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East Wheal Rose Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. East Wheal Rose St Newlyn East, Newquay, TR8 5JD Tel: 01872510750 Date of Inspection: 22 January 2014 Date of Publication: February 2014 We inspected the following standards as part of a routine inspection. This is what we found: Respecting and involving people who use Met this standard services Consent to care and treatment Met this standard Care and welfare of people who use services Met this standard Meeting nutritional needs Met this standard Safeguarding people who use services from Met this standard abuse Safety and suitability of premises Met this standard | Inspection Report | East Wheal Rose | February 2014 www.cqc.org.uk 1 Details about this location Registered Provider Spectrum (Devon and Cornwall Autistic Community Trust) Registered Manager Miss Stacey Lee Overview of the East Wheal Rose is a care home for three people on the service autistic spectrum. Nursing care is not provided. Type of service Care home service without nursing Regulated activity Accommodation for persons who require nursing or personal care | Inspection Report | East Wheal Rose | February 2014 www.cqc.org.uk 2 Contents When you read this report, you may find it useful to read the sections towards the back called 'About CQC inspections' and 'How we define our judgements'. Page Summary of this inspection: Why we carried out this inspection 4 How we carried out this inspection 4 What people told us and what we found 4 More information about the provider 4 Our judgements for each standard inspected: Respecting and involving people who use services 6 Consent to care and treatment 8 Care and welfare of people who use services 9 Meeting nutritional needs 11 Safeguarding people who use services from abuse 12 Safety and suitability of premises 13 About CQC Inspections 15 How we define our judgements 16 Glossary of terms we use in this report 18 Contact us 20 | Inspection Report | East Wheal Rose | February 2014 www.cqc.org.uk 3 Summary of this inspection Why we carried out this inspection This was a routine inspection to check that essential standards of quality and safety referred to on the front page were being met. We sometimes describe this as a scheduled inspection. This was an unannounced inspection. How we carried out this inspection We looked at the personal care or treatment records of people who use the service, carried out a visit on 22 January 2014, observed how people were being cared for and talked with carers and / or family members. We talked with staff and reviewed information given to us by the provider. What people told us and what we found We did not speak directly with the two people who lived at East Wheal Rose due to their complex communication needs. We spoke with the divisional manager, the registered manager and two members of staff. Following the inspection we contacted professionals who had worked alongside staff at East Wheal Rose to ask their opinion of the service. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements. We examined people's care files and found the records were up to date and reviewed as the person's needs/wishes changed. People were protected from the risks of inadequate nutrition and dehydration. People were safeguarded from the risk of abuse because the provider had taken steps to identify the possibility of abuse and prevent it from happening. Premises were adequate although one bathroom required updating. You can see our judgements on the front page of this report. More information about the provider Please see our website www.cqc.org.uk for more information, including our most recent judgements against the essential standards. You can contact us using the telephone number on the back of the report if you have additional questions. There is a glossary at the back of this report which has definitions for words and phrases | Inspection Report | East Wheal Rose | February 2014 www.cqc.org.uk 4 we use in the report. | Inspection Report | East Wheal Rose | February 2014 www.cqc.org.uk 5 Our judgements for each standard inspected Respecting and involving people who use services Met this standard People should be treated with respect, involved in discussions about their care and treatment and able to influence how the service is run Our judgement The provider was meeting this standard. People's privacy, dignity and independence were respected. Reasons for our judgement We did not speak directly with the two people who lived at East Wheal Rose due to their complex communication needs. We spoke with the divisional manager, the registered manager and one member of staff. They spoke knowledgably and with affection about the people they supported. They demonstrated concern for peoples' well-being and a willingness and desire to support them in a way which did not limit or restrict them unnecessarily. We met with the registered manager who told us East Wheal Rose used a range of tools to facilitate meaningful communication with people who used the service. We saw examples of sequence strips, pictorial timetables, social stories and pictorial service user guides. Sequence strips use a small number of images to represent the order of activities in which the person will take part over a short period of time. They are intended to inform the person without overloading them with information which can cause anxiety. Staff told us one person used some Makaton when communicating. Makaton is a method of communication using signs and symbols and is often used by people with learning difficulties. We saw a book with photographs of the person signing to help staff recognise how the person had developed their own signs and what they meant. A member of staff we spoke with told us they found it useful to have a range of communication tools available. We saw an email from a speech and language therapist stating they were impressed by the consistent implementation of speech and language therapy recommendations by the staff team. This demonstrated East Wheal Rose were committed to facilitating effective communication for the people they supported. Staff and management told us they had received training in key word signing and we saw from the records this was due to be updated in April 2014. We saw evidence East Wheal Rose had worked alongside the local speech and language team to support people with their communication needs. | Inspection Report | East Wheal Rose | February 2014 www.cqc.org.uk 6 We saw East Wheal Rose had developed pictorial service user guides to help staff assess satisfaction levels with people regarding the support they received. Following the inspection we contacted a professional who had worked with staff at East Wheal Rose to support someone who lived there. They told us the staff team was committed to ensuring the person had a; "..full and meaningful community presence". | Inspection Report | East Wheal Rose | February 2014 www.cqc.org.uk 7 Consent to care and treatment Met this standard Before people are given any examination, care, treatment or support, they should be asked if they agree to it Our judgement The provider was meeting this standard. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements. Reasons for our judgement The Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (MCA & DOLS) provide a legal framework that protects people who lack the mental ability to make decisions about their life and welfare. We saw, in peoples' care plans Mental Capacity Assessments had been completed in order to assess if people had capacity to make decisions about their care. For example one person had been assessed as lacking capacity to consent to secondary dispensing of medicines. The assessment had involved a relative, GP and community nurse. Following this we saw documentation to evidence a best interest meeting had taken place where it was decided this would be in the persons' best interest. The meeting involved the same people plus a psychologist. East Wheal Rose used a range of communication tools to help staff ascertain the wishes of the people they supported. Staff we spoke with were able to describe how they could establish if people agreed to the care and support they received, both on a day to day basis, and for one off decisions. We saw from the homes training records, staff had completed training in MCA and DOLS. | Inspection Report | East Wheal Rose | February 2014 www.cqc.org.uk 8 Care and welfare of people who use services Met this standard People should get safe and appropriate care that meets their needs and supports their rights Our judgement The provider was meeting this standard. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Reasons for our judgement We looked at the care records for the people who lived at East Wheal Rose. Care plans are essential to plan and review the specific health and social care needs of a person. They are a tool used to inform and direct staff. The care records contained various documents that covered aspects of the person's health and social care needs and associated risks. The files contained information that showed health and social care professionals were consulted and involved in the person's care to ensure that needs were met. Sections were included for health, communication and dietary and medication needs amongst others. One member of staff we spoke with said; "They are updated quite a lot and are full of information".
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