The inspection was carried out on 29 and 30 September 2015. The first day of the inspection was unannounced.
The Croft Care Home is a two storey detached property, close to the centre of Whalley. There are 26 single bedrooms, some with en-suite facilities. There are two lounges, the main lounge is a on the ground floor and has an adjacent quiet area. The second lounge is smaller and is located on the first floor. There is also a separate dining room. A small passenger lift provides access to the first floor and a stair lift is available. There are garden areas and lawns, garden furniture is provided. A small number of car parking spaces are available in the grounds. The service provides accommodation and personal care for up to 26 older people and older people living with dementia. At the time of the inspection there were 25 people accommodated at the service.
The service was managed by 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.
At a previous inspection on 22 January 2014, we asked the provider to make improvements in relation to the safety and suitability of the premises. We received an action plan from the provider indicating they would meet the relevant legal requirements by July 2015 and this action has been sufficiently completed.
At the last inspection on 24 July 2014, we asked the provider to take action to make improvements in relation to care and welfare of people and assessing and monitoring the quality of the service. We received an action plan from the provider indicating they would meet the relevant legal requirements by 30 November 2014. We found sufficient action had been completed.
During this inspection we found the provider was in breach of one regulation of the Health and Social Care Act (Regulated Activities) Regulations 2014. This related to the provider not having proper oversight of the service and showing that they had reviewed the quality monitoring processes.
You can see what action we told the provider to take at the back of the full version of this report.
The people we spoke with indicated satisfaction with the care and support they experienced at the service. Their comments included: “I like it here and I’m happy” and “I think this place is as near to home from home as you can make it.”
Relatives told us of their satisfaction with the improvements at The Croft, their comments included, “I think they have turned a corner” and “Things have improved, It’s much better.”
We asked relatives for their views on the delivery of care, their comments included: “They are looking after (my relative) properly,” “I have no concerns about the care” and “As far as (my relative) is concerned I have no issues at all.”
People had mixed views on the availability and numbers of staff on duty; following the inspection the registered manager told us action had been taken to increase staffing levels. However, we have made a recommendation on ensuring there were sufficient staff, including the processes for monitoring and adjusting the staffing arrangements.
There were some good processes in place to manage and store people’s medicines safely. We found some improvements were needed; therefore we have made a recommendation about the management of medicines.
People made positive comments about the quality, and variety of meals provided at the service. We found various choices were on offer. Drinks were readily accessible and regularly offered. We therefore made a recommendation about supporting people at mealtimes.
People said they liked the accommodation at The Croft and they had been supported to personalise their bedrooms. We found progress was ongoing to refurbish and up-grade the bathing facilities and other areas of the service. However we made a recommendation on making sure the refurbishment continues and meets the appropriate standards.
People spoken with had an awareness of the service’s complaints procedure and processes. They said they would be confident in raising concerns. We found records were kept of the complaints and the action taken. However we noted the services own processes were not always followed. We therefore made a recommendation on the management of complaints.
Staff were aware of the signs and indicators of abuse and they knew what to do if they had any concerns. Staff confirmed they had received training on safeguarding and protection.
We observed people being supported and cared for by staff with kindness and compassion. People told us the staff were kind and caring.
We saw people were treated with dignity and respect and people told us consideration was given to their privacy. Healthcare needs were monitored and responded to. People had individual care plans, however some were lacking in information. We therefore made a recommendation on the care planning process.
We observed examples where staff involved people in routine decisions and consulted with them on their individual needs and preferences. Staff spoken with described how they involved people with making decisions and choices. Discussion meetings were held and people had opportunity to complete satisfaction surveys.
The MCA 2005 (Mental Capacity Act 2005) and the DoLS (Deprivation of Liberty Safeguards) sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. We found appropriate action had been taken to apply for DoLS and authorisation by local authorities, in accordance with the MCA code of practice and people’s best interests.
People were keeping in contact with families and friends. Visiting arrangements were flexible. Arrangements were in place to provide suitable activities and entertainment.
Recruitment practices made sure appropriate checks were carried out before staff started working at the service. Systems were in place to ensure staff received regular training, supervision and support.