Archived: The Croft

The Croft is a very small residential care home that provides care and accommodation for up to three older people. The home is situated in the centre of the town of Appleby. The Croft is a large detached period property set in well maintained gardens with some seating areas for people to enjoy the gardens and there is ample parking space. The accommodation is over two levels with a stair lift accessing the second floor.

There was a registered manager who is also the provider. A registered manager is a person who has registered with the (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.

The recruitment procedures demonstrated that the provider operated an effective recruitment procedure to ensure that fit and proper persons had been employed.

Medicines were being administered and recorded appropriately and were being kept safely.

There were sufficient numbers of suitable staff to meet people’s needs and promote people’s safety.

Where safeguarding concerns or incidents had occurred these had been reported by the registered manager to the appropriate authorities and we could see records of the actions taken by the home to protect people.

Staff had completed initial training that enabled them to deliver care and support safely. However some staff required elements of training to be updated to refresh their skills and knowledge.

People were supported to maintain good health and appropriate referrals to other healthcare professionals were made.

There was a clear management structure in place and staff were very happy with the level of support they received from the registered manager.

Informal audits and quality monitoring systems were used to demonstrate the safety and quality of the home.

We recommended that all staff including the registered manager refreshed and updated their skills and knowledge of some specific topics.

This is a summary of what we found-

Is the service caring?

The staff we saw were considerate, patient and friendly and took the time to ensure people living at the home had their individual needs supported in a relaxed and unhurried way.

Is the service responsive?

We looked at all of the records held about people living at The Croft. We saw that for two people living at the home since our last visit in June 2014 records had been improved. The care plans were now reflective of their individual needs and identified any risks and were informative about how to manage those risks.

Is the service safe?

For one person who had been admitted to the home for a period of respite care we did not see that any assessment of their needs had been carried out before they were offered accommodation in the home. Nor did we see records that showed how their needs had been cared for. This meant that people may not have received the correct care and support in a safe way.

Is the service effective?

Where people may not have had the capacity to make decisions about keeping themselves safe we saw that additional measures had been included in their care plan to keep them safe. The provider/manager should note that where decisions of this type are in place they must meet the requirements of current legislation, including the requirements of the Mental Capacity Act 2005.

Is the service well led?

We spoke with the provider/manager about these matters at the time of our inspection and informed them of their requirements to apply for a Deprivation of Liberties Safeguarding under the requirements of the Mental Capacity Act 2005 with regard to these types of decisions.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

This is a summary of what we found-

Is the service caring?

Everyone we spoke with told us that people were well cared for in this home. One person said, 'The staff know what support I need and are very caring'. A visitor to the home said, 'The staff are lovely, the manager, who lives at the home, is available all the time. Nothing is too much trouble. The care my relative receives is excellent. It's like living in a four star hotel. My relative is much safer here and is physically one hundred percent better. '

Is the service responsive?

We did not see that all of the records of individual care plans or assessments of any risks were in place. However the manager, who lives in the home, showed us the work being undertaken to ensure the appropriate details about how to support people safely would be recorded.

Is the service safe?

Records we looked at showed that some risk assessments had not been carried out to gather information about the risks to people's health, welfare and safety. Individual risks associated with the care and support of people using the service had not been recorded as being assessed or written into a plan of care. This meant that people using the service were not protected due to inaccurate and inappropriate records.

Is the service effective?

We did not see any formal monitoring of the quality of the service however people we spoke with including relatives told us 'nothing was too much trouble for the staff and manager '. We saw letters of thanks and praise from a number of relatives for good care that had been given to people.

Is the service well led?

The registered manager told us about all of the areas of quality assessments that took place regularly. However these were not always formally recorded. The provider might wish to note this. Recording these would support the manager to ensure that regular audits of quality monitoring took place. Due to the size of the home the quality of service provided could be closely assessed and monitored and any shortfalls identified and addressed as soon as possible.

People we spoke with told us they were "very happy" with the care provided in the home. They told us, "The staff are wonderful, they are very kind and nothing is too much trouble'. People, who were able to, were encouraged to carry out as much of their care as they could themselves and the staff helped them with tasks they could not manage on their own.

We looked around the home and found all areas were decorated and furnished to a high standard and were suitable to meet the needs of the people living in the home.

We looked at the records for the recruitment of staff and found that some staff working had not received any formal induction training or continuing training that provided people with the knowledge and skills to perform the care required.

People told us they were happy and well cared for. One person said "If something wasn't right I would tell the manager or staff".