Background to this inspection
Updated
20 November 2019
The 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 Care Act 2014.
Inspection team
The inspection was undertaken by an inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience had experience of caring for older people who use regulated services.
Service and service type
This service is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the 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. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with 14 people who used the service and six relatives about their experience of the care provided. We spoke with seven members of staff including the provider’s representative, the registered manager, the compliance manager, one activities staff, a cleaner and two senior care staff. We spoke with a visiting health professional.
We reviewed a range of records. This included five people’s care records and medicines records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
20 November 2019
About the service
Crescent House is a residential care home for up to 33 older people and people living with dementia. At the time of inspection there were 33 people living at the home.
People’s experience of using this service and what we found
There was a registered manager who had been the manager of the service since it registered with CQC in December 2010.
Staff received training in safeguarding vulnerable adults. They demonstrated they understood their responsibilities to protect people from the risks of harm and abuse.
People’s risks were assessed at regular intervals or as their needs changed. Electronic care plans were readily available to staff who used these to provide care to meet people’s current care needs.
People were involved in planning their care; their care plans clearly showed how people preferred to receive their care. Staff supported people to maintain their dignity and their independence was promoted.
People received care from a consistent group of staff who knew people well. Staff were recruited using safe recruitment practices.
People were protected from the risks of infection by staff who followed the provider’s policies. The management team carried out spot checks on staff and there were extra washing facilities in areas where people petted the animals.
People received their medicines as prescribed. Staff received training in the safe management of medicines and their competencies had been checked.
Staff received an induction which provided staff with a good foundation of knowledge and understanding of the organisation and their roles. Staff received regular updates to their training and supervision to support them in their roles.
People received meals that met their dietary needs and helped maintain their health and well-being.
Staff supported people to attend health appointments and referred people promptly to their GP or other medical services when they showed signs of illness.
People lived in a well maintained, nicely decorated home. People could access communal areas easily. Additional social areas had been developed including a covered patio area where people accessed ponies and an activities room that had facilities designed for people living with dementia.
People were involved in creating activities where they wanted to. People who received all their care in their bedrooms received one to one time with activities staff. The provider ensured people with a disability or sensory loss had access and understood information they were given.
People were supported to express themselves, their views were acknowledged and acted upon. There was a complaints system in place and people were confident that any complaints would be responded to appropriately.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The registered manager and the management team promoted person centred care in all aspects of the service.
The management team were pro-active in using information from audits, complaints, incidents and safeguarding alerts to improve the service. The managers worked with staff to identify ‘near misses’ to understand how things went wrong and involved them in finding solutions.
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 22 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.