The Croft Nursing Home (Barrow)

Updated 25 March 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 25 February 2022 and was announced. We gave the service one day’s notice of the inspection.

Updated 25 March 2022

We carried out this inspection at The Croft Nursing Home (The Croft) on 8 January 2019. The inspection was unannounced which meant the provider was not expecting us.

We last inspected The Croft in July 2016. At that inspection the service was rated good in all five domains. At this inspection we found the service remained good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The Croft is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection.

The Croft provides accommodation and long-term nursing care for up to 46 people with a physical or learning disability. This is for 23 people with nursing needs and 23 people needing residential care and support. People living at The Croft had a range of complex care needs and some required a high level of support with daily living inside and outside of the home.

The service had not originally been developed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. We saw that people at The Croft were given choices in their everyday lives and their independence and personal development was well supported and participation within the local community was very actively encouraged. The service had gone to great lengths to find out what people wanted out of life and to take steps to achieve that.

The home is in its own grounds with easily accessible outdoor patio and garden areas. Accommodation is provided on the ground and first floor of the main building and there is a passenger lift to assist people to access the accommodation on the first floor of the home.

Within the grounds of the home there are four bungalows in the area called ‘The Village’. Each of the four separate bungalow can accommodate up to five people. The adults living in the bungalows can live more independently. They are supported by care staff to go out into the local community, to attend work or day services and to undertake their chosen interests and hobbies. The home has a range of specialist equipment and facilities in both the main nursing home and the separate bungalows to promote mobility and independence for all the people living there.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered person's'. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated regulations about how the service is run.

At this inspection we found the service had continued to maintain its high standards and had also improved the services and support offered. There was no evidence or information from our inspection and ongoing monitoring that demonstrated any serious risks or concerns. We found that staff and management at The Croft were constantly working to improve and develop their service to meet the needs and aspirations of the people who used it and their families. For example, the service was particularly skilled at enabling people to carry out person centred activities focusing on people’s choice, independence, community inclusion and on healthy nutrition.

People who lived at The Croft told us they were happy and felt safe and secure living at the home. People and their relatives expressed great confidence in the staff skills and knowledge and about the effectiveness of the management team. Records showed the staff team completed a wide range of mandatory training and this was confirmed by staff members we spoke with. Regular supervision sessions and annual appraisals allowed members of the staff to discuss their personal development and training needs with their line manager.

Staffing levels were regularly monitored and kept at a consistently good staff to person ratio. People’s individual dependency was kept under review so the service could be flexible to meet a person’s changing personal and social needs.

Risk assessments had been completed, they were detailed and outlined the best course of action, to reduce the level of potential risk. This helped to protect people from harm. Risks in relation to people's care were assessed, understood and managed well. Staff worked very hard to manage risks, whilst not restricting people's opportunities. People were encouraged to lead active lives and were supported to participate in the local community as much as possible.

Staff undertook regular safeguarding training and understood how and when to report any concerns about abusive or poor practice. People's dignity was promoted and their privacy was always respected and we saw that staff approached people in a kind and friendly manner.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The service worked within the law to support people who might lack capacity to make some of their own decisions. Discussions had taken place to involve people, relevant others and medical professionals in decisions made in any someone’s best interest.

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. Records showed that people were fully involved in making decisions about how they wished to live We observed the daily routines and practices within the home and found people were treated equally and their human rights were being protected.

The nursing home and bungalows were well maintained and had been extended to meet people’s needs. All the areas of the home we saw were clean, hygienic and homely places for people to live. We saw that equipment in use had been regularly cleaned, serviced and maintained. We observed staff used personal protective equipment correctly and assisted and moved people in a safe and dignified manner.

Medicines management systems were safe and being well monitored. Staff had undertaken appropriate training in medicines administration to use the electronic systems that had been introduced to continue to improve medication management.

The service had a well established and thorough quality assurance system to meet their registration and commissioning standards and to support continuous improvement to the service. We found that The Croft constantly looked to improve and be innovative in moving the service forward. The Croft had maintained a programme of continued improvement and sustainability over several years to make positive developments for all the people who used the service.

Further information is in the detailed findings below