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Inspection carried out on 20 September 2016

During a routine inspection

The inspection took place on 20 and 21 September 2016. We announced the inspection to the provider at 4.30pm on 19 September 2016. This was because the registration covers a range of different services and we wanted to make sure managers from each service would be available to meet with us and arrange for us to visit and meet with people using the services.

The last inspection took place 27 September 2013

Whiteley Village is a retirement community near Walton upon Thames in Surrey. The Village includes a nursing home, Whiteley House, for up to 86 older people and a residential home, Ingram House, for up to 27 older people, known collectively as the Care Centre. There is also an extra care scheme, Huntley House, for up to 51 older people living in their own flats and receiving personal care when they needed. The service is also registered to provide personal care to anyone living within the village in one of their 262 almshouse cottages and 16 privately owned houses.

The village is run by The Whiteley Homes Trust, a registered charity. The Trust states that it's role is ''To enable our older residents to be as independent as possible and contribute as much as they can to Village life.'' The Trust's admission criteria for people wishing to live in the almshouses or Huntley House is “older generations” (those who have reached state pension age) who are of limited financial means. The Trust accepts people who fund or part fund their own care at the Care Centre.

Whiteley Village is registered to provide four regulated activities. Three of these, accommodation for persons who require nursing or personal care, diagnostic and screening procedures and treatment of disease, disorder or injury for the Care Centre; and the regulated activity of personal care for Huntley House and the domiciliary care service in the rest of the village. At the time of our inspection 95 people were living in the Care Centre and 62 people were receiving personal care and support at Huntley House or in the rest of the village.

There was a registered manager in post for the regulated activity of personal care. The registered manager for the Care Centre had left the organisation earlier in 2016. The person who managed Whiteley House and Ingram House had applied to be registered with the Care Quality Commission and this application was being processed. 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 and associated Regulations about how the service is run.

People living at Whiteley Village were happy there. They felt their needs were met. People felt safe with the care provided and within the environment. There were clear procedures to safeguarding people from the risk of abuse and to investigate any allegations of abuse. The risks to people's safety and wellbeing had been assessed and the staff had guidance on how to help keep people safe. People received their medicines safely and as prescribed. There were enough staff and they were recruited in a suitable way.

People consented to their care and treatment. Where people had difficulty making decisions the principles of the Mental Capacity Act 2005 were followed to ensure people's rights were protected. People's nutritional needs were being met and people living in the Care Centre, Huntley House and the rest of the village had access to freshly prepared nutritious meals if they wanted these. People were supported to stay healthy and their mental and physical health were assessed, monitored and their needs were met. They had access to doctors and other healthcare professionals and the staff worked closely with these professionals to ensure people received the right support.

The staff liked working at the village and felt their views and opinions were listened to. They had access to a range of training and they had good support and guidance. There were regular meetings of all levels of staff and information was shared appropriately.

People received support from staff who were kind, caring and polite. Whilst we witnessed some interactions which were not positive, the overwhelming feedback from people using the service and their representatives was that the staff were very caring. The provider responded appropriately to the concerns we witnessed and spoke with the staff concerned who acknowledged and recognised where their behaviour may have appeared uncaring. People told us they had good relationships with the staff. They staff spoke fondly about the people who they cared for. People's privacy was respected and they were supported to maintain independence and live the life they wanted to. The staff had a good awareness of how to support people at the end of their lives and people were able to receive care at this time which reflected their personal wishes and preferences because these had been discussed in advance with them.

People were involved in planning their own care and their views and opinions were acted upon. The service valued the importance of family and friendships and, where people wished, their families were involved in planning and reviewing their care. People's care needs were met in a person centred way and their individuality was valued and respected. There was a wide range of social events and activities within the village and in the different locations. People were supported to access these, although some people in the Care Centre wished for more opportunities for social activities designed specifically for them.

Senior managers within the Trust were positive role models who were well respected. They valued people who lived at the village and the staff and regularly asked for their opinions. They responded appropriately to feedback and concerns. There were good systems for monitoring the quality of the service and identifying themes and trends. The service worked in partnership with other organisations whilst striving for continuous improvement. There was a very positive culture and a sense of community which was felt by people living there and staff alike. The values of the organisation represented the views and opinions of the people who lived there.

Inspection carried out on 27 November 2013

During a routine inspection

We inspected Whiteley House which has a maximum capacity of 86 people some of whom have complex nursing needs.

During our inspection, we spoke to seven people who lived in the house, six staff, one volunteer and four relatives as well as the registered manager. We carried out this inspection to look at the care and treatment of people who used the service.

We found that each person had a comprehensive care plan that included up to date information. Staff that we spoke with were knowledgeable about the information contained in people’s care plans.

Everyone we spoke with was happy with the care provided. We were told “All staff have an understanding of their needs” and that people were “Generally well cared for.”

We saw evidence that staff had received training in how to identify possible signs of abuse.

We saw on the day of our inspection that the premises were well maintained and safe for the people who lived there.

People that we spoke with told us that generally they felt there were enough staff on duty each day. They said that they did not have to wait for their call bell to be answered. We looked at staffing rotas and call bell records to confirm this.

We saw that staff received regular appraisals and had the opportunity to develop professionally. Staff were happy working at Whiteley House. We were told “There’s a good team spirit.”

The provider monitored the quality of the service and we looked at the results of the latest surveys.

During a check to make sure that the improvements required had been made

During our review we spoke with the manager and we reviewed care files that related to individual people who used the service. We also requested to see further information to new procedures that had been implemented since our last inspection on 23 November 2012.

We saw that the manager had made lots of changes to the way that people's nutritional needs were met. We also saw that they had implemented several new forms to ensure accurate and adequate monitoring for people at risk of malnutrition and dehydration. For example, each duty room had a file specifically for staff to read, record and sign in relation to monitoring and assessing people at risk. We saw that there was an element of person centred care within people's care plans and we found that people's care plans had an up to date nutritional needs assessment.

We spoke to the manager with regards to people using the service having access to specialists. We saw that a meeting had taken place with several healthcare professionals. For example, GP's (General Practitioners), RN's (Registered Nurses) and the Community Matron. This was to discuss the importance of recording referrals and we saw that all relevant parties had agreed to record communications appropriately. We saw that the manager had implemented an action plan to record any changes in a person's dependency. The manager told us that this was done so that any referrals to other healthcare professionals could be identified and acted upon immediately.

Inspection carried out on 23 November 2012

During an inspection to make sure that the improvements required had been made

Our initial inspection visit which took place on 01/11/2012 identified concerns and shortcomings in relation to people receiving adequate assessments of their needs and some people were not being supported with eating and drinking where necessary. This was also reflected within the records of care plans for people using the service. On 23/11/2012 a follow up inspection was undertaken to ensure compliance.

We spoke to the manager and also reviewed the care plans for four people using the service. We saw that there had been significant improvements to records within the care plans that we reviewed and also saw evidence of new practice's that had been introduced in order prevent any further shortcomings. This included a new protocol for people at risk of malnutrition, themed audits and a new action plan for changes of dependency. The manager told us further training was being implemented to ensure that all staff were aware of the importance of carrying out nutritional risk assessments and adapting care plans to reflect those needs.

The care plans reviewed had all been audited and all concerns that were identified had been addressed. No other concerns were identified.

Inspection carried out on 1 November 2012

During an inspection in response to concerns

There were 69 people using the service at the time of the inspection visit. We spoke with seven people and six members of staff. We also made observations throughout the visit and we reviewed seven care plans related to individual people using the service.

We saw that staff were communicating with people respectfully and were giving encouragement at all times throughout the day. People we spoke with told us that they felt they were treated with dignity and respect and felt safe with staff.

One person said "They are very good, they have a lot to put up with here. They do everything everyone asks them to do. I am amazed."

We saw that there was a wide range of nutritious food and hydration available and the people we spoke to all agreed that they felt they had enough food. One person told us “I have asked for a sandwich in the middle of the night before and got it.”

People we spoke with told us that they had no concerns relating to their medications and that they understood the reasons why they were taking their medication. We observed good practice during the medication rounds and saw that the nurse was engaging with the people in a manner which was understandable. However, we did see that records were not always accurate for the recording and obtaining of medicines.

We found shortcomings in relation to people receiving adequate assessments of their needs and some people not being supported with eating and drinking where necessary.

Inspection carried out on 30 July 2012

During a routine inspection

We spoke with people living in the care home and those receiving care from the DCA, All were complimentary regarding the care they received from the staff. We were told staff were kind, caring and helpful and people in the care home told us they felt safe.

People told us they liked living in the village. If they lived in the care home or received care from the DCA they told us they could access anything that was happening for example garden parties or the Jubilee party held in the care home.

Reports under our old system of regulation (including those from before CQC was created)