Care Home: Wyatt House

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What the care home does well A statement of purpose and service user guide are now available that inform people about the services and facilities offered by this home. The care plans give detailed instructions to staff, describing how individual needs should be met. The records for medication indicate that they are kept safely. People who use the service have access to community based health professionals as required. For example visits by professionals such as district nurses where appropriate, general practitioners and chiropodists are noted and any advice or treatment recorded. Specialist diets are catered for and people who use the service have access to community based activities as well as in house ones. Staff were observed speaking and assisting residents with dignity and respect. People who use the service or their nominated person are consulted and agreement reached and recorded into how they choose to spend their money. What has improved since the last inspection? Risk management forms part of the care planning system that is in place. This includes assessment of mobility, pressure care and nutrition and reduces risks to residents. The environment has improved with people who use the service being enabled to choose how to decorate their rooms. What the care home could do better: The registered person must show that training staff receive in areas such as moving and handling and safeguarding adults is substantive to protect the people using the service. Staff must receive training in fire safety regularly. Fire safety equipment and lighting mist be tested and monitored. Key inspection report Care homes for adults (18-65 years) Name: Address: Wyatt House 1 Radford Road Tinsley Green Crawley West Sussex RH10 3NW     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Val Sevier     Date: 0 7 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Wyatt House 1 Radford Road Tinsley Green Crawley West Sussex RH10 3NW 01293881088 01293881001 wyatts@caretech-uk.com www.caretech-uk.com Wyatt House Ltd care home 8 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 8. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Wyatt House is registered to provide care and accommodation for eight adults who have a learning disability. The people living within the home also have associated challenging behaviour and there are currently eight residents. The service is situated in the village of Tinsley Green near Crawley. The accommodation is on the ground floor and all of the rooms are for single occupancy, six of which have en-suite facilities. The service is set in large grounds, which are easily accessible to residents. The Registered Provider is Wyatt Homes Ltd and the Responsible Individual is Stephen James Unsworth. At present the minimum fee is GBP1,275.00 per week, and the maximum fee is GBP2,131.00 per week. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 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: one star adequate 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 quality rating for this service is 1 star. This means the people that use this service experience adequate quality outcomes. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The visit was carried out on the 7th December 2009 between the hours of 10:00 am and 4:00 pm Prior to the visit to the home we reviewed information received from the home; this is the first inspection of the home since it was registered. The Annual Quality Assurance Assessment (AQAA) was returned to the Commission by the due date before we visited the home. The AQAA is a document that we send to a service once a year, in it they are able to comment on improvements they have made, any barriers to improvement to meeting the standards and how they feel the service is Care Homes for Adults (18-65 years) Page 5 of 29 meeting the needs of people who live at the home. We met with the registered manager who assisted us throughout the visit and the area manager who assisted with information about recruitment and training. We met with two staff, one visitor and there were three people who use the service involved in the inspection visit. We have sent ten surveys to staff, five to people who use the service and five to other professionals. At the time of writing the draft report we are waiting for their return. The service has not had any new admissions since our last visit. There were five people living at the home on the day of our visit. We looked at the information available for two people in the care plans, medication records; we also looked at staff files, training records and fire prevention testing and training records. Care Homes for Adults (18-65 years) Page 6 of 29 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 29 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 8 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may use this service and their representatives have the information needed to decide if the home will meet their needs. Assessment processes ensure prospective residents needs are identified before the move into the home. Evidence: The AQAA from the home said:People will only move into Wyatt House once a full and comprehensive assessment has been obtained. All parties will be involved, taking into account the views and compatibility of the others living here already, their families, carers and professional will be part of this process. Wyatt House will provide the person with a service users guide in an appropriate format, and offer them and their families the opportunity to visit the home. The person will be given opportunities to visit regularly for meals, overnight stays and invitations to join us on activities and outings. All fees and terms and conditions will be made available and discussed with the individual to ensure that their needs can be met. Wyatt House currently has vacancies; these vacancies will only be reviewed on completion of the current development plan for the home. The home is due to undergo Care Homes for Adults (18-65 years) Page 9 of 29 Evidence: a period of refurbishment and change once this has been completed the home will reassess the vacancies. The statement of purpose and service users guide will also be altered to reflect the changes in the home. Care Homes for Adults (18-65 years) Page 10 of 29 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. Care planning and risk management processes give good information to staff in order that they can meet individual needs. Evidence: The AQAA for the home told us that:Each person has a comprehensive My Plan which is being been developed with them, and covers all aspects of their personal and social support. The plan respects any cultural and religious needs, and identifies gender specific needs and choices. The plan also recognises the individual health care needs and has an action plan arising from that. As an ongoing, working document; my plan will be used as basis for identifying new goals and aspirations that the person may wish to pursue, as well as a marker of achievements. The ladies and gentlemen are encouraged to choose their own activities and weekly menus. They are supported to develop their life skills, through participation in daily tasks. The ladies and gentlemen are offered choices in activities, within the home and out in the community. These arrangements to be made around any appointments and Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: day services attended. If a person does not like the choice on the menu, they can have an alternative of their choice. The one to one time and staff observations have helped to detail individual likes and dislikes, including clothes, dietary activities and places to go etc. All of the ladies and gentlemen are offered choices of local community participation. Each given the opportunity to choose where they want to go and what to do. Staff assists the ladies and gentlemen to choose their own clothes and personal items and encourage them to make decisions of their own. They are encouraged to choose colour schemes and designs for their own bedding, towels and other items for their rooms. The ladies and gentlemen are encourage to contribute in the running of the home and are actively encouraged to participate in undertaking domestic chores, recycling and shopping. All living at Wyatts take some part in cleaning their own rooms and are encouraged to participate in various life skills, like preparing their own drinks and food preparations. We sampled two care plans and were able to evidence elements of the AQAA. We saw that the care plans give detailed instructions to staff, describing how individual needs should be met. We saw information about the individuals past medical and social needs. The information is centred on the individual and gives an insight into their past experiences. Care plans were in place for areas including mobility, personal care, communication and behaviour. The care plans we saw had been reviewed regularly and as needs changed or something occurred. We could see that the individual was involved where possible and that their next of kin or nominated person had been asked to contribute. On the first plan we saw that there was information on family and social support. There was information on how staff should support the individual. We saw in the care plans information on how staff can communicate with the individual for example: speak slowly and clearly with simple instructions be patient and give time to process. When anxious, staff can offer a number of things, verbal reassurance, physical contact, or a hot drink and snack. These documents had been reviewed monthly and as needed. There were also assessments regarding mental capacity. There was information on what was important to the individual with the addition of likes and dislikes these included environment and activities as well as food. There was detailed information on how staff were to support the individual with their physical difficulties and what action they should take medically. We saw that most staff have been trained in techniques specific for the individual. For the second care plan we saw that the individual has particular issues with clean bathrooms. We saw that staff had detailed instructions on how to lessen the anxieties and behaviours associated with these issues. We also observed staff carry out checks as part of their care, into the cleanliness of the individuals bathroom area. We saw how their physical needs are to be supported by staff for example baths and how to Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: enhance this experience for the individual. We saw written information on how staff would enable people who use the service to make choices. We observed them offering choices in activities, food, and whose company they kept. We also heard people being encouraged to carry out daily living tasks. A requirement had been made following the last visit regarding risk assessments for individuals. We saw that there were risk assessments for falls, swallowing, epilepsy and behaviours for example, and that risk management forms part of the care planning system that is in place. Care Homes for Adults (18-65 years) Page 13 of 29 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. People who use the service are involved in decisions about their lifestyle choices and they are offered a choice of well balanced, nutritious meals. Evidence: The AQAA told us that:All of the ladies and gentlemen have client specific activity plans and have full and active week, which includes enjoyable and practical interests. Those living here enjoy local amenities such as cafes, shopping, bowling, cinema, pubs, drives out, local walks and local parks. The ladies and gentlemen are offered different choices of activities and are encouraged by staff to visit different places, utilising different modes of transport. They are encouraged and supported where appropriate to maintain family links and develop relationships inside and outside the home. One gentleman goes out with his family twice a week for drives and lunches out. Another lady goes home to her family for weekends. A third gentleman has regular visits and contact with his family. The ladies and gentlemen are treated with Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: equality and respect and are continuously encouraged to develop independent skills The ladies and gentlemen are encouraged to eat healthy meals, and are being supported to participate in choosing their own menus, food shopping and the preparation of meals. When we arrived there were five people at the home. We were told that individuals usually go out for part of the day at least to day care or other types of activity. We saw on one care plan that one individual is taken out regularly by their family for a meal and shopping. Another individual receives no regular visits from outside the home. We saw that there were risk assessments for activities outside the home to enable the individuals to participate as fully as possible in an active life safely. We saw that going out for a drive helps to relax one of the individuals. They enjoy going to the shops and wandering round we also saw that there are activities which the individuals do not like such as arts and crafts and bowling. We saw that the two individuals whose plans we saw like to participate in household tasks if they are in the mood to do so. We saw examples of other types of activity enjoyed by people included massage therapy, visual participation in cooking and make up. The reflexologist visited whilst we there and we saw one individual having a hand massage. The meals at the home can be varied for example lunch times there is a free choice, or what is on the menu. We saw that the menu offered several alternatives. We did see on care plans that there was information on how staff were to support individuals with meals. For example risks regarding choking and that special cups are to be used to enable the individual to feed themselves, that food is to be cut into bite sized pieces and the correct plates, guards and cutlery used. We observed staff supporting individuals with their meals using encouragement. Care Homes for Adults (18-65 years) Page 15 of 29 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. People who use the service are supported and any personal and health care provided takes into account the wishes and personal preferences of each individual. Medication is administered and recorded in a way that protects and supports people that use the service. Evidence: The AQAA for the home said:Staff are aware of the policies and procedures in relation to attending to personal care of the ladies and gentlemen and guidelines are in place for any gender specific requirements All are registered with local services: GP, Dentists, Psychiatry, Behaviour support specialist, speech and language, and occupational therapists. As a home we are developing good relations with all the professionals supporting the home. Personal and health care support is delivered with privacy and dignity. Individuals are encouraged to be as independent as possible in this area, and support is always based on an individual basis. The ladies and gentlemens health is monitored by staffs that identify any potential problems and act on these promptly. Six monthly medication reviews are maintained for all the ladies and gentlemen, and are further interim reviews may requested to attend to specific individual needs Two people are receiving support from positive behaviour specialists Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: to manage wellbeing and behaviours, in conjunction with the staff team. Ongoing support is being offered to one gentleman who is not comfortable with having his toe nails cut, and we are currently supporting him with a desensitisation program. Ongoing support for one person who has fear of needles, blood pressure cuffs to support with desensitisation program. All staff have been updated with providers medication training policies and procedures Staff receives training on epilepsy awareness and are trained to administer rectal diazepam, should it be required by two people living here. We saw that people who use the service appeared appropriately dressed for their age, culture and the climate. Staff were observed speaking and assisting people with dignity and respect, for example staff were heard using individuals preferred choice of name when having conversations with them. Records show that people have access to community based health professionals as required, for example visits by professionals such as district nurses where appropriate, G.P, chiropodist are noted and any advice or treatment recorded. We sampled two care plans pertaining to health care needs. The care plans sampled were being used in conjunction with other monitoring documents that are used as part of the care planning process for individuals. We saw that the monitoring documents had been completed and reviewed as necessary. The documents for individual health supporter we called my health plan. We saw that there was a record of what the individual needed help with and what action is needed and who is responsible. For example one individual has episodes when their eyes roll they become anxious and disoriented. Staff must ensure that blood tests are done regularly and keep records to pass to doctor. Medication is kept in a locked cupboard in each individuals room using monitored dosage blister packs, with some additional medication which has been prescribed to use when needed. There is a medication recording chart in the room and a second file in the office which is double signed for each individual each time medication is given. We looked at the two cupboards and records for the two people whose care plans we had seen and saw that records had been kept and these matched the stock in the cupboards. Care Homes for Adults (18-65 years) Page 17 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure enables those people using the service to know that any complaints will be taken seriously and responded to. People living at the home would be safe guarded by the homes safe guarding adults procedures if all staff had received up to date training. Evidence: The AQAA for the home said:The ladies and gentlemen at Wyatt House are provided with a clear and effective complaints procedure, these are presented in a user friendly format. The ladies and gentlemen have one to one key worker meetings have been implemented to talk with staff through their preferred communication system, to raise any concerns that they may have. Three of those living here have close family networks, who maintain regular contact with them. They are encouraged to raise any concerns or issues on the individuals behalf. All staff have attended safeguarding adult training All staff within the home is CRB and POVA checked before commencing employment. All staff undertakes a full Caretech induction. The manager has undergone DOLS training through local PCT, and all staff will be attending similar training. A requirement was made following the last visit to the home regarding training in safeguarding adults. We noted that not all staff have received this training. Action outside of this report will be considered. Since our visit the manager has written to us stating that the staff who had not received training now have. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: We saw that the home has a copy of the West Sussex Multi disciplinary safeguarding adult policy and procedures in place. We saw that the home has had three complaints and that these were resolved using the homes procedure. There are fifteen staff employed at the home. We saw from information on training that there are two training days offered for protection of adults one called safeguarding adults the other adult protection. We saw that nine staff had undertaken the first and twelve the second one. We established with the manager that not all staff had undertaken training in the protection of adults and that one member of staff who is new to the home has not undertaken any training since they started two months prior to our visit. There is a system in place to manage individual monies for people who are not able to do this. These include individual records that detail income, expenditure and balances. Caretech is appointee for one individual whose care records we saw. They receive a monthly cheque. The manager requests money each month for the individual. Only the home manager and deputy can cash cheques and this was seen to be recorded in the accounts book. There is what is called float money which is kept in a wallet in a locked cash box which is used for items under a hundred pounds. We saw from the homes policy that the balance is to be checked at the beginning of the day shift and at the end as night staff come in. We sampled two records and saw that this was not the case. We showed this to the manager and area manager. Care Homes for Adults (18-65 years) Page 19 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In the main the physical design and layout of the home enables residents to live in a safe and comfortable environment. Evidence: The AQAA for the home said:Wyatt House has identified the need to improve existing facilities within the home to provide those living here with more living space and a safe workable kitchen area and conservatory. An external structure has been identified to develop an activity and sensory area. All individual bedrooms are being refurbished and personalised in colour schemes of their choice and with items that they have chosen. A maintenance audit is completed monthly on a monthly basis. The manager showed us the areas that are due to be altered and refurbished soon. This will enable an area to be provided for one individual with staff support away from the other people living at the home. This move it is felt will enhance the quality for all living at the home. We looked around some of the home and we were able to see communal areas such as the dining room, lounge, bedrooms and bathrooms. The garden is accessible with wheelchairs. People who live at the home are encouraged to furnish the room with personal belongings such as furniture and pictures. The home was seen to be very clean throughout, with no malodour. When we walked about the home we saw that rooms are centrally heated, all radiators and pipe work are Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: covered. Windows are fitted with restrictors where necessary and emergency lighting is provided throughout the home. The household equipment is domestic in scale and in keeping with the decoration. The decoration is contemporary and the furniture modern. All areas of the house are accessible to all service users via level access. The home has a large accessible garden with paved areas. We saw from the training files that ten staff have received training in infection control and hand washing facilities were seen to be available in all the key areas. There are clinical waste facilities and soiled waste away from the kitchen and dining area and food storage areas. The laundry floor and wall surfaces are impermeable and a sluice facility is available on the washing machine. Soiled laundry is washed at the appropriate temperatures. Care Homes for Adults (18-65 years) Page 21 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Monitoring systems do not ensure that the staff have all received training to meet the needs of the people using the service are all trained to care for residents. In the main recruitment practices offer safeguards to people at the home. Evidence: The AQAA for the home told us:The staff at Wyatt House are respectful and supportive to the ladies and gentlemen. The staff are motivated to promoting new and alternative ways of working and improving the service that we provide; enabling the individuals chosen life style. Staff are encouraged to speak up when they have concerns. We hold monthly team meetings where staff is encouraged to participate to discuss any current issue. The staff team understand individual persons needs, like and dislike. Through the implementation of My Plan, staff provide the ladies and gentlemen with consistent approaches The staff team are of mixed gender and age, which provides those living here with diverse range of characters to suit individual needs. Caretech have a robust recruitment and selection process, with a regional recruitment manager who works closely with the manager to ensure recruitment is completed successfully to the service needs. All staff have monthly supervisions to continually monitor their performance, achievements, attitudes and progress. Staff training is ongoing and the training matrix is updated to reflect this. Three staff have applied for NVQ training. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: A requirement was made following the last visit to the home regarding training for safeguarding adults we noted that not all staff have received this training and when looking at the information given by the manager on staff training we could see that there were other areas where staff have not all received training. For example manual handling, food hygiene, epilepsy, infection control, health and safety. We looked at three staff file for people who had started at the home since our last visit. We saw that all checks had been carried out. Caretech hold all information centrally and send a proforma to the service with the information regarding recruitment checks such as dates of receiving them and CRB numbers. The home uses regular agency staff to support the homes staff in meeting the needs of individuals who use the service. The manager explained that they request the same staff from the agency and some of these have been working at the home for over a year. We saw that staff have received regular supervision. We saw that all the staff except one has had Caretech in house training in non violent crisis intervention. West Sussex social services and health have indicated to the home that they prefer staff to have SCIP training. The home has managed to secure two places so far for this training. Care Homes for Adults (18-65 years) Page 23 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The systems and procedures monitor and maintain the quality of the service provided and which, promote the safety and welfare of those living and working in the home. The exception to this is training. Evidence: The AQAA told us that:The manager is registered to undertake NVQ4 and LMA training. The management approach is to provide an open, positive and inclusive atmosphere, which ensures service users benefit from a well run home. The home undergoes regulation 26 visits on a monthly basis which highlights any area that may require attention. Policies and procedures are in place to guide and facilitate staff within their job role. Support is offered throughout the team to ensure that the service is running effectively. All staff attend mandatory training We listen to the ladies and gentlemen and their families; and the choices they make regarding the home, activities, trips out etc. These are respected and staff will support individuals with the choices they make. The registered manager Louisa Milne is due to start her registered managers award in Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: January. The area manager also came to the home to support the staff during our visit. Everyone at the home assisted by providing written documentation and answering questions relating to the inspection process. We were able to speak to the manager and area manager regarding training. They told us that Caretech provides training regularly every two months. However this may mean that staff who commence work in between these periods have to wait and may not have essential training till some time into their employment. The manager showed us that she is starting to source training externally to the company. We saw that the certificate related to the homes registration was displayed in the hallway and has the details of the core registration for the home. The registered provider for the home is Caretech. We noted that there are regulation 26 visits undertaken and a record is kept of these visits. We saw that the manager has undertaken staff meetings about the running of the home but also about the changes that are taking place with the building. It was not clear how the people who use the service are involved or their nominated person or advocate in decision making about the service. We saw the policies available to staff and that when these are altered or amended the staff sign to say that they have read them. We looked at the records for fire safety training and monitoring of equipment. The records were divided in to old building and new building and it was not clear whether the fire alarm system had been tested regularly. The manager explained that they had alternated between the two buildings then had set the alarms off daily for a while to train new staff. We discussed this with the manager and area manager and they are to write a policy on testing the fire system. We saw that fire equipment was checked seven times in ten months. Emergency lighting was checked monthly from July 2009. We saw that fire training is carried out yearly by an external trainer and the staff receive a refresher every three or six months. The records of whether staff have received training regularly were not clear. We saw that West Sussex Fire Authority had been to the home in November 2009 and had made recommendations about outside lighting being available in the event of an evacuation in the dark. They will return to the home once the refurbishment has been completed. Care Homes for Adults (18-65 years) Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 23 13(6) All staff must know how to identify all forms of abuse and know the procedure for reporting any instances of abusive practices, to ensure vulnerable residents are adequately protected. 16/04/2009 Care Homes for Adults (18-65 years) Page 26 of 29 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 1 42 23 23 (d)(e) The registered person must ensure that the staff receive training in fire safety on a regular basis and that records reflect this training. To ensure the safety of people living and working at the home. 22/01/2010 2 42 23 23 (c) The registered person must ensure that the fire safety equipment is tested on a regular basis and that records reflect this testing. To ensure the safety of people living and working at the home. 22/01/2010 3 42 13 13 (4)(5)(6) The registered person must ensure that all staff receive all mandatory training and training that is necessary to meet specific needs to ensure that the people who 07/03/2010 Care Homes for Adults (18-65 years) Page 27 of 29 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 use the service have their needs met. To ensure that all needs of all individuals are met safely. 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 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!