Inspection on 09/08/06 for The Wheelhouse

This inspection was carried out on 9th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 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

The Wheelhouse 27/09/05

The Wheelhouse 26/04/05

The Wheelhouse 18/10/04

The Wheelhouse 11/05/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

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 Key Unannounced Inspection 9th August 2006 09:00 The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 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.V302033.R01.S.doc Version 5.2 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.V302033.R01.S.doc Version 5.2 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 Lian Hobden Care Home 5 Category(ies) of Learning disability (5) registration, with number of places The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is five (5) Service users must be aged between eighteen (18) and fifty (50) years on admission 27th September 2005 Date of last inspection 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 communication skills. The current scale of fees range from £1246.30 To £1275.11 The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at The Wheelhouse are referred to as ‘residents’. This report reflects a key inspection based on the collation of information received since the last inspection and an unannounced site visit conducted by an Inspector on the 9th August 2006 starting at 09.00am and leaving at 1.00pm. The site visit included a tour of the premises and an examination of various records including medication, care and staffing records. The Inspector met with the Registered manager, staff members on duty including and the maintenance person. Staff where spoken to during the inspection whilst they were working and in private. During this site inspection visit, the inspector met two of the residents briefly as they were on their way out, but one resident was at home and was cooking cakes with staff support. It should be noted that due to the limited verbal communication of residents, much of the evidence from this report has been gleaned from observation, examination of records and conversation with staff. It has therefore not been possible to use direct quotes from residents about their care on this occasion. What the service does well: The registered manager and staff are good at ensuring residents are supported to take an active part in the running of their own lives and as stated in the homes’ Statement of purpose ‘All service users are respected as individuals who have individual needs that require an individual care package. Our mission is to promote independence and honour privacy and dignity. We strive to provide a totally holistic approach to life where physical, social and psychological well being is upheld and given equal importance through person centred planning’. The residents have complex needs but they are cared for and supported as young men living in the community. The home was found to do most things well. The manager of the home was found to be especially good in supporting residents and staff. The staff members interviewed expressed how much they enjoyed their work and were very complimentary about the manager. There were no requirements or recommendations from this inspection, which reflects the high standards in place. The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 Page 6 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 Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 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.V302033.R01.S.doc Version 5.2 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): 1,2,3,4 & 5 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The statement of purpose and service user guide clearly says what service will be offered. EVIDENCE: Since the last inspection the home has had a referral from East Sussex Social Services, and the manager is in the process of undertaking a pre-assessment of the young man to ascertain if the home can meet his needs. The home has a comprehensive policy and procedures for the admittance of new service users. A full and comprehensive assessment is carried out prior to any person moving into The Wheelhouse to ensure the home can met the needs of the individual. The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 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): 6,7 & 9 Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. The registered manager and staff demonstrate their knowledge of the individual residents, and are aware of the complex needs of the residents and encourage them to have an independent lifestyle as far as possible. EVIDENCE: The inspector reviews all three care plans of the residents living at The Wheelhouse, and reviewed the new Person Centred Planning format. The format and information is of a very high standard, and all staff would have a good insight on how to work, care and support the individual residents in their preferred manner. The Plans had a recent photograph and contain information on the likes and dislikes, health issues and other relevant information. The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 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): 12,13,15,16 & 17 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home’s links the local community are good and enrich residents’ lives socially and educationally. The manager and staff team are enthusiasm and are always looking for new ideas to enrich the residents’ lives. EVIDENCE: Residents have a weekly planner, which list all their activities. They are involved in the running of the home, which includes shopping for food, and this is an enjoyable activity linked to having lunch out in the restaurant. One resident has no real family contact, but he meets up with his old tutor on a weekly basis and this person is very important to him and advocates for him. The manager and two other members of staff have recently attended a course called PATH (planning positive possible futures and planning alternative tomorrows with hope), which looks at planning positive lifestyles for all people. The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 Page 11 The manager is very enthusiastic about finding suitable employment opportunities for the residents to ensure they have positive community involvement. The examples she gave were for one resident that enjoys posting things, look for a paper round. Another resident really likes pushing the supermarket trolleys; the home will be approaching their local supermarket and enquiry if he could with staff support push trolleys back to the shop entrance from the car park. Following the Football world cup the two residents who had an interest were encouraged to support their country of their birth and they had their national flags in their bedrooms. The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 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 the following standard(s): 18,19 & 20 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents receive personal support appropriate to their physical, emotional and healthcare needs. All personal and healthcare needs are well documented. EVIDENCE: The residents have been involved in an initiative in conjunction the Community Learning Disability Team (CLDT) called ‘My Health action plan’ which has been completed by the individuals’ key worker and highlights the health issues they may have. All residents are registered with local GP and health checks are regularly carried out. The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 Page 13 The manager has concerns for one resident who health has deteriorated over the last year and has been admitted into hospital. The manager has called a review meeting including the young man’s care manager and the GP to discuss his future health needs and to ensure the home can met his changing health needs. The medication files and storage were inspected and found to be in order. All staff have had the relevant training and are all deemed to be competent in the administrating of medication to the residents. There was a medication error reported in March 2006 and since that time the manager has reviewed the home’s medication policy and procedures and now two staff are responsible for the giving of medication and the residents are escorted into the kitchen. It was noted that the care manager of the resident involved in the medication error was informed and they are in receipt of the new policy and procedures. There has also been additional training for staff in May 2006 in the care of medicines. The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 Page 14 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): 22 & 23 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Following a complaint and an adult protection issue in March 2006 the manager has reviewed the way in which she will manage these situations if they occur in the future, and has provided training for the staff team. EVIDENCE: There was a staffing issue following the Adult Protection alert following a complaint about the conduct of two staff toward the residents of The Wheelhouse in a soft play area of another organisation, where it was alleged the staff were heard shouting at the residents. The manager with support from the organisation undertook disciplinary action. The staff involved received written warnings and two weekly supervisions and the opportunity to undertake further training in the protection of vulnerable adults. The manager was very upset at this incident as she has very high standard of conduct and expects the staff to have too. It is now evident now the manager is managing the home well, and the staff respect and recognise her authority. All the staff interviewed said that the manager was a good role model as she always put the residents first. The staff now employed within the home have a good understanding of the organisations policy and procedure on adult protection and from the preinspection information and the training matrix highlighted recent training to support the staff in Gentle teaching, Crisis Prevention and Intervention, Anxiety and Depression and Managing Aggression and Challenging Behaviour. The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 Page 15 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 & 30 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The overall standard of the environment including the décor and furnishing are good and provide a homely and attractive place for residents to live. EVIDENCE: Since the last inspection there has been a new central heating system installed and the home will benefit this in the coming winter. The inspector undertook a full tour of the home including all the bedrooms, bathrooms and communal areas. The residents’ bedrooms are decorated to a high standard and reflect their individual interest and culture. They are very hard on the environment, but the décor and maintenance has improved now the home has the services of a maintenance person for two days per week. His remit also includes the maintenance of the garden area, which was also very well kept. The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 Page 16 The manager has plans to install a sensory area in the garage area from equipment, which was given to The Wheelhouse from a home that has recently closed. The manager has obtained planning permission and the assurance from the fire service; there is a need for some building work to be carried out including a new doorway. When completed this facility could enrich the lives of the residents. The home was clean and free from offensive odours. The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 Page 17 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): 32,34 35 & 36 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s recruitment procedure. The staff now have the skills and experience to meet their needs and support them. EVIDENCE: Since the last inspection there has been new staff employed at the home, fortunately, two staff were transferred from a home that has closed and they are both are senior support staff. They were on duty and were interviewed at this inspection and both are very happy to be working at The Wheelhouse, they both commented on the manager’s commitment to the home and the residents. The inspector saw the recruitment and staff records of the newest staff members and found them to be in order. Also since the last inspection as mentioned in standards 22 and 23 there has been staffing issues around the conduct of two staff when out in the community towards the residents, this has now been resolved satisfactory. All staff have completed a full induction and many were progressing to various levels of NVQs. The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 Page 18 The manager supplied a copy of the training matrix for the home as part of the pre-inspection questionnaire information and the training within the last year has been very comprehensive and will ensure the staff have the training and knowledge to meet the changing needs of residents. Also it was evident from the records held at the home that the staff received regular supervision from the manager. The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 Page 19 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): 37,39 & 42 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The manager has a good understanding on the area in which the home needs to improve, she has a clear development plan and vision for the home. EVIDENCE: The manager has become the registered manager of the home and she has greatly improved the service; she is enthusiastic but realistic with good ideas on how to improve the service. The manager is well qualified and holds many relevant qualifications, and is currently completing the Registered Manager’s Award (RMA). The promotion of choice and opportunities are stated clearly in the home’s Statement of Purpose and because of the residents’ communication difficulties alternative communication methods are used within the home. The inspector saw this used through a method called PECS and through the use of objects or reference and the actions of the residents are acted upon. The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 Page 20 From the pre-inspection questionnaire that was completed and signed by the manager, all the requirements relating to the health and safety of the home are up to date and accurate and in order. The overall maintenance of the home has improved since the last inspection, and the home now has the services of a maintenance person for two days per week. The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 Page 21 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 Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X The Wheelhouse DS0000021268.V302033.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action 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.V302033.R01.S.doc Version 5.2 Page 23 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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