Whittingham House

Updated 14 July 2023

TThe 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 team was made up of 2 inspectors. An Expert by Experience carried out telephone calls to relatives following the inspection. 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

Whittingham House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Whittingham House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. An interim manager was in post who left shortly after the inspection. A new interim manager is now in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 6 June 2023 and ended on 15 June 2023. We visited the service on the 6 and 7 June 2023.

What we did before 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 with 7 people who used the service and spent time talking to people and observing care delivery in communal areas over the 2-day visit, including lunch time observations. We spoke with 9 staff members including the interim manager. We looked at 14 people's care records and multiple medicine records. We looked at records relating to safeguarding, accidents and incidents, quality assurance systems, recruitment and safety records, including records relating to premises and equipment. Following our site visits, we spoke with 10 relatives by telephone.

Updated 14 July 2023

About the service

Whittingham House is a care home providing accommodation for persons who require nursing or personal care for up to 70 people including people living with dementia. At the time of our inspection, 59 people were living at the service.

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

The provider had not identified or managed health and safety risks and hazards. Risks were not always safely monitored or managed, for example risks relating to falls, moving and handling, distressed reactions and eating and drinking. A lack of information and follow up across people's care plans meant people were at risk of harm. Systems in place to protect people from the risk of abuse were not effective. The provider had not always reported concerns to external agencies, such as the local authority and CQC where required. Whilst we found medicines were administered safely, we found medicines were not safely secured and other minor improvements were required. Staff were deployed to meet people's needs but were often task focused.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Capacity assessments had not always been completed, and conditions on Deprivation of Liberty authorisations had not been met. People's needs and choices were not always updated in care plans to reflect current needs.

The providers quality assurance systems were not effective. Whilst some audits were being completed, they did not identify any of the concerns found at this inspection. There were also no effective checks at provider level. We received mixed feedback about the culture of the service from staff.

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

The last rating for this service was good (published 04 June 2021).

Why we inspected

We received concerns in relation to safeguarding staffing and poor care. As a result, we undertook a focused inspection to review the key questions of safe, effective 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 changed from good to inadequate based on the findings of this inspection.

We have found evidence the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to risk, safeguarding, consent, meeting nutritional needs and governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.