Archived: Crest House Care Home

People required a range of help and support in relation to living with memory loss, dementia and personal care needs.

The home is two houses which have been converted into one building with large communal rooms. The home has a passenger lift and wide staircases with handrails to assist people to access all areas of the building.

This was an unannounced inspection which took place on 17 and 18 February 2016.

Crest House had a registered manager. 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 2008 and associated regulations about how the service is run.

Risk assessments and care documentation had not been completed for all identified care needs. For example pressure area care and diabetes. When changes to people’s health and care needs had occurred this information had not been clearly updated, we saw that accidents and incidents had not been documented consistently and wound maps did not contain dates to show when injuries had occurred.

Mental capacity assessments had not been completed and information in relation to decision making for people was unclear. Training and in house procedures had not been updated to ensure that all staff were aware of current protocols and guidance around MCA and DoLS.

We found that recruitment information needed to be improved to ensure a clear picture was available to evidence that new staff had appropriate checks and training completed before they commenced work. Induction information was not completed in all staff files seen.

Medicine systems and ‘PRN’ procedures needed to be improved. Checks when people moved into the service were not robust. This meant that people may be at risk of receiving medicines in an inappropriate manner.

Robust systems were not in place to ensure the continued assessment and monitoring of systems within the home. Notifications had not been completed by the registered manager or provider in a timely manner.

The registered manager was in day to day charge of the home, supported by a deputy manager and the registered provider. People and staff spoke highly of the registered manager and provider and told us that they felt supported by them. Staff told us that the manager spent most days at the home and therefore had a good overview of the home and knew everyone living there well.

We received only positive feedback from people, staff and relatives. People felt that Crest House was homely and had a warm and open atmosphere.

Staff felt that training provided supported them to provide the best care for people. Staff were encouraged to attend further training, with a number having achieved National Vocational Qualifications (NVQ) or similar and staff were supported by a programme of regular supervision. Staff demonstrated a clear understanding on how to recognise and report abuse.

People were encouraged to remain as independent as possible and encouraged to participate in regular activities. People had their privacy and dignity respected and staff knew people and their preferences well.

Feedback was gained from people and meetings had taken place.

People gave positive feedback about the food and told us the food was ‘Very good.”. People’s nutritional needs were monitored and people had a choice of meals provided. Staff were aware of people’s likes and dislikes and we saw that meal times were a positive interactive experience for people. People who required assistance had this provided by reassuring and patient staff.

We found a number of breaches of Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what actions we told the provider to take at the back of the full version of the report.

We observed the interaction between people in the home and this was seen to be positive and constructive at all times. We saw staff asked for people's consent before they provided any care or treatment. People, who were able to, told us they were asked for their consent before any care and support was provided. They told us they were happy living at the home and with the care and support provided. One person who used the service told us, ''I can not fault the service and care in anyway.' Another said, 'I am happy with everything.'

We looked at the systems and processes that the home had in place to ensure the people who used the service were protected from abuse. These processes ensured that staff knew what constituted abuse and what to do if it was suspected.

We reviewed the recruitment practice and found the home followed a thorough recruitment process.

We looked at the systems and processes the home had in place to respond to complaints. These processes ensured complaints could be raised and resolved to people's satisfaction.