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Inspection carried out on 16 March 2017

During a routine inspection

The inspection was carried out on 16 March 2017 and was unannounced. There were 29 people living in the home at the time of our visit.

Croft House provides personal care and accommodation to a maximum of 29 people, mainly older people and people living with dementia. It is an adapted property which provides accommodation in single rooms some of which have en-suite facilities. The communal rooms are on the ground floor. There is level access to the lower floor and a passenger lift to the first floor. There is an enclosed garden which people can easily access from the ground floor.

The last inspection was in June 2016. At that time we found the service was in breach of five regulations, regulation 11 (Consent), regulation 12 (medicines), regulation 13 (safeguarding), regulation 18 (staff training) and regulation 17 (good governance). We told the provider they must make improvements. The providers, who had always prided themselves on delivering the best possible care to people, acknowledged the shortfalls and acted promptly to address them.

During this inspection we found the provider had taken action to address the concerns identified at our previous inspection. We were assured they were actively engaged in implementing systems to ensure the continuous improvement of the service.

There was a registered manager in place. 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.

We found the service was exceptionally caring. Everybody we spoke with told us the staff were very caring, kind and compassionate and always treated people with respect. During the inspection we observed staff had developed positive relationships with people. We saw all the staff including those employed as housekeepers and laundry assistants took the time to talk with people as they carried out their work. All the relatives we spoke with were full of praise for the home and the standards of care provided. Everybody we spoke with told us they could recommend the home

Staff we spoke with demonstrated a commitment to making people’s lives as good as possible. We found examples of staff going out of their way to make sure people’s individual needs and wishes were met. We found staff knew people well and were attentive to their needs; they focussed on people’s strengths and supported them to maintain their independence. The providers were actively involved in the day to day running of the home. Throughout the day we observed they provided excellent role models for staff.

We found staff were proactive in making sure risks were addressed and managed so that people were supported to maintain their independence.

People who lived at the home and their relatives told us they felt Croft House was a safe place. Staff knew how to recognise and report any concerns about people’s safety. Any concerns about people’s safety and welfare were identified, dealt with and reported to the relevant agencies. The required checks were done before new staff started work and this helped to protect people from the risk of abuse.

There were enough staff available to meet people’s needs. Throughout the inspection we observed staff were attentive to people’s needs and took care to make sure there was always a member of staff in the communal areas. Improvements had been made to the way staff were trained and supported to deliver safe and effective care. People told us they were confident staff knew how to look after them properly.

We found improvements had been made to the way people’s medicines were managed. People received their prescribed medicines safely.

We found risks to people’s health, safety and welfare were identified and action was taken to minimise and manage risks.

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Inspection carried out on 7 June 2016

During a routine inspection

The inspection took place on 7June 2016 and was unannounced.

Croft House provides accommodation and personal care for a maximum of 29 older people and people living with dementia. It is an adapted property and accommodation is provided in single rooms some of which have en-suite facilities. The building has access for people with disabilities and there is a passenger lift to the first floor. At the time of the inspection there were 27 people living in the home.

The last inspection was in January 2014 and at that time the provider was compliant with all the regulations inspected.

There was 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.

People described the staff as caring, kind and compassionate and throughout the day we observed staff were attentive, kind and patient. People were treated with respect and staff knew about people’s individual likes and dislikes. We saw staff took time to offer people choices and encourage them to make decisions about their day to day lives.

People living in the home told us they felt safe and people’s relatives told us they had no concerns about people’s safety. The staff we spoke with told us they would recommend the service to family and/or friends and they knew how to recognise and report abuse. However, we found that although safeguarding concerns were dealt with they not always reported to the relevant agencies and the actions taken were not always recorded.

We found that people’s medicines were not always managed properly and safely. In addition, when people were having their medicines covertly, disguised in food or drink, the correct processes were not always followed to show when and by whom it had been decided this was in the person’s best interests.

There were enough staff and people told us staff were available when they needed assistance. New staff did not start work until all the necessary checks had been done. This helped to reduce the risk of people being cared for by staff unsuitable to work in a care setting. Staff had induction training when they started work and we saw there had been training on topics related the needs of people living in the home. However, there was no system in place to show what training staff were required to complete or how often they should attend refreshers to make sure they were kept up to date with safe working practices.

The building was clean and well maintained. Improvements to the environment took account of the needs of people living in the home, for example an enclosed courtyard garden had been created to enable people to go outside easily and safely. We found risks to people’s safety and welfare were identified and dealt with in practice. However, the actions taken were not always reflected in people’s care records.

People enjoyed a variety of food and drink and their individual needs and preferences were catered for. People who needed help to eat and drink were supported by staff in a sensitive and discreet way. However, we found there was a risk of people’s nutritional needs being overlooked because of shortfalls in the record keeping.

People had access to the full range of NHS services to make sure their health care needs were met.

We found people’s needs were assessed. People had individual care plans, however, although the approach to the delivery of care was person centred this was not reflected in the care plans which were lacking in detail. This created a risk people could receive care which was inconsistent or not in accordance with their wishes.

People and their relatives told us they were involved in care planning but this was not reflected in the care records.

People were offered the oppor

Inspection carried out on 7 January 2014

During a routine inspection

During the inspection we spoke with four people who used the service and one person’s relatives. People told us they were happy with the service, one person said it was “Marvellous”, another said it was “A home from home”. People told us the staff were kind and caring and said there was plenty going on to keep them occupied. They said the food was very good and they were always offered an alternative if they didn’t like something.

We also looked at information on the website carehome.co.uk which showed 18 people had made comments about Croft House, all of which were positive giving the home on overall recommendation rating of 9.8. One person said Croft House provided care which was “Person centred and respectful” and another said “Love and compassion are the main ingredients here”.

We found people’s wishes were respected, their needs were assessed and care and treatment was planned and delivered to take account of people’s individual needs.

We found people were cared for in an environment which was clean and well maintained and there was an ongoing programme of refurbishment and redecoration.

We found people were protected because the correct checks were done before new staff started work.

People were protected from the risks of receiving care and/or treatment that was inappropriate or unsafe because their records were kept up to date and were stored correctly.

Inspection carried out on 13 December 2012

During a routine inspection

During the visit we had the opportunity to speak with four people who used the service and two relatives who were visiting. Everyone told us they were very happy with the care and support provided at Croft House. Visitors told us they were involved in discussions/decisions about their relatives care needs and were kept informed about any changes. One said "it's really good here, home from home. My relative is well looked after, it's a lovely home." Everyone said the staff were wonderful and the owners, who worked in the home every day, were very approachable and supportive. People said the food was very good and the home was clean and comfortable.

Inspection carried out on 23 January 2012

During a routine inspection

During the visit we had the opportunity to speak to people using the service and a number of relatives who were visiting. Everyone told us they were very happy with the care and support provided at Croft House. Visitors told us they were involved in discussions/decisions about their relatives care needs and kept informed about any changes. Everyone said the staff were wonderful and the owners, who work in the home every day, were very approachable and supportive. People said the food was very good and the home was clean and comfortable.

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