Archived: Croham Place

We found the following examples of good practice:

The provider had a robust system in place to ensure that visitors and external staff entering the premises had their vaccination status and lateral flow tests (LFT) checked. For those visiting who were unable to obtain and complete an LFT before entering, there was a designated toilet just inside the entrance which was dedicated to visitors being able to complete their testing here. We saw evidence of a substantive supply of LFTs available for such use. In addition, face masks and alcohol gel was in plentiful supply by the entrance and temperatures of anyone visiting were checked and recorded by a staff member.

The provider had implemented appropriate social distancing in all communal areas across the three units. For example, the dining areas and living rooms had appropriately spaced chairs to ensure a distance of 1-2 metres between residents could be maintained.

The provider had an admissions process in place. Whilst only one resident had been admitted during the COVID-19 pandemic, we were assured that a negative polymerase chain reaction (PCR) test and LFT were checked prior to admitting this resident from secondary care. The isolation period in this instance was not relevant as the resident was nursed in bed; however, the manager advised any positive result would indicate a seven day isolation period and would require a negative LFT result after this time prior to leaving their room.

Our observations during the inspection confirmed staff were adhering to personal protective equipment (PPE) and social distancing guidance.

The provider had ensured staff who were more vulnerable to COVID-19 had been assessed and plans were in place to minimise the risk to their health and wellbeing.

Croham Place is a care home registered to provide personal care and nursing for up to 28 adults who have a range of complex needs. The service is divided into three separate units. The largest is The Manor which is a home for 14 physically disabled adults with complex care needs requiring nursing intervention. The Beeches is a house for 12 men with acquired brain injuries (ABI) and behaviours that may challenge others. The Nightingales is currently closed and is being rebuilt to accommodate nine people. The proposed date for it to re-open is September 2019.

Relatives told us they felt their family members were safe living at Croham Place. Staff knew how to protect people if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing had been assessed and staff knew how to minimise and manage identified hazards to help keep people safe from harm or injury.

Appropriate staff recruitment processes helped to ensure people were protected. We saw there were enough properly trained and well supported staff to meet people’s needs.

People received their medicines as prescribed and staff knew how to manage medicines safely.

Relatives and social care professionals told us people received effective care. Staff had access to a wide range of training and they were supported with regular and structured supervision.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). DoLS provides a process to make sure people are only deprived of their liberty in a safe and correct way. There were policies in place in relation to this and the service had ensured the local authorities had carried out the appropriate assessments for people who might have been deprived of their liberty. Staff supported people to make choices and decisions about their care wherever they had the capacity to do so.

People were supported to have a varied and balanced diet and food that they enjoyed and they were enabled to eat and drink well and stay healthy.

Staff supported people to keep healthy and well through regular monitoring of their health and wellbeing.

Relatives and social care professionals told us staff were kind and caring. We saw staff treated people with dignity, respect and compassion. Staff understood people’s needs and helped them to express their views and wishes where ever possible.

People were encouraged to maintain relationships that were important to them. Relatives said they were made to feel welcome when they visited the home.

Care plans were in place which reflected people’s specific needs and their individual choices. Relatives of people were involved in reviewing their relations’ care plans and we saw people were supported to make decisions about their care and support.

People had access to their local community and could choose to participate in a variety of in-house and community based social activities. We also saw staff encouraged and supported people to be as independent as they could and wanted to be.

People using the service and their relatives were encouraged to give feedback on the service and there was an effective complaints system in place.

Relatives said the registered manager encouraged feedback and sought to develop and improve the service for people. Staff told us they felt well supported and enjoyed working in a positive environment.

Staff told us they were clear about their roles and responsibilities and they had a good understanding of the ethos of the service.

Systems were in place to monitor the safety and quality of the service and to get the views of people about the quality of the service. These auditing processes helped to make improvements were necessary.

Further information is in the detailed findings below

At our previous inspection in June 2016, we found a breach of legal requirements because the provider did not have appropriate arrangements in place to ensure people were protected from the risk of abuse. The provider sent us a report stating what they would do to meet legal requirements in relation to the breach.

Our inspection on 22 February 2017 was carried out to check the provider was now meeting the legal requirements. This report only covers our findings in relation to this topic. You can read the full report from our last comprehensive inspection, by selecting the 'All reports' link for Croham Place on the Care Quality Commission (CQC) website.

Croham Place is a home which is registered to provide nursing and personal care for adults who have a range of complex needs. The service is divided into three separate units. The largest is the Manor which is home to 13 physically disabled adults with complex needs requiring nursing intervention. The Beeches is a house for eleven men with acquired brain injuries (ABI) and behaviours that may challenge others. The Nightingales is a bungalow shared by two people with autistic spectrum disorders. At the time of our inspection there were 26 people living in the home.

The service had a registered manager. 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 a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our inspection on 22 February 2017, we found the provider had made the required improvements and the legal requirements were met. The provider had appropriate arrangements in place to help ensure people were protected from abuse. The bank and agency staff we spoke with understood their responsibility to protect people from abuse and had good knowledge of how to do so.

Croham Place is a care home that is registered to provide personal care and nursing for up to 23 adults who have a range of complex needs. The service is divided into three separate units. The largest is The Manor which is a home for 14 physically disabled adults with complex care needs requiring nursing intervention. The Beeches is a house for seven men with acquired brain injuries (ABI) and behaviours that may challenge others. The Nightingales is a bungalow shared by two people with autistic spectrum disorders (ASD).

At our inspection in May 2015, we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to how the provider supported staff, met people’s needs and managed the service. We asked the provider to tell us how and when they would make the required improvements. These actions have now been completed.

During this inspection we found that the provider was meeting the regulations in relation to how it supported staff, met people’s needs and managed the service.

The service 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 (Regulated Activities) Regulations 2014 about how the service is run.

People were cared for by a sufficient number of staff. However, there was a shortage of permanent employed staff so the provider used agency staff to fill the gaps in staffing. The agency staff did not have the required knowledge to help keep people safe.

People told us they were safe. This was also the view of their relatives. People were protected from avoidable harm. Staff were supported by the provider to deliver effective care through relevant training, supervision and appraisal.

People received their medicines safely because there were appropriate procedures in place for ordering, storing, administering and recording medicines which were consistently followed by suitably qualified staff.

People received the help they needed to maintain good health and had access to a variety of healthcare professionals. Employed staff understood the relevant requirements of the Mental Capacity Act 2005 and how it applied to people in their care.

People were protected from the risk and spread of infection because staff understood their responsibilities in relation to infection control and followed the procedures in place. All areas of the home were clean and well maintained. The premises were of a suitable layout and design for the people living there. Equipment was regularly service and well maintained.

People were satisfied with the quality and quantity of food they received. People were treated with respect, compassion and kindness by staff. They were involved in making decisions about their care and where appropriate, their relatives were also involved.

People were encouraged and supported to be as independent as they wanted to be. People had the opportunity to participate in activities within the home and were supported to access the community.

People knew how to make a complaint and felt able to do so if the need arose. People were willing to express their views on the care they received and had their comments listened to and acted on.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to there being a lack of staff knowledge on how to protect people from the risk of abuse.

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

During this follow up inspection we spoke with eight people who used the service, a visiting relative, the newly registered manager, a team leader, six care workers and the maintenance person. People who lived at Croham Place and a visiting relative told us that overall they were satisfied with the care and support provided at the care home. For example, people said most of the staff that worked at the home were kind and caring. One person told us 'the staff teat me well here. Another person said 'the staff are very kind and patient and they treat my relative extremely well. I'm very happy with care home; it's one of the best I've seen, and don't want to see my relative moved again'. We saw the way most staff interacted with the people who used the service was characterised by warmth, kindness and respect.

We found evidence that indicated the provider had taken appropriate action to improve the opportunities people had to develop their independent living skills as well as engage in meaningful activities in the wider community.

However, although people told us they were happy and we saw they were well supported by staff; we found that failures by the provider to promote independence meant people who lived at Croham Place may not have sufficient opportunities to maintain their independent living skills, as well as learn new ones. We also found people's social needs and wishes were not being fully met. This was because people were not always given enough appropriate opportunities and support to participate in meaningful activities both at home and within their local community. The provider may also wish to note that mealtimes could be made a more positive experience for all concerned.