Whiston House

Updated 13 November 2019

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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type:

Whiston House is a 'care home' for people living with autism and learning disabilities. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. 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. The registered manager was supported by a deputy manager.

This inspection was unannounced.

Inspection activity started on 27 September 2019 and ended on 27 September 2019.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included information received from the provider about deprivation of liberty applications and their outcomes and other events which they are required to send to us by law. We used information the provider sent to us in the Provider Information Return. This is information we require providers to send us at least once a year to give some key information about the service, what the service does well and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

During our inspection visit we spoke with four people. Some people living at the service, due to their complex care needs and disabilities were unable to give us their feedback. We spent time with people to see how staff supported them. We also spoke with three care staff, a senior carer, the deputy and the registered manager.

We reviewed a range of records. This included three people's care records and medicine records, training and supervision records and records relating to the quality monitoring and management of the service.

After the inspection

We spoke with two relatives by telephone.

Updated 13 November 2019

About the service

Whiston House is a 'care home' and is registered to provide accommodation and personal care for a maximum of fifteen people. At the time of the inspection 11 people were living at the service, including one person who was in hospital. The service was divided into two areas. The top part of the service was called ‘The Willows’ which was more suitable for people who were more physically able; the bottom part of the service was called ‘The Oaks’ which was suitable for people with mobility issues.

Within both areas of the service people had access to a communal lounge, dining room, kitchen, shared bathrooms, and laundry room. Each person's bedroom had its own ensuite facilities. There was a large garden which people could access when they wished.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 15 people. Eleven people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design. The service was split into two separate smaller units and fitted into the residential area where there were other large domestic homes.

The service had not 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. Most people using the service received planned and co-ordinated person-centred support that was appropriate and inclusive for them. However, a few people needed to be involved in more meaningful activities to prevent the risk of social isolation and to support them to lead more fulfilling and active lives. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

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

People received care and support that was personalised to their individual needs. Most people participated in a range of activities that met their individual choices and preferences. This were recorded in their daily records and their goals and aspirations had been identified monthly. However, a few people’s records showed that they participated in very few meaningful activities. Goals and aspirations had not been identified for them. There was no information on what support and encouragement some people had received to lead a more fulfilling, meaningful and active life.

People indicated and said they felt safe living at Whiston House. Risks to people's health, safety and well-being were assessed, and action was taken to remove or reduce the risks. Some of the risk assessments were not individualised and contained generic information. This had been identified as a shortfall and the registered manager was taking action. Staff were clear and knowledgeable on how to keep risks to individual people to a minimum.

People were safe and protected from avoidable harm because staff knew how to identify and report any concerns relating to the risk of abuse. People received safe care and support as the staff team had been trained to recognise signs of abuse or risk and understood what to do to support people safely.

People received support with their medicines by staff who had received training and who had been assessed as competent. There were systems in place to respond to any medicine errors and regular checks were completed to ensure that people were receiving the right medicine at the right time.

Staff members followed effective infection prevention and control procedures. The service was clean and fresh. The provider had arrangements in place for the maintenance and upkeep of the building.

The provider took appropriate actions following any incidents and learning was shared with staff to prevent re-occurrence.

The provider followed safe recruitment practices when employing new staff members. Staff received the training they needed to undertake their roles effectively and safely. New staff completed an induction training programme. Staff received regular supervision and felt well supported by the registered manager and deputy manager.

People received help and support from a kind and compassionate staff team with whom they had developed positive relationships. People were supported by staff members who were aware of their individual protected characteristics like age and gender and disability and these were respected.

People's needs were assessed prior to them using the service. People were supported to have choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems supported this practice.

Staff knew people well and quickly identified when people’s needs changed. When people were unwell or needed extra support, they were referred to health care professionals and other external agencies. Staff supported people with their nutritional needs to help maintain their health and wellbeing.

People were supported to maintain a healthy diet and had choice regarding the food and drinks they consumed.

People were provided with information in a way they could understand. The provider had systems in place to encourage and respond to any complaints or compliments from people or those close to them.

The provider understood the requirements of their registration with the Care Quality Commission and was meeting the legal requirements. The provider had effective systems to monitor the quality of the service they provided and to drive improvements where needed. The registered manager had good links with the local community which people benefited from.

Staff knew their roles and were able to tell us about the values and the vision of the service. The registered manager and senior management team carried out regular audits to check the quality of the service. The registered manager provided leadership and considered the views of people, their relatives and staff about the quality of care provided. The registered manager and staff used the feedback to make improvements to the service.

Rating at last inspection:

At the last inspection the service was rated Good. (Published 31 January 2017)

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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