towards improving the environment and service. The planned programme for redecorating continues and a new carpet has been laid in the hallway and stairs. At the last inspection five of the requirements were raised because of the unsuitability of a resident’s placement at the home. This resident had requested to be moved, and has been supported to find a more appropriate placement, and he will be moving out in the near future. A comprehensive cleaning regime has been introduced, and the home is now noticeably cleaner and more hygienic. The manager is also introducing Person Centred Planning (PCP) and the inspector saw evidence of this in the care plans of residents. With other local homes within the Craegmoor organisation, The Wheelhouse staff are involved in the training strategy and since the beginning of September 2005, staff have been attending various training courses including Health and Safety, First Aid, Food Hygiene, Moving Handling, Autism, Understanding Challenging Behaviour, Makaton and Protection of Vulnerable Adults (POVA).
The Wheelhouse DS0000021268.V258340.R01.S.doc Version 5.0 Page 6 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 Wheelhouse DS0000021268.V258340.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection The Wheelhouse DS0000021268.V258340.R01.S.doc Version 5.0 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 the following standard(s): 3&4 The home has a comprehensive policy and procedures for the admittance of new service users. Following the unfortunate miss-placement of one resident, the manager will ensure that the policy and procedures will be adhered to in the future. EVIDENCE: The home will soon have a vacancy and the manager has started to inform prospective service users of this service. Since the last inspection, the home has supported the resident who was unhappy living at The Wheelhouse to find a more appropriate placement. The resident was out during this inspection, but it was evident that the home had taken his unhappiness seriously, and with the input and support from an advocate he will be moving on to a more suitable placement. The Wheelhouse DS0000021268.V258340.R01.S.doc Version 5.0 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 the following standard(s): 6,8,9 & 10 Residents’ care and support needs are now well managed enhancing their independence and overall quality of life. EVIDENCE: The home is introducing Person Centred Planning (PCP) and care plans are being reviewed and reorganised to contain relevant information. The staff team are aware of the complex needs of the residents and encourage them to have an independent lifestyle as far as possible. All information relating to the individual resident is stored appropriately and kept confidentially in the office. The Wheelhouse DS0000021268.V258340.R01.S.doc Version 5.0 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 the following standard(s): 16 & 17 When the home has the equipment the staff team support the residents to learn and keep practical skills they need each day to the best of their abilities. There continue to access the local area with staff support EVIDENCE: It was reported to the inspector during this inspection that the residents are encouraged to take part in domestic activities, and an activity that all the residents were involved with the loading and unloading of the dishwasher. However, the dishwasher has been broken for many months, and for hygienic purposes they cannot be involved in washing up and drying of utensils. The Wheelhouse DS0000021268.V258340.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 20 The home is fully aware of all the health needs of the residents, which are recorded appropriately in the individual care plans. EVIDENCE: The residents living at The Wheelhouse are unable to retain, administer and control their medication. Therefore, all staff are trained to administer medication, and the home has a comprehensive policy and procedures for dealing with medicines. The Wheelhouse DS0000021268.V258340.R01.S.doc Version 5.0 Page 12 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 the following standard(s): EVIDENCE: These standards were inspected at the last inspection on the 26th April 2005 and found to be met fully. The manager confirmed that there has not been any concerns or complaints raised since the last inspection. The Wheelhouse DS0000021268.V258340.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 24,25,26,27,28, 29 & 30 The residents live in a homely environment, and their bedrooms reflect their taste and interests. The cleanliness of the home was found to be greatly improved since the last inspection. EVIDENCE: Since the last inspection the manager has introduced a comprehensive cleaning rota for all staff to follow, and it was evident that the cleanliness of the home has improved. There is a re-decorating programme underway, with some areas completed, and there is new carpeting in the hallway. The kitchen was found to be clean, and there are plans for a new fridge to be installed. As mention previously in this report the dishwasher has been broken for many months, and this is an inconvenience to the staff and residents. The Wheelhouse DS0000021268.V258340.R01.S.doc Version 5.0 Page 14 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33 & 35 The staff team continues to remain stable, with good leadership from the manager. They are enthusiastic and committed to training to improve the service offered to residents. EVIDENCE: Since the last inspection the manager has matured into the role of manager, and she has. With other local homes within the Craegmoor organisation, The Wheelhouse staff are involved in the training strategy and since the beginning of September 2005, staff have been attending various training courses including Health and Safety, First Aid, Food Hygiene, Moving Handling, Autism, Understanding Challenging Behaviour, Makaton and Protection of Vulnerable Adults (POVA). The manager is also studying towards her Registered Manager’s Award (RMA), and has plans for further training when she has completed the RMA. The Wheelhouse DS0000021268.V258340.R01.S.doc Version 5.0 Page 15 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39 & 43 The manager is well motivated and full of enthusiasm, and since the last inspection has gained in confidence in managing the home and the staff team. She continues to have a sound ethos and her priority is the well being of the residents. EVIDENCE: Since the last inspection the manager has introduced a cleaning rota and this has improved the cleanliness of the home. She has sensitively gained the experience in directing staff and has taken on the role of the manager in a very professional way through example setting, supervision and team meetings, She has made application to the CSCI to become the registered manager. The Wheelhouse DS0000021268.V258340.R01.S.doc Version 5.0 Page 16 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 X X 3 3 X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X 3 3 3 Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 2 17 Standard No 31 32 33 34 35 36 Score X 3 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
The Wheelhouse Score X X 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X X 3 DS0000021268.V258340.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? No 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 16 17 & 30 Regulation Requirement Timescale for action 30/11/05 13(3) The Registered Provider must 16(2)(j)(k) replace the dishwasher to ensure a hygienic kitchen area, and support residents to maintain their domestic skills RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Wheelhouse DS0000021268.V258340.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection East Sussex Area Office 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
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