Archived: Croftside

Updated 12 November 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 1 September 2015 and was unannounced. The inspection was carried out by two adult social care inspectors.

As part of the inspection we also looked at six care records and care plans relating to the use and storage of medicines. We looked at their individual care records and risk assessments to help us see how their care was being planned with them and delivered by the staff. We also looked at the staff rotas for the previous two months, staff training and supervision and recruitment records. We also looked at records relating to the maintenance and the management of the service and regarding how quality was being monitored within the home.

During the inspection we spoke with 10 people who lived in the home, five care staff, a member of domestic staff, the two supervisors on duty, the registered manager and the home’s operations manager. We also spoke with two visiting relatives and a GP. We observed care and support and staff interactions in communal areas and at breakfast and lunch time.

Before our inspection we reviewed the information we held about the service. We looked at the information we held about notifications sent to us about accidents and incidents affecting the service and the people living there. We looked at the information we held on safeguarding referrals, concerns raised with us and applications the manager had made under Deprivation of Liberty Safeguards (DoLS).

We had not received a Provider Information Return (PIR) from the registered manager. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We are aware of the reason why it was not done.

Updated 12 November 2015

This unannounced inspection took place on 1 September 2015. We last inspected Croftside in December 2013. At that inspection we found the service was meeting all the six regulations that we assessed.

Croftside is a residential home located in the village of Milnthorpe and is close to all the local amenities and services. The home has three units, the one on the ground floor provides care and support for people living with dementia. The home provides accommodation on two floors for up to 34 people. The first floor is accessible by a passenger lift and all the bedrooms are for single occupancy. At the time of our visit there were 33 people living in the home.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

We found at this inspection that there was a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because there were not sufficient numbers of support staff at night time to meet the assessed needs of people living in the home and in emergency situations.

There was a breach of Regulation 13 of the Health and Social Care Act 2008(Regulated Activities) Regulations 2014. This was because the registered provider had not made sure that suspected or alleged abuse had been acted upon quickly and in line with local safeguarding arrangements to keep people safe.

There was a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the assessments of people’s care, treatment and support needs were not always in place, planned in detail and reviewed to support person centred care and did not always show how some risks were to be managed.

The Care Quality Commission (Registration) Regulations 2009 require that the registered provider notifies the Commission without delay of allegations of abuse and accidents or incidents that had involved injury to people who used this service. This is so that CQC can monitor services responses to help make sure appropriate action is taken and also to carry out our regulatory responsibilities. The sample of people’s records that we looked at showed examples of incidents and accidents that had occurred that should have been reported to CQC.Our systems showed that we had not received these notifications. The failure to notify us of matters of concern as outlined in the registration regulations is a breach of the provider's condition of registration and this matter is being dealt with outside of the inspection process.

You can see what action we told the provider to take at the back of the full version of the report.

We spoke with people who lived at Croftside and they made positive comments about their home and told us they felt it was a safe place to live. They told us that staff were “kind” and “helpful” and helped them to do things for themselves. People living there told us that care staff respected their privacy and treated them with respect. We saw that the staff on duty approached people in a friendly and respectful way and everyone we spoke with told us that they felt safe living at the home.

We spent time with people on all the units. We saw that the staff offered people assistance and took the time to speak with people and take up the opportunities they had to interact with them and offer reassurance if needed.

They service had safe systems for the recruitment of staff to make sure the staff taken on were suited to working there. On the day of the visit there were sufficient care staff available to support the people living there. We saw that care staff had received induction training and ongoing training and development and had supervision once employed.

Medicines were being safely administered and stored and we saw that accurate records were kept of medicines received and disposed of so they could be accounted for.

People knew how they could complain about the service they received and information on this was displayed in the home. People we spoke with were confident that action would be taken in response to any concerns they raised.

We have made a recommendation about obtaining information on best practice in relation to providing evidence of who holds PoA for individuals and ensuring the annual review of DNACPR forms and decisions.