CQC report explained · a residential care home
What the CQC found at The Wheelhouse
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from harm, risks were assessed, staffing was considered sufficient and medicines were managed safely. Inspectors were only somewhat assured about social distancing and admitting people safely for respite care.
- Effective?
- Good
- Staff used the correct consent and best-interest procedures. People's needs were assessed, care plans were personalised, staff were trained and health professionals were involved when needed.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were supported to communicate, make choices and be as independent as possible.
- Responsive?
- Good
- Care plans reflected people's needs, preferences, communication and interests. People took part in activities, stayed connected with relatives and had their complaints handled appropriately.
- Well-led?
- Good
- Management and quality checks had improved. Staff felt supported, records and audits were used to identify improvements, and the home worked with health and social care professionals.
What inspectors found, July 2021
Rated Good; inspectors found kind, personalised care and major improvements since the previous inspection, with some infection-control points still needing attention.
Inspectors made an unannounced visit on 2 June 2021. They met most people living at the home, observed care, spoke with staff and managers, checked care and medicines records, and contacted relatives and health professionals afterwards.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were protected from harm, medicines were managed safely, staff understood people's needs, and care was personalised. People were supported to make choices, stay independent and keep in touch with family and friends.
The home had improved substantially since the previous inspection. Earlier problems with safeguarding, consent and quality monitoring had been addressed. The CQC removed a condition that had required monthly progress reports, and the home was no longer in breach of regulations.
Inspectors were only somewhat assured about social distancing and the safe admission of people coming for respite care. They discussed these points with the manager, who said they would review them.
Kind and respectful care
Staff were described as kind and compassionate. They supported people's dignity, communication and independence in everyday care.
“People were treated with dignity and respect and cared for by staff who were kind and compassionate” from the report
Personalised support
Care plans reflected people's strengths, choices, communication needs and individual goals. Staff supported people to take part in activities they enjoyed.
“Care plans were focused on people's strengths, abilities and individual goals.” from the report
Safe medicines practice
Medicines were explained to people, records were well completed and audits were used to check practice.
“The Medicine Administration Records (MAR) were well completed which meant we were assured medicines had been administered.” from the report
Improved leadership
Management systems had improved significantly since the previous inspection. Staff reported better communication, training, teamwork and morale.
“There were significant improvements in leadership and quality monitoring systems” from the report
Community links and activities
People were supported to visit local shops, cafés and restaurants, see family, and take part in activities such as sailing and gardening.
“People were part of their local community and enjoyed going to the local shop, walking and visiting local coffee shops and restaurants.” from the report
Some infection-control arrangements needed review
needs fixingInspectors were only somewhat assured about social distancing and safely admitting people for respite care. The manager agreed to review these areas.
“We were somewhat assured that the provider was meeting shielding and social distancing rules.” from the report
Care plans were still being developed
minorThe manager was still adding more detail about communication and equipment needs, including photographs to make plans easier to use.
“The registered manager was in the process of reviewing current care plans to make them more detailed about people's communication and equipment needs.” from the report
Main entrance could be easier to find
minorInspectors said more could be done to help external visitors locate the main entrance.
“Further steps could be taken to help external visitors find the main entrance area.” from the report
- 01What changes have you made to social distancing arrangements since the inspection?
- 02How do you safely admit people who come to the home for respite care?
- 03How are you keeping care plans up to date with each person's communication and equipment needs?
- 04What face-to-face training has been completed since COVID-19 restrictions were lifted?
- 05How do you check that the improvements made after the previous inspection are being maintained?
This was an unannounced follow-up inspection after the previous Requires Improvement rating; inspectors assessed all five key questions and also reviewed infection prevention and control arrangements. This explanation was written from the published report of 20 July 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2019
Covenant Care - The Wheelhouse was rated Requires Improvement; inspectors found risks around safeguarding, people’s rights, dignity and management.
Inspectors visited on 25 and 28 March 2019. The first day was unannounced. They observed people, spoke with relatives, staff, managers and health professionals, and reviewed care records, staff files, medicines records and management checks.
The home was not always safe. Potential safeguarding incidents were not always reported, some cleaning chemicals were left where people could reach them, and some areas were not clean. Medicines were generally managed safely and there were enough staff to meet people’s needs.
People’s rights, choices and dignity were not always protected. Restrictions had been placed on access to items and areas without the correct capacity assessments or best-interest decisions. Inspectors also saw some communication and staff interactions that were not respectful or person-centred.
All five areas were rated Requires Improvement. The home had been rated Good at the previous inspection in July 2016. Inspectors found three legal breaches and imposed conditions on the provider’s registration.
Medicines
Inspectors found generally good medicines practice, including clear records, safe storage at the home and checks when medicines were given.
“Good practice in medicine management included clear record keeping, orderly storage, monitoring the use of medicines, using codes when a medicine was not administered and two staff check hand written entries.” from the report
Community activities
People were supported to take part in a wide range of activities and to access the community. The home had adapted vehicles to support this.
“People had access to three vehicles which had been modified to enable them to access the community.” from the report
Health support
People were supported to attend appointments and access several health professionals. Hospital passports were also in place.
“People were supported to access a range of healthcare professional such as their GP, opticians, chiropodists and dentists.” from the report
Staff support
Staff received training, supervision and support from managers. Training covered conditions relevant to the people using the service.
“Staff received training which included training in conditions relevant to people's health care needs.” from the report
Safeguarding reporting
seriousSome unexplained bruising incidents had not all been investigated or reported to the local safeguarding team. Inspectors also raised a safeguarding alert after an allegation was disclosed but had not been reported under the provider’s policy.
“However, they had not all been investigated and reported to the local safeguarding team.” from the report
Restrictions and consent
seriousPeople had restricted access to items and areas including food, drinks, clothing and the kitchen. The required capacity assessments, best-interest decisions and reviews were not always in place.
“There was no evidence of the restrictions being regularly reviewed.” from the report
Management checks
seriousThe home’s quality checks did not identify the problems found by inspectors. Incidents were recorded but were not analysed for patterns that might help prevent similar events.
“The quality assurance processes did not pick up on the issues identified during the inspection.” from the report
Dignity and respect
needs fixingInspectors saw language and continence-related discussions that could be undignified. Staff did not always follow guidance about how to support people during anxiety.
“People's privacy and dignity at The Wheelhouse and supported living accommodation was not always upheld.” from the report
Cleanliness
needs fixingSome areas were not clean on the first inspection day, including floors, surfaces and toilets. The report recommends referring to national infection-control guidance.
“We found on the first day of the inspection, areas of The Wheelhouse were not clean.” from the report
- 01What changes have been made to ensure every safeguarding concern is investigated and reported promptly?
- 02How are restrictions on access to food, drinks, clothing, toiletries and communal areas now assessed, authorised and reviewed?
- 03How do you check that staff protect people’s dignity and follow each person’s communication and anxiety-support guidance?
- 04What has been done to improve cleanliness and prevent cross-contamination in the laundry area?
- 05How are accidents, incidents and quality checks now reviewed to identify patterns and prevent problems being missed?
This inspection covered the residential home and the supported living service, but most concerns related to the home; people in supported living were not available to speak with inspectors. This explanation was written from the published report of 25 October 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of The Wheelhouse
4 rated inspections over 7 years: the service has held its Good rating throughout.
- July 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2016Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2014GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- December 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- February 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 30 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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76 live-in carers within about two hours of Somerset
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,370 a week. 62 can care for a couple. 12 years' experience on average.
“She looked after my mum, who can be incredibly challenging, so well and so gently, and we always felt confident that my mum was getting the best care available.”
“She was not phased by anything, she was adaptable, kind & gave us complete confidence to go away & not worry about a thing!”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.