Whitby Court Care Home

Whitby Court Care Home is a care home providing personal and nursing care to older people, some of whom were living with dementia. The home can accommodate up to 51 people. At the time of this inspection 46 people were using the service.

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

People told us they felt safe and well supported by caring staff. Staff followed clear policy and procedure to report any concerns for further investigation. Known risks for people had been assessed and were regularly reviewed with up-to-date information to help keep people safe.

Safe recruitment processes were followed to ensure suitable people were employed. Safe numbers of staff were on duty, and this was reviewed to ensure people’s changing needs were met.

Staff treated people with respect and upheld their privacy and dignity. People received their support from regular staff whom they knew well.

Staff received appropriate induction, training, and support to carry out their roles. People were supported to take their medicines safely as prescribed, and staff followed good infection, prevention, and control practices.

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.

People provided their consent to, and were involved with, planning their care and support. People's

preferences were recorded and wherever possible, staff supported people to maintain their independence. Staff had access to clear and concise care records which were up to date.

Staff were supported by an experienced registered manager who was passionate about providing people with the best care and support. The registered manager completed a range of audits and checks with provider oversight and input to ensure systems and processes remained effective and to identify any areas that could be improved.

Rating at last inspection and update

The last rating for this service was good (published 21 April 2022)

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service died. The information shared with CQC about the incident indicated potential concerns about the management of risk, associated with a failure by some staff to maintain accurate and contemporaneous records and the management and administration of people’s medicines. This inspection examined those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Whitby Court Care Home is a care home providing personal and nursing care to older people, some of whom were living with dementia. The home can accommodate up to 51 people. At the time of this inspection, 50 people were using the service.

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

People told us they felt safe living at the service and relatives were happy with the support being provided. Staff described an improved, positive culture within the service and told us they felt valued.

Safe recruitment processes were in place and followed. A safe number of staff were on duty and deployed effectively to ensure people’s needs were met. Staff had received appropriate safeguarding training and referrals had been made when required.

Risks to people had been assessed and recorded. Action had been taken to mitigate risks wherever possible.

Medicines were administered safely. Infection, prevention and control measures had been improved following the last inspection and thorough, effective systems were in place to monitor the quality and safety of the service provided.

The senior management team had an increased presence in the service to ensure they had effective oversight. Lessons had been learnt following the last inspection and extensive steps taken to prevent reoccurrence and continuously improve the service.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 25 March 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We carried out an unannounced focused inspection of this service on 12 February 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve their infection, prevention and control, risk management and governance systems used to monitor the quality and safety of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Whitby Court Care Home is a care home providing personal and nursing care to older people, some of whom were living with dementia. The home can accommodate up to 50 people. At the time of this inspection, 38 people were using the service.

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

Effective infection prevention and control measures had not always been in place or followed by staff and management. Risks in relation to transmission of infections had not been fully considered. This had placed people at risk of harm.

The registered manager had not always been open and honest when things had gone wrong. Systems and processes in place to monitor the quality and safety of the service provided had not always been effective in highlighting shortfalls.

There was enough staff on duty to ensure people’s care and support needs were being met. Staff had been recruited safely and thorough recruitment processes were in place. Medicines were stored, recorded and administered as required. Staff had received safeguarding training and knew the process to follow if they had any concerns.

The registered manager and provider had used innovative ways to ensure people remained in contact with their relatives. People were happy with the care and support they received.

The provider and registered manager were responsive to the concerns and shortfalls found at the inspection. They took immediate action to address the concerns. They were committed to ensuring lessons were learnt when things had gone wrong and continuously improving the service.

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

Rating at last inspection

The last rating for this service was good (published 18 April 2019).

Why we inspected

We received concerns in relation to poor infection prevention and control measures in place as well as staff not following government guidance in relation to Covid-19. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

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

Enforcement

We are mindful of the impact of the Covid-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the Covid-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to infection, prevention and control practices and governance processes in place at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

People’s experience of using this service: People were happy with the service provided and felt safe. People received support from staff who were trained, supported in their role and encouraged to continuously develop their skills. Staff understood how to identify and report any safeguarding concerns.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People told us staff were kind and caring and respected their privacy and dignity. Staff understood the importance of promoting and encouraging food and fluids. Staff spent time getting to know people and their life histories. Activities on offer provided stimulation and social interaction with other people who used the service.

Care plans were in place to give staff the information they needed to support people in line with their preferences. People felt valued by the service. They had regularly opportunities to provide feedback on the service they received; action taken as a result was shared with them.

Regular checks and audits on the quality and safety of the service were completed by the registered manager and the provider. The registered manager was passionate about ensuring the service continuously improved, addressed any concerns promptly and learnt lessons when shortfalls were found. People and staff spoke highly of the management team and their approach.

The registered manager shared their skills and knowledge with other services and participated in pilots to improve the care in the wider area. The service had good links with the local community and other professionals to promote and improve people’s health.

For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk

Rating at last inspection: Good (report published 8 December 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

When we last inspected the service in September 2015 we found two breaches of regulations. We found that staffing levels on the nursing floor were not always sufficient to care for people safely or to enable all people to pursue interests of their choice. We also found gaps in records which monitored people’s clinical care needs, for example fluid and nutritional charts and moving and handling charts. Records of people’s involvement about their care were not sufficiently detailed to ensure staff had the information they required.

At our inspection on 28 October 2016 we looked again at staffing levels and found that the registered manager had worked hard to recruit staff to ensure there were sufficient staff on duty to cover all shifts. People and relatives told us there was enough staff on duty to meet their needs. We looked again at fluid and nutritional charts and moving and handling charts. We found that in general staff ensured up to date and accurate information was contained with records; however there was still some improvement needed to ensure the care records of people were person centred.

The home had 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.

Whitby Court Care Home provides residential and nursing care for up to 50 older people, some of whom are living with a dementia. The building was recently built for purpose and presents an attractive living environment. There are a number of communal areas for people to use. On the ground and first floor of the service there is a large lounge area and a dining area. On the lower ground floor there was a beach room and garden room for people to spend time and pot plants. The lower ground communal areas did not have heating so was mainly used in the summer months. On the ground floor there was a small games room and a small café and on the first floor a train room with a working train set. There is a passenger lift to assist people to all floors and the home is located close to transport links and the local park. At the time of the inspection there were 48 people who used the service.

Risks to people’s safety had been assessed by staff and records of these assessments had been reviewed. Risk assessments covered areas such as falls, moving and handling, nutrition, risks associated with people’s health and behaviour that challenged. Staff told us how control measures had been developed to ensure staff managed any identified risks in a safe and consistent manner. However, some risk assessments were generic and not individual to the person.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty were being met. People subject to DoLS had this recorded in their care records. However, mental capacity assessments were not decision specific. Best interest decisions were not recorded in care plans. We have made a recommendation about this.

People were protected by the services approach to safeguarding and whistle blowing. People who used the service told us they felt safe and could tell staff if they were unhappy. People told us staff treated them well and they were happy with the care and service received. Staff were aware of safeguarding procedures, could describe what they would do if they thought somebody was being mistreated and said that management acted appropriately to any concerns brought to their attention.

Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. Safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

Appropriate systems were in place for the management of medicines so that people received their medicines safely.

Staff had been trained and had the skills and knowledge to provide support to the people they cared for. Staff were supported through regular supervision and appraisals.

We saw that people were provided with a choice of healthy food and drinks, which helped to ensure that their nutritional and hydration needs were met.

People were supported to maintain good health and had access to healthcare professionals and services. People had access to out of hour’s medical care. People were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments.

There were positive interactions between people and staff. We saw that staff treated people with dignity and respect. Staff were attentive and interacted well with people. Observation of the staff showed that they knew the people very well and could anticipate their needs. People told us that they were happy and felt very well cared for.

People’s independence was encouraged. Activities, outings and social occasions were organised for people who used the service.

The registered provider had a system in place for responding to people’s concerns and complaints. People and relatives told us they knew how to complain and felt confident that staff would respond and take action to support them. People did not raise any complaints or concerns about the service.

There were effective systems in place to monitor and improve the quality of the service provided. Staff told us that the home had an open, inclusive and positive culture.