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We are carrying out a review of quality at Croxley House. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Inadequate

Updated 3 February 2021

About the service

Croxley House is a residential care home providing personal and nursing care to 22 people at the time of the inspection. The service can support up to 33 people.

Croxley House consisted of two floors. The ground floor had living facilities which included staff office space, the kitchen, dining rooms, living rooms and people's individual bedrooms, all of which had a toilet attached. The second floor was made up of all bedrooms.

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

People were at significant risk of harm in relation to poor manual handling and support with meeting nutritional needs. Risk assessments and care plans did not identify people’s up to date support needs and staff were inconsistent with their knowledge of what support people needed.

Where safeguarding risks had been identified in the past, the registered manager and staff team had not learnt from this and implemented changes to protect people.

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 and in their best interests; the policies and systems in the service did not support this practice

The staff did not have adequate training and knowledge of processes. For example, in the event of a fire staff could not confidently tell us what they would do. The service did not have a dedicated person responsible for this.

Records showed there was a risk of people not being supported at night in the event of an emergency. Night spot checks had not been carried out by the management team.

Overall, the service had processes in place for infection prevention control. Although we observed some staff in the home not wearing the correct Personal Protective Equipment (PPE).

The registered manager did not lead effectively, and this put people at risk of harm. Quality audits completed were not robust and did not find areas where significant improvement was needed.

Relatives we spoke with were happy with the overall support their family member was receiving.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 26 April 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

We received concerns in relation to staff training, meeting nutritional needs and governance. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led.

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 requires improvement to inadequate. This is based on the findings at this inspection.

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 coronavirus and other infection outbreaks effectively.

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

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to unsafe moving and handling, risk to people whilst eating and drinking, lack of staff training and governance practices at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found

Inspection areas

Safe

Inadequate

Updated 3 February 2021

The service was not safe.

Details are in our safe findings below.

Effective

Inadequate

Updated 3 February 2021

The service was not effective.

Details are in our effective findings below.

Caring

Requires improvement

Updated 3 February 2021

Responsive

Requires improvement

Updated 3 February 2021

Well-led

Inadequate

Updated 3 February 2021

The service was not well-led.

Details are in our well-Led findings below.