Archived: The Croft

Updated 10 April 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Notice of inspection and the inspection team:

This inspection took place on 11 March 2019 and was unannounced. The inspection was carried out by one inspector.

Service and service type: The Croft 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.

What we did:

Before the inspection we reviewed information available to us about this service. This included the Provider Information Return (PIR). This contains details about incidents the provider must let us know about, such as abuse. We assess the information that providers send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection

We spoke with one person who was able to express their views, but not everyone chose to or were able to communicate with us, therefore we observed the support provided by staff. We spoke with a one person’s relative by telephone, the following day of the inspection. We spoke with two support workers, the registered manager and the Nominated Individual (NI) who represented the registered provider. We looked at one person's care records, recruitment records for two staff and reviewed records relating to the management of medicines. We also looked at records in relation to complaints, staff training, maintenance of the premises and equipment and how the registered person monitored the quality of the service.

After the inspection, we sought additional information from the registered manager to corroborate our findings.

Updated 10 April 2019

About the service:

The Croft provides accommodation and personal care for up to six people who have a learning disability. The service does not provide nursing care. There were four people living at the service at this inspection.

People’s experience of using this service:

People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible. The registered manager had not understood and applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. Staff were overly protective of people, preventing them from carrying out some tasks they could do for themselves. People did not always have access to activities in the community that were based on genuine choice, and right for them, where they could mix with other people.

People’s information and communication needs had been identified, and recorded in their care plans in accordance with the Accessible Information Standards. These are a set of standards setting out the specific approach for providers of health and social care to identify, record, share and meet the communication needs of people with a disability, impairment or sensory loss. However, individuals’ identified communication needs were not always being met.

Where people lacked capacity, best interest decisions were not being made in line with the requirements of the Mental Capacity Act 2005.

Systems were in place to keep people safe. Staff had good understanding of safeguarding procedures and how to report concerns. However, where accidents and incidents had occurred these had not prompted investigation to learn from such incidents and prevent reoccurrence.

Staff had access to a range of training, however none of the staff, (including new staff with no care experience) had completed the Care Certificate or a recognised National Vocational Qualification (NVQ). All new staff are required to complete the Care Certificate as part of their induction to ensure they are trained to nationally recognised standards. This training provides new staff with knowledge and skills to carry out their roles and responsibilities.

The governance arrangements were not always effective. There was a lack of systems in place to measure and review the delivery of care and support against current guidance. Staff recruitment practices had not been carried out robustly to ensure people were protected from staff unsuitable to work with vulnerable people. Although, the registered manager was carrying out some audits, these were not identifying where improvements were needed, and ensure risks and regulatory requirements were understood and managed.

Overall people’s medicines were managed well. Staff understood and put into practice control measures to prevent the spread of infection. There were sufficient staff to meet people's needs.

People were supported to have access to food and drink of choice and were cared for, by staff that knew them well. The registered manager and staff worked well liaising with other teams and services to ensure people received the support they needed to maintain their health. People’s needs were responded to in a timely manner. Staff had supported a person well, during the end of their life which had ensured they had a dignified death. People's privacy and dignity was promoted and respected. Significant improvements had been made to the premises to ensure people lived in a safe and comfortable environment.

Staff were aware of the vison and values of the company and talked of a positive culture within the service. Systems were in place to ensure people’s concerns and complaints were listened and responded to.

Rating at last inspection: Since the last inspection of The Croft in July 2017 the provider changed from a Partnership to a Limited Company. The Croft is the same service, but now under a new registration. This will be the first inspection of The Croft under the new registered provider.

Why we inspected: This was a planned inspection to rate the service under the new registration.

Enforcement: Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up: During this inspection we found improvements were needed. We will continue to monitor all intelligence received about this service to ensure that the next planned inspection is scheduled accordingly.

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