Archived: The Croft

The inspection was carried out on 31 October and 1 November. It was unannounced.

The Croft is a residential care home that provides accommodation and personal care for up to four people. It specifically provides a service for older people who have a learning disability and some who are living with dementia. At the time of inspection, there were three people living at the Croft.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. The service ethos is to enable people with learning disabilities and autism to live as ordinary a life as any citizen.

The Croft had not had a registered manager since May 2017. We asked the deputy and quality manager about this and they said that there had been a manager in place but they had resigned before registering with the Care Quality Commission (CQC). The provider is currently recruiting for a replacement who will become the registered manager.

The atmosphere at the Croft was relaxed and friendly. People and staff interacted with kindness and respect. There was an inclusive, supportive and homely culture that reflected the provider’s visions and values. People living at the Croft were supported to live full and enriching lives as much as possible. Staff knew people well and had the appropriate knowledge and training to keep people safe. Positive risk taking was encouraged to ensure people could maintain skills and experience new things.

There continued to be enough staff to support people and staff continued to have the training and support to provide people with high quality care that responded and adapted to people's changing needs. Staff had a good working relationship with associated professionals, so people received care and support from professionals as and when they required it. Relatives told us that they were kept informed of changes in people's physical and emotional health.

Medicines continued to be managed safely. Daily checks ensured that if there were any shortfalls, these were quickly identified and resolved. The clean and well-maintained premises continued to meet the needs of people and staff knew how to protect people against the spread of infection.

Care continued to be steered by developments in best practice. The provider and manager attended a variety of forums and developments were discussed in team meetings and through training sessions. Support plans were person centred and thorough and were written in a way that was meaningful to people. Peoples communication needs were assessed and staff used different methods to enable people to communicate their views and choices in their own way, through discussions, reviews and resident’s meetings.

People were 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 worked with people and their relatives to ensure that support plans and support reflected their care needs. People discussed what they would like to happen if they were to pass away, and their wishes were respected.

The manager sought feedback from people using the service, staff, relatives and health professionals and an accessible complaints procedure was available. Complaints, compliments, accidents and incidents were recorded, and these were collected and analysed by both the manager and the provider to identify patterns and if lessons could be learnt. Regular checks and audits were carried out to ensure issues were identified and resolved.

People's information was kept securely in the office and staff respected people's privacy, dignity and confidentiality. The previous CQC rating of 'Good' was displayed on the provider's website and in the hallway for people to see.

Further information is in the detailed findings below.

The Croft provides accommodation and personal care for up to four people with a learning disability. It specifically provides a service for older people who have a learning disability and some who are living with dementia. At the time of the inspection there were three people living at The Croft and one vacancy. The service is a chalet bungalow with accommodation provided on two levels. It is set in the centre of Woodchurch village, with its shops, doctors’ surgery, church, garage and pubs. Each person has a single room with ensuite shower facilities and there is a communal bathroom, kitchen/ diner and lounge leading to a conservatory. There is an enclosed garden at the back of the bungalow. There is parking available at the service as well as on street parking.

The service has 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 their medicines safely and when they should. Risks were assessed and staff took steps to keep people safe whilst encouraging their independence wherever possible.

People were involved in the planning of their care and support. Care plans contained information about people’s wishes and preferences. They showed people’s skills in relation to tasks and what support they required from staff, in order that their independence was maintained. People had reviews of their care and support where they and/or their representatives were able to discuss any concerns or aspirations.

People were supported to make their own decisions and choices and these were respected by staff. Staff had received training in the Mental Capacity Act (MCA) 2005. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant. The registered manager understood this process.

People were protected by safe recruitment procedures. New staff underwent an induction programme, which included shadowing experienced staff, until staff were competent to work on their own. Staff received training relevant to their role. Staff had opportunities for one to one meetings and team meetings, to enable them to carry out their duties effectively. The majority of staff had gained qualifications in health and social care. People had their needs met by sufficient numbers of staff. Staff rotas were based on people’s needs, health appointments and activities.

People were relaxed in staff’s company and staff listened and acted on what they said or gestures and body language. People were treated with dignity and respect and their privacy was respected. Staff were kind and patient in their approach, but also used good humour. Staff had built up relationships with people and were familiar with their life stories and preferences.

People had a varied diet and could be involved in planning the menus and preparing vegetables. Staff encouraged people to eat a healthy diet. People had a varied programme of interactive and leisure activities and accessed the community as they wished.

People were supported to maintain good health and attend appointments and check-ups. Appropriate referrals were made to health professionals when required. People did not have any concerns, but felt comfortable in raising issues. Their feedback was gained both informally and formally. The registered manager and deputy manager had an open door policy and took action to address any concerns or issues straightaway to help ensure the service ran smoothly.