Wendover House

Updated 30 June 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector on site over two days and an Expert by Experience who carried out telephone calls to relatives, after the site visit.

An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Heathcotes Wendover House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This service is also registered for the regulated activity personal care to enable them to support people living in a 'supported living' setting, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living. At the time of this inspection the regulated activity personal care was not being provided and therefore not reviewed.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke informally with one person who used the service. We spoke with five staff which included the registered manager, a team leader and three support workers. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed the environment and a range of records. This included three people's care records and six medicine records. We looked at four staff files in relation to recruitment and six other staff files in relation to training and supervision. We reviewed a sample of health and safety records, fire records, in house audits and team meeting minutes.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, rotas, provider audits and policies and procedures. We spoke with five relatives to get their view of the service.

Updated 30 June 2022

About the service

Heathcotes Wendover House is a residential care home providing accommodation and personal care to people with a learning disability. The service can support seven people and at the time of the inspection six people were being supported.

Heathcotes Wendover House accommodates people in one adapted building. All of the bedrooms have ensuite facilities and people share a bathroom, lounge and kitchen/diner. There is a small separate sitting room which has been converted into a sensory area.

The service is also registered for the regulated activity personal care to enable them to support people in a two bedroomed supported living service, next door to the care home. At the time of the inspection the regulated activity personal care was not provided. Therefore, only the regulated activity Accommodation for persons who require nursing or personal care was looked at as part of this inspection.

People’s experience of using this service and what we found

Most relatives felt their family member was safe and happy living at the service. They commented “[family members name] is happy and most importantly not ill-treated, they are free to do what they want, independent, and can choose to say no if they do not want to do something,” and “ [Family members name] enjoys living there and all is good.”

Some relatives still felt there was a lack of continuity of staff and that activities, communication, meals and management of laundry could be improved. Those areas were being addressed by the provider.

Risks to people were identified and mitigated. Staff were aware of people’s risks and how best to support them. Risks around fluid monitoring and the environment needed further consideration. Action was taken to mitigate those findings.

Staff were suitably recruited, although recruitment files did not contain photos or risk assessments regarding the decision to employ a staff member, where this was required. The registered manager confirmed this would be addressed.

Auditing and monitoring of the service was taking place which enabled the provider to identify shortfalls in the service provided. Improvements had been made to records, with further improvements identified and being implemented.

Sufficient staff were provided with the service actively recruiting into vacancies which had reduced agency use. Staff felt better trained and supported in their roles with gaps in training and supervision identified through the providers auditing. This was being addressed.

Systems were in place to safeguard people from abuse and staff were proactive in recognising and reporting potential safeguarding incidents. Accident and incidents were recorded and showed debrief of incidents to prevent reoccurrence.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support: Model of care and setting maximises people’s choice, control and Independence. People were encouraged to make choices and the service was working to promote their independence.

Right care: Care is person-centred and promotes people’s dignity, privacy and human rights. The service was working to further develop person centred care. A dignity workshop had taken place and the provider continued to address practices where people’s privacy and dignity was not upheld.

Right culture: Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. The provider was proactive in addressing the culture within the service with staff roles defined, further training provided, rota better managed to meet the needs of people within the service and action taken where staff attitudes and behaviours did not promote the right culture.

The registered manager had been proactive in improving the service and had a clear focus on what they wanted to achieve to further promote person centred care, sustain improvements and continue to develop the service. A relative commented “[registered managers name] is really trying to bring stability and change to the service, which is positive.”

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 8 December 2021) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since November 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced focused inspection of this service on 20, 21 September and 6 October 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, safeguarding, staffing, recruitment practices, good governance and informing us of incidences without delay.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements and warning notices. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Heathcotes Wendover House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.