We carried out a review of the data available to us about Wheatlands on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Wheatlands, you can give feedback on this service.
Wheatlands is a residential care home providing accommodation and personal care to a maximum of 53 people. The home currently uses double bedrooms for single occupancy which means they take a maximum of 46 people. At the time of the inspection, 45 people were using the service. Accommodation is provided in one adapted building consisting of two units.
People’s experience of using this service and what we found
People felt safe living at the home and with the staff who supported them. The provider’s staff recruitment procedures helped to protect people from harm. Staff had been trained and knew how and when to report any concerns about people’s well-being. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the provider's policies and procedures supported this practice. Risks to people were assessed and there were plans in place to mitigate risks. People received their medicines when they needed them from staff who were trained and competent. The provider followed best practice in relation to infection control and prevention and management of risks relating to COVID-19.
The views of people were sought and valued. There were effective systems to monitor and improve the quality of the service provided. The provider worked in partnership with other professionals to ensure good outcomes for people. Staff morale was good and staff told us they felt well supported. Staff received the supervision and support needed to carry out their role effectively. The provider was aware of legal requirements and of their responsibility to be open and honest when things go wrong.
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 19 July 2019).
Why we inspected
We received concerns in relation to the general care and welfare of people. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
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 remained good based on the findings of 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 Wheatlands 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.
We found the following examples of good practice.
• A visiting policy was in place that was complied with. Visitors were provided with a lanyard with their own personal hand sanitiser, hand washing pictorial guidance and a new pen that they could use during their visit. These were stored for 72 hours after use and sanitised.
• Upon entry to the home, a television screen continuously showed a video of guidance on infection prevention and control (IPC) policies and how to use personal protective equipment (PPE).
• The home was clean, hygienic and uncluttered. Additional cleaning time had been allocated to the housekeeping staff since the pandemic and cleaning schedules were checked daily as part of the general manager walk round to ensure compliance.
• People were encouraged to engage in an activity programme to promote their social and emotional wellbeing that had been adapted to ensure compliance with current guidance. This included virtual coffee mornings with their relatives and virtual story telling with the local school.
• People were generally supported by separate staff cohorts in each community they lived in to reduce the risk of transmission of infection. Where staff were required to work across separate communities, they underwent additional lateral flow tests and were not permitted to work with different communities on different days.
• People were required to self-isolate in line with current guidance when they tested positive for COVID-19. Where people did not comply with self-isolation due to their lack of understanding, a mental capacity assessment was undertaken and best interests decisions were made to reduce risk of transmission in the least restrictive way possible. One person lacked insight into the need to self-isolate so a sensor mat was placed across their door to alert staff should they leave their room.
• The registered manager was proactive in identifying learning and taking action to improve the service. When there was a COVID-19 outbreak at the home, the registered manager identified what had been managed well and what could be improved. This information was collated and shared with staff and actions were put in place to mitigate risk and improve the service going forward.
• Staff were well supported by the provider. Staff were able to access support with their health and wellbeing via the intranet and had access to a 24 hour careline should they need it. The provider had also arranged a question and answer session with an expert in microbiology to ease staff anxieties around COVID-19 vaccinations.
Wheatlands is a care home providing personal care for up to 53 older people, some of whom are living with dementia. At the time of the inspection, 46 people lived at the service.
People’s experience of using this service:
People told us they enjoyed living at the service and felt safe. Support was provided by a consistent team of staff who had a good understanding of people’s care and support needs. Staff were visible around the service and it was clear positive, caring relationships had been developed.
Topical medicines had not always been recorded appropriately. We have made a recommendation about the management of some medicines. Safeguarding concerns had been referred to the local authority when required. Although equipment had been serviced at regular intervals, timely action had not always been taken to address all shortfalls found. The registered manager addressed these concerns following the inspection.
People were looked after by staff who had the skills and knowledge to carry out their roles. Systems had been developed to ensure people at risk of malnutrition or dehydration were closely monitored and relevant professionals contacted for guidance and advice. Any accidents and incidents were closely monitored and recorded.
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 supported this practice. People were involved in decisions and their choices were respected. Information was not always presented in a way people could understand. We have made a recommendation about accessible information.
People had opportunities to take part in stimulating and enjoyable activities. Consideration was given to people’s specific interests and how participation could be encouraged. Staff had the time to spend one to one with people. Care plans were person-centred which ensured support was provided in a consistent way that was led by people.
Systems were in place to monitor and improve the service to ensure people received a good quality service. Some systems and records could have been developed to further drive improvement. Regular feedback on the service provided was requested from people, relatives and professionals.
People and staff spoke positively of the management team. The service was well-run by a registered manager who was passionate about ensuring people received the support they required and engaged with the community.
Rating at last inspection:
Good (report published 24 December 2016).
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Wheatlands is registered to provide accommodation with personal care to a maximum of 53 people. There were 36 people living at the home on the day of our inspection. Some people occupied double rooms which were used as single occupancy. Due to this the home was considered full when 46 people were accommodated there. People were cared for on two units, the Corris unit and the Ellis unit which predominantly provides care for people with dementia.
A registered manager was in post and was present during our 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 felt safe living at Wheatlands and felt safe when staff supported them. Staff had received training in how to protect people from any abuse, discrimination and avoidable harm. They understood the action they would need to take if these occurred. Risks to people and the environment had been identified and assessed. Staff followed the plans which were in place and helped to reduce these risks.
Relationships between people, their relatives and staff were positive, caring and respectful with plenty of smiles and laughter. Everyone was relaxed and comfortable in each other’s company. People felt they mattered and felt listened to when expressing their choices and wishes.
People were supported and spoken with in a dignified and respectful manner. Staff showed warmth and affection when caring for people. Staff respected people’s privacy and encouraged their independence whilst keeping them safe. People were given the time they needed to understand, respond and communicate with others.
People were supported to be involved in conversations and interests that meant something to them. Staff encouraged and supported people to reminisce and identify how they wanted to spend their time. Staff knew the people they supported and what was important to them. People were cared for as an individual and staff responded to changes in people’s needs to make sure these were met.
People received the care and support they wanted and felt staff respected and knew their preferences in how they wanted their care delivered. Staff understood people's care needs and how to support them effectively. They were provided with training to ensure they had the skills and knowledge to effectively meet these needs.
People were involved in making decisions and giving consent to their own care. When people could not make their own decisions their rights were protected. Where decisions were made on people’s behalf these were made in their best interests.
Staff supported people to maintain a healthy balanced diet and supported them to make their own choices about what they wanted to eat and drink. People’s routine health needs were met and referrals were made quickly when people needed other healthcare support or staff were worried about a person’s health.
The provider had introduced a new programme to enhance dementia care. This had improved and enhanced the wellbeing of people who lived at the home.
People were happy with the care and support they received and gave positive comments about the staff and management at the home.
The culture at Wheatlands was positive, warm and friendly. People were involved in what happened at the home which included the recruitment of new staff. Staff were proud to work at the home and were passionate about delivering care that responded to people’s individual needs.
During our visit, we saw positive interactions between staff and people who lived at the home and people were treated with dignity and respect. Care was provided in a calm and relaxed manner.
The number of people living in the home, and consequently the dependency levels had recently reduced. This meant that staff felt able to meet the needs of the people currently living at the home.
We confirmed therefore that there were enough qualified, skilled and experienced staff to meet people's needs. We did, however, find that previously there had been a problem with staffing levels when dependency levels were higher. The provider may wish to note that staffing levels were not always reviewed and increased to reflect people's changing needs. This meant that people were at increased risk of not receiving care that was safe and met their needs.
Everyone we spoke with told us they were satisfied with their care. Care plans were well written, clear and contained detailed information about people's individual needs. This meant staff understood how people preferred their care to be delivered.
People who used the service and their representatives were able to contribute to their reviews. People told us that they enjoyed the food and drink provided within the home. They said they were able to choose what they wanted to eat from the menu and where they preferred to eat a meal.
People were protected from the risk of infection because appropriate guidance had been followed.
There was a robust recruitment procedure in place to ensure people were protected. This meant that only people who were fit to work in health and social care were appointed.
Staffing levels on Ellis unit were not sufficient to meet the current needs of the people that lived in the unit. We discussed this with the regional operations manager who was present during our inspection. They acted promptly during our visit to increase the staffing levels.
People told us they visited the home before they moved in to make sure it was the right place for them. They told us they felt involved in the planning of their care and were able to choose what they wanted to do, for example activities, trips and their meals. People told us the staff respected their privacy and dignity.
People said they felt safe living at the home. One person commented, 'The staff treat me well'. Staff told us they had received training in keeping people safe. They demonstrated an understanding of the different forms of abuse and knew the procedure to follow if they suspected abuse.
People told us they liked that staff were kind and caring. One person said, 'The staff are lovely here.' Staff told us they had attended a range of training courses to equip them with the knowledge and skills to effectively carry out their duties.
People said they were satisfied with the service they received. We saw the provider had arrangements in place to seek the views of the people who used the services through residents' meetings and satisfaction surveys.