The Wheelhouse

The Wheelhouse is a residential care home providing personal care for up to four people with learning disabilities and autism spectrum disorder. At the time of the inspection, three people were living at the service.

The Wheelhouse is a four-bedroom house, situated over two floors. There was a homely atmosphere with several communal spaces for people to relax in. This included a large garden and cabin, where people liked to listen to music. People’s bedrooms were spacious and decorated to their individual preferences.

The service has been developed and designed 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 this service and what we found

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People were safe. Staff knew people and risks to their wellbeing. This meant they understood actions to be taken to minimise risks and support people to feel calm and happy in their home. There were robust risk assessments for people and the building, to ensure the environment was safe to live in. People received their medicines safely from staff who were trained and competent. When incidents occurred, the registered manager and staff worked together to identify lessons learned and act to ensure incidents did not reoccur.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff had the skills and knowledge to meet people’s needs. They had received specialised training in positive behaviour support, autism and epilepsy to understand people and their support needs. Staff also had a thorough induction and regular supervision to support them in their roles. People had regular input from a variety of health and social care professionals to promote their wellbeing. Their nutritional needs were met. The building had been adapted to ensure that people’s preferences and support needs could always be met.

People appeared relaxed and happy around staff they knew well. We observed people interacting with staff by smiling and holding their hands. Staff told us they had mutual respect for people and genuinely enjoyed working at The Wheel House. One staff member said, “It’s all about people. We’re here for them. That’s what it’s all about.” A relative spoke highly about staff. They said, “Meeting the staff at The Wheel house was absolutely amazing. The show of love around them is very infectious and it was a blessing to see and witness it.” A professional was also complimentary, telling us, “I always find the staff very kind & caring at The Wheelhouse and very supportive to people’s needs.”

People were supported to be involved with activities that they were interested in. This included holidays, trips to the zoo and London, as well as horse-riding and swimming. No complaints had been received since the previous inspection, however there was a clear complaints process that was regularly reviewed with people, relatives and staff. Staff knew people’s communication needs well and recognised signs that they were happy or unhappy. Although no one was receiving end of life support at the time of inspection, staff continued to explore people’s preferences and choices regarding this.

Everyone we spoke to was complimentary about the registered manager and deputy manager and felt the service was well-led. Staff felt involved in a supportive, team working culture, where they were encouraged to share any concerns and ideas. Feedback was continually sought from people, staff, relatives and professionals to improve the service. The management team were supported by company quality assurance teams to ensure they were up to date with current legislation and guidance.

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 30 November 2016).

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.

The Wheelhouse provides accommodation and personal care for a maximum of four adults with learning disabilities and autistic spectrum disorders. At this inspection four people were living there.

A registered manager was in post and was present throughout this inspection. 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.

People were safe as staff had been trained and understood how to support people in a way that protected them from danger, harm and abuse. People had individual assessments of risk associated with their care and support. Staff members had access to people’s risk assessments and were aware of how to protect people from harm.

The provider followed safe recruitment practices with staff before they started work to ensure they were safe to work with people. People received help with their medicines from staff who were trained to safely administer these. People had their medicine when they needed it.

People received care and support from staff that had the skills and knowledge to meet their needs. Staff members attended training that was relevant to the people they supported. Staff received support and guidance from a management team who they found approachable.

People had their rights upheld by staff members who knew the appropriate legislation which directed their roles.

People were involved in decisions about their care and had information they needed in a way they understood. When people could not make decisions for themselves staff understood the steps they needed to follow to ensure people’s rights were upheld.

People had access to healthcare when needed and staff responded to any changes in their need promptly and consistently. People were supported to maintain a healthy diet and regular exercise which promoted well-being.

People’s likes and dislikes were known by staff who supported them in a way which was personal to them. People had positive relationships with the staff members who supported them. People had their privacy and dignity respected and information personal to them was treated with confidence.

People and staff members felt able to express their views and felt their opinions mattered. The provider and registered manager undertook regular quality checks in order to drive improvements. The provider engaged people and their families and encouraged feedback.

Our inspection team was made up of one adult social care inspector. We answered our question; Is the service safe? Below is a summary of what we have found. The summary is based on our observations during the inspection. Four people were resident in the service at the time of our inspection. We undertook a tour of the home, looked at staff records and records relating to the management of the service. We spoke individually with the manager.

We found that the home had made the improvements they told us they would. This included a total refurbishment of the laundry facilities and replacement of all floors throughout the home. The upgrading of the environment in this way meant that the home could now be appropriately cleaned and thus reduce the risk of the spread of infection. We also saw evidence that through the process of on-going auditing and training, the home had ensured that staff had a better understanding of infection control.

Below is a summary of what we found. The summary describes what people who used the service and the staff told us, what we observed and the records we looked at. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found the home to be clean and tidy at the time of our visit. Some outstanding maintenance work however meant that some areas of the home could not be appropriately cleaned so as to reduce the risk of infection. In particular the laundry room required re-tiling and a number of floor coverings throughout the home were damaged and needed to be replaced. Staff had received training in infection control and used personal protective equipment, such as gloves and aprons to ensure that they protected themselves and others.

Staffing levels were sufficient to meet the needs of the people who lived at The Wheelhouse. We were told that two people required 1-1 staffing throughout the day and saw that this was always provided. Staff demonstrated a good understanding of the needs of the people who lived at the home. We saw that people were appropriately supported throughout the inspection.

We found evidence that the home had taken steps to ensure that it was compliant with the Mental Capacity Act and Deprivation of Liberty Safeguards. Through staff training and ongoing care plan reviews we found that the home had taken appropriate action which ensured that people received support that protected their legal rights and balanced safety with choice.

Is the service effective?

We saw that people had good relationships with the staff who supported them and we observed positive relationships between them. We found that the home had good systems in place to ensure that people were appropriately consulted and informed about their care. Where people were required to make more complex decisions about issues such as treatment, the home had appropriate systems in place to gain valid consent.

Is the service caring?

We observed that people received sensitive and discreet care. We saw that people's choices were respected and that staff involved them in their care. We found that people had comprehensive care plans which provided detailed guidance about how they should be supported. This meant that the provider had taken steps to ensure people received the care they needed in a way that made them feel comfortable.

Is the service responsive?

People's needs were continually assessed. Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and support had been provided in accordance with people's wishes. Staff had a good understanding of people's needs and demonstrated that they recognised and responded when these changed.

Is the service well-led?

The provider had good systems in place to monitor and improve the services provided. The registered manager had a good knowledge and oversight of the running of the home. The provider had various systems in place to ensure it regularly monitored and audited the quality of service provided at The Wheelhouse.

We observed positive two-way interaction between staff and people living at the home. We saw from care plans and the use of various aids to communication such as pictures and objects of reference that every effort was made to involve people in developing and implementing their own care plans.

We examined all the care plans for the four people living at the home and found that they were inclusive, person-centred, relevant and regularly reviewed to ensure the welfare and safety of people.

Staff we spoke with understood what constituted abuse and were familiar with the proper procedures to follow in relation to safeguarding people. All had received recent training and relevant contact numbers were readily available.

We examined four staff files which showed that people were only allowed to work with people at the home once proper checks and induction training had been completed.

There were appropriate storage, recording and administration procedures in place at the home in relation to medication to ensure that people were kept safe.

The home had clearly displayed information about their complaints procedure. This was also displayed in pictorial format to support people living at the home.

We spoke with two care staff in addition to the manager. They told us they felt well supported and were provided with the necessary training and knowledge to fulfil their roles. Staff expressed satisfaction with the positive work the home was undertaking with the people living there. We observed interactions between staff and the people they cared for, and saw that these were conducted in a sensitive and professional manner.

We reviewed relevant supporting documentation for staff and the people living in the home. We found that people in the home had opportunities to express their views about aspects of their care and the day to day operation of the home. All records viewed were well ordered, accessible, updated and securely stored