Inspection on 07/01/09 for Wheatsheaf House

This inspection was carried out on 7th January 2009.

CSCI found this care home to be providing an Excellent service.

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 20/02/07

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Wheatsheaf House 5 High Street Cottenham Cambridgeshire CB24 8SA     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Dragan Cvejic     Date: 0 7 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Wheatsheaf House 5 High Street Cottenham Cambridgeshire CB24 8SA 01954250799 01954250799FP Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): CareTech Community Services (No.2) Ltd Name of registered manager (if applicable) Mr Samuel James Gilchrist Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability mental disorder, excluding learning disability or dementia Additional conditions: 1 named female over the age of 65 with a learning disability 1 named female with a learning disability and mental disorder Date of last inspection Brief description of the care home 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 takeaway restaurants etc. that this busy Fenland village has to offer. Cottenham is within fifteen miles of Cambridge, from where it is an hours 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 Care Homes for Adults (18-65 years) Page 4 of 28 care home 10 Over 65 1 2 0 0 10 1 Brief description of the care home 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. The house was to be re-wired and re-decorated starting just 2 days after this inspection.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 two flats, recently developed from what was previously three bedsits. Apart from one fee set for an individual, the others paid average fee for all other users as agreed with social services. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The home was reviewed through an Annual Service Review in January last year and some comments and finding in this report are taken from that report. The unannounced visit took place on the 07 January. On the arrival, all residents were out, three on their daily programme, one had gone shopping and one stayed with his family in Cornwal. The manager informed us, the regulators, of planned rewiring of the electricity in the home and redecoration that was supposed to start just 2 days after this site visit. An Expert-by-experience was called to help determine the level of choice that people living here, residents, were experiencing. The expert talked to a resident after a long wait for her to return from her shopping trip. Three residents files were checked, two staff records, medication storage, procedure Care Homes for Adults (18-65 years) Page 6 of 28 and records and some other procedures. An incident where a resident made accusations was handled by the home well and this event was also used to evidence outcomes for residents in the area of protection of residents. We have received 3 questionnaires, two from residents and one from staff that we used for this inspection. We monitored the service through telephone contacts, too. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 8 of 28 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information about the home was made very accessible to potential and existing residents. The home carried out an effective and comprehensive assessment prior to a offering place to potential residents to ensure that they could make a clear and informed choice and, once admitted, their needs were met. The home exceeded minimum standard requirements. Evidence: The homes statement of purpose was reviewed and updated in August. The manager explained how he used a new assessment format that exceeded the standards by addressing details of how the new person would fit into the home and get on with existing residents. The manager stated that he had to refuse a referred person when he was unsure of the homes capacity to meet the assessed needs. A distric nurse spoken to during the site vist stated: The manager is always helpful, the staff are very good. I am very happy with how the home is run and residents cared for. The needs of current residents were fully met. One of the staff comments stated, on Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: the question what is done well: The home provides good support to residents and staff, considers individual needs, offers choice and always listens to the views of the residents. Contacts were seen in checked files, but they were assessed previously and met the standards. Care Homes for Adults (18-65 years) Page 12 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were in control of their lives through involvement in care plans, risk assessments and participation in running the home. Evidence: Three residents were case tracked and their files were checked as a part of the inspection process. Care plans were improved since the previous inspection and with added details were more descriptive and, as staff stated, easier to work with. They were written in the first person and indicated residents involvement. A new, piloting care planning for the organisation was carried out in this home. A person centred planning approach was implemented and gave very positive results in the entire holistic care approach to each individual. Apart from regular reviews, the areas that changed more often than the reviews timescale, were reviewed at the time of the change. An example was of the seating arrangement in the dining room when the safety of the resident was considered to be much higher in a different place. External professionals were also consulted about this Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: and contributed to this improvement. The expert by experience talked to a resident and commented in his report: Resident spoken to chose when to go out and where she wanted to go, for example she liked to go bowling and swimming. She also enjoyed cooking, and she said that she gets to choose her favourite food, and goes to Tesco to choose the food she wants to eat, she also contributes with the household chores by preparing the vegetables in the kitchen. User 1 chose whether to bath or shower, she said she prefers to take baths, and she chose who she liked to help her with her bathing and dressing as well as choosing her own clothes. Two residents decided to share temporary accommodation in a flat while the main refurbishment takes place. The manager stated that residents get involved in recruitment of staff and one or two residents also sit on the panel and ask questions. Another example of excellent practice was allowing a resident to change her daily programme and supporting her to fit her new programme that she chose herself into her lifestyle. Care Homes for Adults (18-65 years) Page 14 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents were able to control their lives and were supported to exercise choice, independence, their rights, and to explore reasonable risks. Evidence: The majority of residents had a structured weekly programme that was set during care planning meetings with them. Several residents attended college. A case tracked resident had started swimming in a local pool during general swimming, supported by staff. The expert by experience concluded in his report: In summary the expert found the home to be very friendly and that the only resident he got to talk to seemed happy and had lots of choice regarding her lifestyle, care and money. The manager explained that one of the residents regularly goes to church accross the road and that the home had an agreement with the church to use their premises for Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: certain meetings and even staff training when a bigger place was necessary. Residents had their holiday in New Forest, they also went on a trip to York. Two residents were, at the time of the visit, getting ready for a longer holiday in Centre Parks, while the refurbishment of the home was carried out. All their expenses were covered by the organisations funding. Residents were cooking according to rota, in turns. They also took part in weekly shopping and were encouraged to buy things they personally liked, to share with others. Care Homes for Adults (18-65 years) Page 16 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home respected residents wishes, privacy and dignity when their healthcare was dealt with. Residents were protected with clear and safe healthcare and medication procedures and practices. Evidence: Care plans clearly instructed staff on how personal care should be offered to service users. Daily records were compared for 3 case tracked users with their care plans and recorded staff input matched actions from care plans. Staff commented that care plans were now written much better and were used to guide them in offering care. An example was seen in one of the files where a residents comment stated: I can do my toe nails, but I prefer the chiropodist to do them for me. In the section of professional contacts two recent chiropody visits were recorded. The staff allerted the community nurses team to the need to change medication for a resident who suffered from epilepsy. The records indicated: Eye test due December 2008, and in the file there were the results from this eye test. Medication for three residents was checked and were accurate with good records. Care Homes for Adults (18-65 years) Page 17 of 28 Care Homes for Adults (18-65 years) Page 18 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home highly valued the safety of residents and a number of procedures and policies were in place to ensure residents protection. The home exceeded minimum standards in this area. Evidence: The home had an effective and clear complaints procedure. It was developed in picture format and was given to all residents. It stated the time scale for responding, investigating and reporting back to a complainant. Residents commented in their questionnaires that they knew how to complain. One stated: I do know, but there is nothing to complain about. There was a case of an allegation made by a resident, that the manager and the home handled extremely well and professionally. The case was reported to the Adult Protection Team, the home maintained confidentiality and fully cooperated in the investigation that cleared the whole staff team from this allegation. The other examples of protection of residents was seen during the site visit. One was moving a resident around the dining table to ensure her better protection; the other was building a seizure management plan for a resident that staff initiated; the third was the evidence that the home provided all information including the complaints procedure in picture format, making it alailable and understandable to all residents and their families. Protection of residents was approached very sensibly. Some risks were allowed, to Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: promote residents independence, but without compromising their protection. Social workers were involved in all protection issues to ensure objective, but effective measures were in place for residents protection. Care Homes for Adults (18-65 years) Page 20 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some major constructual elements of the home were not appropriate for progressing residents and the organisation arranged re-wiring structural electricity and refurbishment of the home, to create an appropriate environment where residents could fully use their abilities and independence. Evidence: The home was getting ready for major works and refurbishment. Some electricity problems, such as tripping fuses, required major works and the organisation arranged for the entire home to be re-wired. This would provide extra sockets and allow residents to use the new electrical equipment they aquired. The organisation planned to refurbish the home at the same time and to lay new carpets. As the packing process was in progress, the environment could not be fully inspected during this site visit. However, the action taken demonstrated the organisations determination to improve conditions for residents. During this time, the home arranged appropriate infection control measures. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff team was skilled, experienced and able to meet the residents needs. Residents were protected by procedures that ensured proper vetting of new staff and training appropriate to their roles and residents needs. Evidence: Two staff files were checked and contained the evidence of appropriate checks carried out prior to starting work with residents. The stable staff team also meant that residents had continuity of care and good relationships with staff. Staff spoken to also stated that they were happy with their responsibilities and knew how to help and support residents. Training had improved and staff felt that it was relevant, well timed and well organised. Training records showed that the training was very good. The home exceeded standard on NVQ qualified staff, having much more than 50 of staff holding this qualification. The deputy manager was quite pleased with the opportunity to do NVQ 4 and gain the Registered Managers Award. All staff attended POVA (Protection of Vulnerable Adults) training and knew how to implement it to protect residents. She also stated that she felt well supported through supervision. She supervised 3 staff members too. Supervision records in staff files were up to date and showed Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: regularity. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home promoted and encouraged safe working practices and listened to staff and residents to identify all potential hazards and minimise them. Residents were protected, but still allowed to exercise autonomy, individuality and creativity. Evidence: The stable and able manager with people and management skills, determined to support residents and staff was in post. He created an atmosphere where staff felt respected, supported, valued and were encouraged to express their positive ideas and innovation skills. The organisation appointed a quality officer and improved the quality assurance process that, consequently, improved listening to residents and following their wishes and preferences. Residents were informed of the outcomes of their comments. They chose the pattern of new carpets and influenced choice of colours when redecoration took place. Safety of residents was in focus when procedures were set and reviewed. The work on Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: rewiring the home was also undertaken to ensure protection of residents. This inspection showed that the home continually worked on improvement of services and provisions for residents and the expert by experince shared the opinion that the service could be rated as excellent in terms of outcomes for residents. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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