Inspection on 20/02/07 for Wheatsheaf House

This inspection was carried out on 20th February 2007.

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

Wheatsheaf House 07/01/09

Wheatsheaf House 12/12/05

Similar services:

Chesham House

Argyll House

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

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

CARE HOME ADULTS 18-65 Wheatsheaf House 5 High Street Cottenham Cambridgeshire CB4 4SA Lead Inspector Dragan Cvejic Key Unannounced Inspection 20th February 2007 10:00 Wheatsheaf House DS0000065460.V327584.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 Wheatsheaf House DS0000065460.V327584.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. Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wheatsheaf House Address 5 High Street Cottenham Cambridgeshire CB4 4SA 01954 250799 01954 250799 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) CareTech Community Services (No.2) Ltd Mr Samuel James Gilchrist Care Home 10 Category(ies) of Dementia - over 65 years of age (1), Learning registration, with number disability (10), Learning disability over 65 years of places of age (2), Mental disorder, excluding learning disability or dementia (1) Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 1 named female with a learning disability and mental disorder 1 named female over the age of 65 with a learning disability 1 named male over the age of 65 with a learning disability and dementia 12th December 2005 Date of last inspection Brief Description of the Service: Situated at the end of the village of Cottenham, Wheatsheaf House is opposite the church, and within walking distance of the amenities, such as shops, pubs, and take-away restaurants etc. that this busy Fenland village has to offer. Cottenham is within fifteen miles of Cambridge, from where it is an hour’s train journey to London. The house consists of three single bedrooms and a bathroom on the first floor, and one double bedroom, one single bedroom and a shower room and toilet on the ground floor. There is a large lounge, dining room, kitchen and conservatory on the ground floor as well as a laundry, office and sleeping-in area. There are gardens to the front and rear of the house: access for wheelchairs is by a ramped entrance to the conservatory from the car parking space at the rear of the house. In addition there is an annex, consisting of three single bed-sit units, each with its own en-suite shower room and kitchenette at the rear of the home. A communal room with cooking facilities, and a laundry room, form part of the annex. Apart from one fee set for an individual, the average fee for all other users was £700.19 per week. Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out during the midday hours and lasted for 3 hours. The main methodology was case tracking, with other methods used to inform this report, such as: a tour of the premises, observing staff working with service users, talking to the manager and to a staff member. Various documents held in the home were checked. The majority of service users were within the age range of 40-65, but at the time of this site visit, there was one user over 65, for which the home had a condition of registration and one aged 18. The home was allocated extra hours to ensure that user’s needs identified as one-to-one supervision were met. What the service does well: What has improved since the last inspection? The approach of identifying areas for improvement was part of the home’s philosophy. The manager introduced an atmosphere where both staff and service users could express their initiative, and where existing procedures were constantly under review in order to be made better. The home arranged a meeting with the Learning Disability Partnership where the complaints procedure was reviewed and the path for complaints was agreed, providing social services as the next instance after the internal procedure. Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. Wheatsheaf House DS0000065460.V327584.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 Wheatsheaf House DS0000065460.V327584.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home exceeded standards both in their welcome pack, which allowed users to get a full picture of the home and, once admitted, how their needs were met. EVIDENCE: The home provided information to all potential and existing service users in their Welcome Pack, where all provisions were explained. The service user’s guide was produced in picture format, making it more accessible to service users. The admission process could be seen in users’ files, as in two files inspected, clearly documented that all areas of users’ lives were assessed prior to admission. The files also demonstrated how the users’ needs were met, not only through health care notes where appropriate external professionals were involved, but also through recorded activities, and risk assessments for outings and holidays. Service users were allocated an hour for individual, one –to-one discussions on their progress, events or anything they wanted to raise. A service user’s holiday with his family in Cornwall was discussed and recorded in the checked Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 9 file. The variety of activities, the timed and appropriate involvement of external professionals to act preventatively determined the excellent rating, as National Minimum Standards were exceeded. Contracts clearly described what was provided but took a step ahead of the minimum requirements addressing risk taking, describing both the home and individual room and being signed by either users or their relatives. Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were treated as individuals and their individual abilities were promoted and they were encouraged to take risks and explore new areas, ideas and events as they wanted. EVIDENCE: Very well prepared and maintained care plans demonstrated how care was provided for service users and contained evidence that the plans were agreed with them. A part named “Individual support required” was particularly well written. At the end of it there was a short, concise summary of the needs and actions. One of the users was a member of the Learning Disability Parliament and attended meetings and events organised by Speaking Up, an organisation that supports people with disabilities. Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 11 An observation of a user, first reading magazines, which he enjoyed, and then moving to the lounge, demonstrated how gentle, patient and respectful staff were allowing and encouraging users to decide how they spent their time. Users were fully involved in life in the home. They were offered the opportunity to take part in the recruitment process, they discussed the complaints procedure and were actively involved in house chores, shopping, cooking, serving and arranging washing up. Risk was also very well managed. Each individual had a clear risk assessment that was kept up to date and all new suggested or planned activities were risk assessed. One of the files indicated a planned visit to Duxford Museum and Air show and the risk assessment was drawn up for that event, a holiday in Derbyshire for another user was also risk assessed. Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users were able to control their lives and were supported to exercise choice, independence, their rights, and to explore reasonable risks. EVIDENCE: All service users had a set daily programme. They were involved in college, voluntary work and attending day centres as part of their involvement in programmes promoting practical skills. Apart from these, they all enjoyed a variety of recreational and leisure activities in and out of the home. The home kept records of service users activities and encouraged them to respect the agreed weekly programme, but also promoted new activities, such as a planned visit to Duxford. A service user attended a party at his friends’ house and this was discussed at his one-to-one meeting with his key-worker. His regular attendance of Speaking Up confirmed the users’ involvement in the Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 13 local community. A user was getting ready to go to visit her brother and said: “I have got everything. I packed presents for my nieces.” Some service users were taking part in food preparation. Users were regularly making their packed lunch on weekdays, when they attended day centres. One user was able to and used a chopping board. This activity was well risk assessed. Menus were decided by service users and any alternative choices were recorded. Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 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. 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. The home respected service users wishes, privacy and dignity when their healthcare was dealt with. Service users were protected with clear and safe healthcare and medication procedures and practices. EVIDENCE: Personal and healthcare support was provided according to plan and there was evidence on how actions were taken when health issues were identified for a user. Bowel problems were first reported to the GP, several visits by the GP followed, His medication was reviewed and staff observed reactions. A specialist examination in hospital was arranged. The orthoclinic was contacted and involved in the care of a user with calliper. One of the female workers insisted to be helped by a female worker and the manager ensured that a rota was drawn up to ensure there was always a female carer on duty. One of the users did not have any prescribed medication, records for three others were checked and were accurate. No one was, at the time of the site visit, prescribed controlled drugs. Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 15 The home addressed potential problems related to ageing, not only for the user over 65, but for all of them, as the age range was within 40-65 for the majority of service users. Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 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. 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. The home valued highly the safety of service users and a number of procedures and policies were in place to ensure users’ protection. EVIDENCE: The home developed a clear and concise complaint procedure and produced it in picture format, making it very accessible to all service users. Service users were included in discussions on procedure with the Learning Disability Partnership, when the procedure was clarified and social services were included in the path for potential investigations. The procedure was included in the Service User’s guide and in the terms and conditions given and signed by service users or their relatives. The home had not had any complaints. Service users were well safeguarded not only within the home, but in all other identified potential hazardous situations as well. For example, the home closely monitored users safety in public places and on public roads and drew up risk assessments for the activities and trips out. Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users felt free and comfortable in a safe and well-maintained environment. EVIDENCE: The tour through the main building showed a well-maintained and homely environment was created for service users. A bright and sunny conservatory overlooked the back garden and provided access to two flats, used by very independent service users. Located in a village north of Cambridge, the home still had good access to public transport and the city of Cambridge was easily accessible. Internally, the home was arranged in a domestic style. Users’ paintings were framed and hung on the walls around the house. The home had a hoist that was regularly serviced, but not currently used. Other facilities, such as a raised bed, were obtained after assessment by an occupational therapist. Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 18 A special mattress was also used to reduce the risk of pressure sores for a service user. The laundry room was in the process of total refurbishment after being damaged in a fire, caused by the washing machine. A new washing machine was since obtained, ensuring the service users could still do their washing despite problems with the laundry room itself. Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team was skilled, experienced and able to meet the service users needs. Service users were protected by procedures that ensured proper vetting of new staff and training appropriate to their roles. EVIDENCE: The staff were clear of their roles and responsibilities. They knew service users well and knew their preferences, likes and dislikes. A staff member showed commitment by patiently waiting to help a service user move to the lounge. She knew how to communicate with the user in way that created trust, comfort and a professional friendliness. The team atmosphere was visible through the observation of staff working in the home in an organised, structured and meaningful way. The staff ratio was appropriate and service users were very pleased with an extra day shift, funded for a user who needed one–to-one supervision. The night sleep-in duty had been replaced by a waking shift, due to the need of the same user. Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 20 The balance of male and female staff reflected the gender of service users, but a female worker was present on each shift, responding to the requirement of a female user to be cared for by female staff. The home offered a good training programme to staff and the records showed that all staff were up to date with all mandatory training. The NVQ programme was ongoing, 4 staff were currently undertaking training and the home hoped to achieve the required 50 of NVQ trained staff when the current attendees complete their training. The manager confirmed that all checks were carried out during the recruitment procedure. The file checked showed that all required documents were present. Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensured that safe working practices were in place and service users benefited from clear safe working procedures. EVIDENCE: The manager was very skilled and created an open, constructive and innovative atmosphere, not only among staff, but also among service users. His training was up to date. The ethos of the home and the inclusive style allowed service users and staff to be constantly involved in the running of the home. Users usually asked questions during the visit of potential job applicants: “Do they drive? What is their experience?” Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 22 The organisation carried out quality assurance reviews on a 6 monthly basis, consulted the users, staff and relatives and created an action plan based on findings. Safe working practices were in place. The recent fire demonstrated how the home was prepared to react in an emergency. The home was evacuated within 5 minutes. The fire area was isolated. When the fire brigade arrived, they praised both staff and service users for their action. The laundry room door was to be replaced with a new fire door. Currently, refurbished existing fire door was used temporarily, to ensure infection control and fire precautions measures were in place. The risk assessment covered this temporary arrangement and safety in the home, pointing out to a potentially higher risk in case of fire, until the new door arrives. Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 23 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 4 2 3 3 4 4 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 X 3 X Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? 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. 1 Refer to Standard YA32 Good Practice Recommendations When the current staff complete their NVQ training and the home achieves 50 of trained staff, they should plan for the future to prevent the percentage from falling under the required 50 . Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Wheatsheaf House DS0000065460.V327584.R01.S.doc Version 5.2 Page 26 - 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. 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