Background to this inspection
Updated
10 January 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This announced inspection took place on 17 December 2017. The inspection was announced in advance as this allowed the manager to prepare the people they supported at Wheal Gerry to know that an inspector would be visiting their home. With this knowledge they were then prepared and were able to choose if they wished to partake in the inspection process. The inspection was conducted by one adult social care inspector.
We reviewed the Provider Information Record (PIR) before the inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and the improvements they plan to make. We also reviewed other information we held about the service and notifications we had received. A notification is information about important events which the service is required to send us by law.
During the inspection we spoke with one person living at the service, the manager, operational managing and two care staff. We looked around the premises and observed care practices on the day of our visit.
We looked at two records relating to people’s individual care. We also looked at staff recruitment files, staff duty rotas, staff training records and records relating to the running of the service. We saw feedback from a health and social care professionals about their experience of working with the service. After the inspection we spoke with two relatives.
Updated
10 January 2018
We carried out this announced inspection on 17 December 2017. The inspection was announced as this allowed the registered manager to prepare the people they supported at Wheal Gerry to know that an inspector would be visiting their home. With this knowledge they were then prepared and were able to choose if they wished to be involved in the inspection process. At the last inspection, in November 2015, the service was rated Good. At this inspection we found the service remained Good.
Wheal Gerry has three houses in close proximity of each other. Each house accommodates one person with staff support at all times. At the time of the inspection two people were living in two of the houses. A third person was in the process of moving to Wheal Gerry and was involved in the furnishing of their new home. Wheal Gerry is part of Green Light PBS Limited, an organisation providing support and care for people with autism living in Cornwall.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
A new manager was appointed in September 2017 and had submitted their application to us to be the registered manager for the service. 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.
We met with one person who used the service as one person was not able to meet with us. There was a calm, relaxed and friendly atmosphere in the service. We observed that staff interacted with the person in a caring and compassionate manner. The person said they were happy with the care they received. Comments from their relatives included, “This is the most settled [Person’s name] has been. He is very happy there.” Another relative said “I have faith in the staff. I know [person’s name] is cared for by staff that really care.”
Care and support was provided by a consistent staff team, who knew people well and understood their needs. Care documentation informed staff of the person’s background and how they would like to receive support. It identified the person’s communication needs and this was shared with other agencies when necessary. For example sequence strips and easy read information were used to support effective communication.
Care records were up to date, regularly reviewed and accurately reflected people’s care and support needs. People, who received care, or their advocates, were involved in decisions about their support and consented to the care provided. Risk assessment procedures were designed to enable people to take risks while providing appropriate protection. Relatives’ commented that “Communication is so much better than anywhere else [person’s name] has been before.”
Transition work that staff undertook with people who were coming to live at Wheal Gerry was individualised. The manager had met with the person, family members and other health and social care professionals to discuss how the person would best be supported with the transition from their current placement to Wheal Gerry The person was also encouraged to take part in decorating their accommodation, choosing colours, furnishings and to bring personal items so that it could be decorated in line with their preferences and wishes.
Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. There were sufficient numbers of suitably qualified staff on duty. Staffing levels were adjusted to meet people’s changing needs and wishes. With the planned admission of another person to the service the manager told us staffing levels would be increased to ensure they would be able to meet this person’s needs.
Staff were supported through a system of induction, training, supervision and staff meetings. This meant they developed the necessary skills to carry out their roles. Staff knew how to recognise and report the signs of abuse. There were opportunities for staff to raise any concerns or ideas about how the service could be developed.
People were supported to maintain good health, have access to healthcare services and receive on-going healthcare support. Staff supported people to arrange and attend appointments to see their GP and other necessary healthcare appointments.
People were supported to eat and drink enough and maintain a balanced diet and were involved in meal planning. Guidance from dieticians regarding specific health conditions were gained and acted upon to ensure the person received the appropriate diet for them.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. A person had requested restrictions were put in place around accessing food. This was discussed with all relevant parties and an agreement in how this would be managed was agreed by all.
Staff ensured people kept in touch with family and friends. Relatives told us they were always made welcome and were able to visit at any time. People were supported to access the local community and take part in a range of activities of their choice. Staff supported people individually and in groups to attend activities of their choosing.
The environment was clean, well maintained. The person’s own house was personalised to reflect people’s individual tastes.
People and their families were given information about how to complain. The manager was visible in the service, regularly working alongside staff to provide care and support for people. There was a positive culture within the staff team and staff said they were supported by the manager.
There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed. People and their families were involved in the running of the service and were regularly asked for their views through on-going conversations with staff and surveys.
Further information is in the detailed findings below