Crest House Care Home

Updated 12 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors. One inspector visited the service and another inspector made calls to people’s relatives.

Service and service type

Crest House Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Crest House Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people that used the service and 4 people’s relatives. We spoke with 5 members of staff including the provider, registered manager, deputy manager and care staff. We looked at 3 people’s care plans and related risk assessments. We reviewed multiple medicine records and records relating to the quality of the service. We looked at 2 staff member’s recruitment documents and spent time with people and staff. We received feedback from 3 professionals that work with the service.

Updated 12 January 2023

About the service

Crest House Care Home is a residential care home providing accommodation and personal care to up to 21 people. The service provides support to older people. At the time of our inspection there were 14 people using the service.

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

Quality assurance systems were not always effective in identifying issues at the service. Improvements were needed to audits relating to the environment and medicines. The provider needed to improve oversight of quality assurance processes to ensure that risks to people could be identified and managed.

The provider and registered manager instilled a caring, person centred culture which the staff team reflected. People’s care plans were person-centred and written in partnership with people. People were supported by staff that were safely recruited and trained to meet people’s assessed needs.

People, relatives and staff told us they were given regular opportunities to give feedback on the service and felt listened to by the management team. Health professionals were positive about partnership working with staff at the home.

People and their relatives were positive about their experience of the service and the support provided by staff. One relative told us, “It’s smashing there, like a home from home. They are like extended family and [person] is well cared for. The carers are amazing people. Because it’s a small home, you get to know everyone, and they make me feel welcome too. You couldn’t ask for more.”

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. People were offered choices by staff and were empowered to make their own decisions.

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 13 December 2018).

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service sustained a serious injury. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk of the environment. This inspection examined those risks.

As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to good governance 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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.