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Inspection Summary


Overall summary & rating

Good

Updated 6 April 2018

Croft House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Croft House is registered to accommodate six people with learning disabilities; at the time of our inspection there were five people living in the home.

At the last inspection in November 2016 this service was rated as requires improvement. At this inspection, we found that improvements had been made and sustained and the service was rated good overall.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.

People received care from staff that knew them and were kind, compassionate and respectful. There were usually sufficient staff to provide the care and support people required.

People’s needs were assessed prior to moving to the home, care plans based on their individual needs and preferences were in place and were kept under review. Risks to people had been identified and measures put in place to mitigate any risk. However, one person had an identified risk and there was not a plan in place to give staff guidance how to reduce the risk.

Medicines were managed in line with the prescriber’s instructions. The processes in place usually ensured the administration and handling of medicines was suitable for the people who used the service. The registered manager was in the process of reviewing medicines with the GP to make sure there were clear instructions on when to give all medicines.

There were appropriate recruitment processes in place and people felt safe in the home. Staff understood their responsibilities to keep people safe from any risk or harm and knew how to respond if they had any concerns.

Systems were in place to ensure the premises was kept clean and hygienic so people were protected by the prevention and control of infection. There were arrangements in place to make sure action was taken and lessons learned when things went wrong, to improve safety across the service.

Staff were supported through regular supervisions and undertook training, which helped them to understand the needs of the people they were supporting. People and where appropriate their relatives were involved in decisions about the way in which their care and support was provided.

People’s diverse needs were met by the adaptation, design and decoration of premises.

Staff understood the need to undertake specific assessments where people lacked capacity to consent to their care and / or their day-to-day routines. However, these had not always been completed for a specific decision. Care plans included information about how the person had been supported to make their own decision.

People’s health care and nutritional needs were met and relevant health care professionals were appropriately involved in people’s care.

People were supported to take part in activities which they wanted to do, and encouraged to participate in events within the local community. Care plans were focused on the person and their wishes and preferences

People were cared for by staff who were respectful of their dignity and who demonstrated an understanding of each person’s needs. Relatives spoke positively about the care their relative received and felt that they could approach management and staff to discuss any issues or concerns they had.

There were comprehensive systems in place to monitor the quality and standard of the home. Regular audits were undertaken and any shortfalls addressed. Concerns we had identified about the registered manager having time to work on improvements at our previ

Inspection areas

Safe

Requires improvement

Updated 6 April 2018

The service was not consistently safe.

The staff team kept people safe from avoidable harm. The premises were kept clean and hygienic to reduce the risk of infection.

Risks associated with people's care and support were minimised because risk assessments had been completed and were followed by staff. However, these were still being developed for some areas where people may be at risk.

Appropriate recruitment processes were in place and suitable numbers of staff were usually deployed to meet people's needs. Staff were being recruited to ensure more staff were available.

People were supported with their medicines as prescribed by their GP. The registered manager was reviewing medicines with the GP to ensure that guidance on how much medicine to give was clear.

Lessons were learned and improvements were made when things went wrong.

Effective

Good

Updated 6 April 2018

The service was effective.

People's needs were assessed and met by staff who were skilled and had completed the training they needed to provide effective care.

People were encouraged to follow a balanced diet. They had access to healthcare services when they needed them.

Staff gained consent from people to provide care and understood people's right to decline their care. Capacity assessments were not always based on a specific decision.

Caring

Good

Updated 6 April 2018

The service was caring.

The staff team were kind and caring and involved people in their care and support.

People's privacy and dignity were promoted and protected by the staff team.

They were provided with support and information to make decisions and choices about how their care was provided.

Information was made available to people using their preferred method of communication.

Responsive

Good

Updated 6 April 2018

The service was responsive.

People were supported to be involved in the planning of their care. Care plans were focussed on them as an individual and included information about their wishes and preferences.

A complaints policy was in place and information readily available to raise concerns. People knew how to complain if they needed to.

Well-led

Good

Updated 6 April 2018

The service was well-led.

The registered manager had an action plan to address the areas of concern we found. Areas for improvement had been identified and work was on-going to address these.

There was clear leadership and management of the service which ensured staff received the support, knowledge and skills they needed to provide good care.

Feedback from people was used to drive improvements and develop the service.

Comprehensive audits were completed regularly at the service to review the quality of care provided.