We carried out a review of the data available to us about Wheatsheaf House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Wheatsheaf House, you can give feedback on this service.
We found the following examples of good practice.
In line with current guidance two visitors could be nominated by their family member/friend who lived at the home, and visit by appointment. The visitor completed a rapid COVID-19 test, had their temperature checked and declared their health status re COVID-19. There were gaps between visits to reduce the risk of people encountering other visitors, staff or other people from the home. Visitors would also be required to wear the supplied PPE (personal protective equipment).
Staff supported people to use computer tablets and phones to video call and/or speak to family and friends. This promoted people’s social welfare, particularly when people’s day centres were closed due to COVID-19. Musical groups continued via video calling supporting people’s well-being and kept people in contact with friends who had a shared interest.
End of life visits were organised with a family member/friend accessing their relatives’/friends room. PPE would be worn by the visitor.
People had their temperature checked twice a day to monitor their health. Staff had their temperature checked when they started their shift or twice if working a long shift.
Staff were observed to be wearing their PPE correctly including face masks. Staff did not appear to be fiddling with their face masks when worn. Staff were bare below the elbow and were wearing a minimum amount of jewellery with long hair tied up that promoted good infection control.
Wheatsheaf House is a residential care home registered to provide personal care to eight people who have a learning disability. Accommodation is provided in one house with six bedrooms and two self-contained flats in the grounds. Six people were living at the service on the day of our inspection.
The service has been developed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using the service and what we found
People continued to feel safe living at the service. Risk assessments had been completed to ensure that action was taken to keep people safe. Staffing levels were appropriate to meet people’s needs in a timely manner. People received their medication as prescribed. There were systems in place to record, monitor and learn from accidents and incidents.
Staff had the knowledge, skills and support they required to meet people’s needs effectively. People’s physical, emotional and social needs were identified so staff could meet these. People received support with eating and drinking when needed. People were supported to maintain good health and were supported by or referred to the relevant healthcare professionals. People consented to their care or, when appropriate, best interest decisions were taken on their behalf.
People's needs and wishes were met by staff who knew them well and what made them happy. We saw and were told of many examples of staff going 'above and beyond' to help and support people they cared for. People’s privacy and dignity was protected and promoted.
People, relatives and staff told us the service had strong leadership and an open and supportive culture. The service identified areas for improvement so that people received a good service.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 09 March 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
This inspection was undertaken by one inspector on 9 March 2017. At the last inspection on 9 December 2014 the service was rated as ‘Good’. At this inspection we found the service remained ‘Good’.
A registered manager was in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. However, the registered manager was on maternity leave at the time of this inspection. The deputy manager was providing day to day management of the service and a registered manager from one of the organisation's services was also providing management support during the week.
Systems were in place to manage risks to people using the service and to keep them safe. This included safeguarding, eating and drinking, mobility needs and accessing the community.
There was sufficient numbers of staff on duty to safely assist and support people. The recruitment and selection procedure ensured that only suitable staff were recruited.to work with people using the service.
The registered manager and staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported to have choice and control over their lives as much as possible. Staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice.
People’s needs were assessed, so that their care was planned and delivered in a consistent way. The management staff and care staff talked knowledgeably and enthusiastically about the people they supported and knew their care needs well. Staff offered people choices, for example, how they spent their day and what they wanted to eat. These choices were respected.
People experienced a good quality of life because staff received training that gave them the right skills and knowledge to meet their needs. People were supported and assisted with their daily routines, shopping and accessing places of interest in the community.
People received appropriate support to maintain a healthy diet and be able to choose and help prepare their meals. People had access to a range of health care professionals, when they needed them.
Staff were clear about the values of the service in relation to providing people with compassionate care in a dignified and respectful manner. Staff knew what was expected of them and we observed staff putting these values into practice during our inspection.
The provider had a range of systems in place to assess, monitor and improve the service. People had been consulted about how they wished their care to be delivered and their choices had been respected. People, their relatives and staff were asked for their feedback about the quality of the service provided. Feedback was used to recognise good practice and to drive improvements where shortfalls were identified.
Further information is in the detailed findings below.
This unannounced inspection was carried out on 09 December 2014. The last inspection took place on 14 October 2013, during which we found the regulations were being met.
Wheatsheaf House is registered to provide accommodation and personal care for up to eight people who have a learning disability. Nursing care is not provided. There were six people living in the home when we visited.
At the time of our inspection a registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. We found that people’s rights were being protected as DoLS applications were in progress where required and had been submitted to the relevant local authorities.
We saw that people who lived in the home were assisted by staff in a way that supported their safety and that they were treated respectfully. People had health care and support plans in place to ensure that staff were aware of their care needs. These plans recorded for staff people’s individual choices, their likes and dislikes and any assistance they required. Risks to people who lived in the home were identified, and plans were put into place by staff to minimise these risks and enable people to live as safely and independently as possible.
Staff cared for people in a warm and sensitive way. Staff were assisting people with personal care, cooking and domestic tasks throughout our visit to the home.
Members of staff were trained to provide effective and safe care which met people’s individual needs and wishes. Staff understood their roles and responsibilities and were supported by the manager to maintain and develop their skills and knowledge through regular supervision, appraisals and ongoing training.
People felt able to raise any suggestions or concerns they might have with the registered manager. People felt listened to and reported that communications with the registered manager and members of staff was very good.
Arrangements were in place to ensure that the quality of the service provided for people was regularly monitored. People who lived in the home and their relatives were encouraged to share their views and feedback about the quality of the care and support provided.
We found that care records were current and reflected the needs of people who lived in the home.
Safeguarding policies to protect vulnerable adults were in place and staff had undertaken safeguarding training.
There were systems in place to check that people were satisfied with the care and support they received and regular audits undertaken to monitor the quality of the services provided.
There was an effective system in place to deal with any complaints or concerns people who lived in the home or their relatives might raise.
Overall we found that the provider had taken sufficient action to address the shortfalls identified at our previous inspection in relation to the premises of the home and to staff training.
The health and social care professionals who we spoke with told us they would recommend the home as a place to live. One stated, 'People get good support and staff are very caring'. One care manager from the local learning disability partnership reported, 'Everything seems to run along nicely there. They keep in close contact with us and ring us if there's ever a problem to discuss it; I have no concerns about the service.'
We found the provider was compliant in four of the six outcomes we assessed. Although people received good care from staff who knew them well, improvements were required in relation to the maintenance and cleanliness of the premises, and in relation to staff training.