Whitfield

Whitfield is a residential care home providing personal care for up to 30 older people who may be living with dementia in one large adapted building. At the time of our inspection there were 27 people using the service.

People’s experience of using this service and what we found

People told us they felt safe living at the service. Relatives were confident staff knew their loved ones well and supported them in the way they preferred.

Potential risks to people’s health and welfare had been assessed and there was guidance in place for staff to mitigate the risks. Accidents and incidents were analysed to identify patterns and trends, actions taken had been effective in reducing the risk of them happening again.

Staff had been recruited safely, there were enough staff to support people in the way they preferred. Staff had received training appropriate to their role. People received their medicines as prescribed.

Checks and audits had been effective in identifying shortfalls and the action taken had been effective. People had been involved in making changes in the service and were supported to have visitors. The environment had been adapted to meet people’s needs.

People were supported to eat and drink to maintain a balanced diet and hydration. People’s needs were assessed and when their needs changed, they were referred to healthcare professionals for guidance.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 31 December 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 18 November 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Whitfield on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Whitfield is a residential care home providing personal care to 24 older people who were living with dementia at the time of the inspection. The service can support up to 30 people in one large adapted building.

People’s experience of using this service and what we found

People appeared to be happy living at the service. People appeared relaxed and comfortable with staff and each other.

The provider and registered manager had completed checks and audits on the quality of the service. These had been effective at identifying shortfalls. However, the actions taken, and the improvements made had not been clearly recorded. Records to show how people had been engaged and how staff were supported had not been consistently clear or accurate.

Potential risks to people’s health, welfare and safety had been assessed and there was clear guidance for staff to reduce the risk. Accidents and incidents had been recorded and analysed, but records were not clear what action had been taken and if it had been effective.

Staff had been recruited safely and there was enough staff to meet people’s needs. Staff received training appropriate to their role. However, they had not received regular supervision to discuss their practice and development.

People received their medicines as prescribed. Staff monitored people’s health and referred them to healthcare professionals when required. Staff followed guidance to keep people as healthy as possible.

People were supported to eat a balanced diet. People had access to activities they enjoyed and kept themselves as active as possible.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Each person had a care plan that contained details of their choices and preferences. People met with staff before moving into the service to check staff would be able to meet their needs. People were treated with dignity and respect. People’s end of life wishes had been recorded. Staff worked with the GP and district nurse to support people at the end of their lives.

Complaints had been recorded and investigated following the provider’s policy. The environment had been developed to support people living with dementia following good practice guidance. People were given information in a way they can understand.

The registered manager attended local forums to keep up to date with developments to understand how to continue improvements within the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 23 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the governance of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Whitfield is a care home registered to provide accommodation and personal care for up to 30 older people living with dementia. Accommodation is set over two floors. There is a lift to assist people to get to the first floor. Bedrooms are on both the ground and first floor and there are separate communal areas. It is located in the village of Whitfield and set back from the main road that runs through the village. At the time of inspection there were 25 people living in the service.

The service had a registered manager in post. 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.

This is the first inspection of this service, under its new registration.

Staff knew how to recognise and respond to abuse. The registered manager was aware of their responsibilities regarding safeguarding people and staff were confident the registered manager would act if any concerns were reported to them.

Staff completed incident forms when any accident or incident occurred. The registered manager analysed these for any trends to see if any adjustment was needed to people’s support. Risks relating to people’s health and mobility had been assessed and minimised when possible. Regular health and safety checks were undertaken to ensure the environment was safe and equipment worked as required. Regular fire drills were completed.

There was enough staff to keep people safe. Staff were checked before they started working with people to ensure they were of good character and had the necessary skills and experience to support people effectively.

Staff had the induction and training needed to carry out their roles. They had received training relating to people’s specific needs. Staff met regularly with the registered manager to discuss their training and development needs.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. DoLS applications had been made to the relevant supervisory body in line with guidance.

People were supported to eat and drink healthily. Staff had sought advice and guidance from a variety of healthcare professionals to ensure people received the best care possible. People’s medicines were managed safely.

People and their relatives said that staff were kind and caring. Staff knew people well and their likes and dislikes formed part of their care. People were treated with dignity and respect.

Staff were responsive to people’s needs. Detailed assessments were carried out before people moved into the service and care plans were reviewed regularly by the registered manager.

People took part in a variety of activities within the service. People and their relatives told us musicians and entertainers regularly visited the service to perform and, “There was always something going on.” There was a complaints policy in place and people and their relatives told us they knew how to complain if they needed.

Staff and relatives told us they thought the service was well-led. Staff told us they were well supported by the registered manager and there was an open and inclusive ethos within the service. The registered manager told us, “This is not a work place, it is people’s home. We put our heart and soul into ensuring people have the best time here, whilst they are with us.”

The registered manager was experienced in working with older people and providing person centred care. CQC had been informed of any important events that occurred at the service, in line with current legislation.

The registered manager regularly carried out audits to identify any shortfalls and ensure consistent, high quality, personalised care. People’s relatives, staff and other stakeholders were regularly surveyed to gain their thoughts on the service. These were collated and analysed and action was taken when necessary.