Whetstone Hey Residential Care Home

We found the following examples of good practice.

• The service had a system to facilitate visiting. Visitors booked onto an allocated slot which were spaced out throughout the day to avoid potential infection transmission with other visitors. All visitors were asked to complete a health screening form and were provided with face masks to wear throughout their visit. Visits were currently limited to outdoors, however the registered manager explained the provider was currently exploring different options including the use of perspex screens to enable visits to take place indoors.

• The service had increased the cleaning schedules and routines to reduce the risks of cross infection. Residents commented positively on this and told us, “Staff are doing lots of cleaning.”

• We observed staff wearing the correct personal protective equipment (PPE) throughout the inspection and all of the residents we spoke with confirmed staff wear PPE when providing personal care.

• New residents were supported to self isolate for 14 days upon admission. The registered manager ensured staff were available to reassure people, develop relationships and respond to their needs during this period.

• One resident told us how they had found isolation during the Covid-19 pandemic particularly difficult, as family members had been unable to visit. We were told, “I like to go out into the garden for an hour and staff support this.” Staff had also been proactive in reducing the impact of loneliness by facilitating telephone and video calls to loved ones.

Further information is in the detailed findings below.

Whetstone Hey is a residential care home providing personal care to 39 people aged 65 and over at the time of the inspection. The service can support up to 42 people. The care home accommodates people in one adapted building.

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

People and their families were consistently positive about the care they received. People told us that they felt safe living there and received all the care they needed. They told us that they felt cared for by the staff team and that there were a range of activities in place which took their previous interests into account. People were happy with the meals provided and considered the building to be clean, well decorated and welcoming.

Our last visit identified shortcomings although these did not result in breaches of our regulations. These included no evidence to confirm that legionella checks had been undertaken, capacity of people had not always been assessed and there was no programme of activities. These had now all been addressed.

People received care in a safe environment with appropriate equipment. Risks associated with their care was fully taken into account. People received medication safely and, in a person-centred manner. There were sufficient staff available to meet people’s needs and attend to them. New staff were recruited robustly. Systems protected people from abuse. The building was clean and hygienic with staff having access to suitable equipment to limit the spread of infection.

People were now 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. Staff received training and supervision in order for them to perform their role. The environment was tailored to take people’s needs into account. People’s nutrition and health were supported and promoted.

People were supported in a dignified and caring manner, enabling them to have their privacy respected. People were enabled to communicate in their preferred manner and were given time to express themselves. Care plans were person-centred and included the needs of people in all aspects of their daily lives. Activities were now in place and sought to reduce the risk of social isolation.

The service had responded improvements needed at the last inspection. Audits supplemented the drive for improvements. People and their families were invited to comment on the quality of care provided. Links with the local community were established.

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.

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 Requires Improvement (published 12 June 2018).

Why we inspected

This was a planned inspection based on the previous rating.

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

Whetstone Hey 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 home accommodates up to 42 people in purpose-built premises. The home does not provide nursing care.

The home is required to have a registered manager. 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 2008 and associated Regulations about how the service is run. A new manager had been appointed in January 2018 and had started the process for registration with CQC.

People we spoke with believed the home was safe. Maintenance records showed that regular checks of services and equipment were carried out by the home’s maintenance person and testing, servicing and maintenance of utilities and equipment was carried out as required by external contractors.

The home had a manager, deputy manager, care team leaders, senior carers and care assistants. There was a care team leader on every shift and during the day there was also a senior carer. This ensured there was a senior person who was able to administer medication on each floor.

Ancillary staff covered cleaning, laundry and kitchen duties. They were managed by the home services manager and there was also a domestic supervisor who people spoke highly of. All parts of the premises looked clean. The home had received an excellent score following an infection control inspection in February 2018 and the kitchen had a five star food hygiene rating.

We looked at the recruitment records for three members of staff who started working at the home recently. Records showed that robust recruitment procedures had been followed to ensure staff were of good character.

We looked at the arrangements for people’s medication. We found that, in general, medicines were stored and handled safely, however there were some areas for improvement. Hand-written entries on MAR sheets had not been signed. These should be double signed, first by the member of staff making the entry, and second by another member of staff who has checked that it is correct. Prescribed creams and ointments were only signed for occasionally and this did not show they had been applied consistently as prescribed.

Risk assessments were recorded in people’s care notes but effective plans were not always in place to reduce the risks identified. A log of accidents and incidents was maintained and the records showed that appropriate action had been taken when accidents occurred.

Staff received training about safeguarding as part of their induction, with updates periodically. We spoke with staff who said they would have no hesitation in reporting any concerns. The manager had reported safeguarding incidents as required and full records were kept of safeguarding referrals that had been made.

The previous manager had made appropriate DoLS applications to the local authority. Some of these had been authorised but others were still awaiting consideration.

People could choose where they wanted to eat and who they sat with. The cook was aware of people’s preferences and told us they always made an alternative for people who did not want to have the meals on the menu. People told us they enjoyed their meals and had plenty to eat and drink.

There was a programme of on-line training for all staff to ensure that they knew how to work safely. This was supplemented by practical moving and handling, fire safety and first aid training. The manager told us all of the care staff were required to complete the Care Certificate.

People who lived at the home told us that the staff provided them with good care and support. One person commented “I love it here.” Another person said “It’s marvellous.” Everyone had their own bedroom and personal care was provided in a discreet way in the privacy of the person’s room. There was a sense of community within the home and one person who had lived there for a number of years told us “The staff are like my second family. They are all good to me from the cleaners to the higher ups.”

People’s personal information was kept securely in offices that were locked when unoccupied and this protected their confidentiality. We also noted the use of room numbers rather than names on files to protect confidentiality.

The care files we looked at showed that people’s care and support needs were assessed covering all aspects of their health and personal care needs. The assessments fed into a lengthy document called ‘My Health Needs’.

There was no planned programme of regular social activities. The manager told us that the home had been without an activities organiser for the last few weeks but two part-time activities organisers had now been appointed.

The home's complaints procedure was displayed and people we spoke with said they would tell the manager or another member of staff if they had any complaints.

We saw evidence of regular staff meetings which were well attended. The minutes of the staff meetings showed that staff felt able to express their views. People living at the home told us they attended resident meetings and records showed that these were held regularly.

There was a schedule of quality audits for the year and these had all been completed to date. We looked at the records and found evidence of regular checks of care plans, kitchen hygiene, meals, laundry, medication, infection control, health and safety, maintenance and gardens and finance. These were accompanied by action plans for improvement as needed.