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The Whitecroft Requires improvement

Reports


Inspection carried out on 18 February 2019

During a routine inspection

About the service:

• The Whitecroft is a residential care home that was providing personal care to 48 people aged 65 and over, some who were living with dementia.

People’s experience of using this service:

• People at risk of choking were not always monitored in accordance with their risk assessment which put them at risk of unsafe care.

• Kitchen staff were not aware who was at risk of choking as there was an incorrect list in the kitchen area.

• Staff were stretched during busy times and this impacted on people care especially during mealtimes.

• People who needed support in their rooms were waiting slightly longer after pressing call bells during mealtimes. People who needed support during mealtimes were not receiving this.

• Quality audits were present to drive improvement and to monitor quality within the service. However, care plan audits were not identifying people were not always receiving safe care in relation to choking risks.

• People told us staff were kind towards them and we observed mainly positive interactions between people and staff. Where a poor interaction was observed this was raised directly with management.

• People’ medicines were managed safely at the service and staff had completed training.

• The home, including people’s bedrooms, was clean. Systems were in place to minimise the risk of spread of infection.

• Staff were supported to have the skills to do their job and received regular training, supervision and appraisals.

• People were supported to have good outcomes in relation to their healthcare and the service worked well with health professionals to support this.

• People at risk of pressure wounds were monitored well by staff.

• People’s privacy and dignity was respected as were people’s individual needs. Staff at the service were non- discriminatory.

• Activities took place at the service but required more structure and resource so that everyone at the service could participate if they were unable to leave their room.

• Care was personalised and regularly reviewed. People were involved in this process along with their family or advocate to provide support.

• We made three recommendations around health and safety for evacuation procedures, frequency of controlled drugs audits and training in compassionate care.

Enforcement:

• We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around , safe care and treatment and support during mealtimes.

Details of action we have asked the provider to take can be found at the end of this report.

Rating at last inspection:

• Good - last report published 2 July 2016.

Why we inspected:

• This was a planned inspection to check if the service was meeting the legal requirements.

Follow up:

• We will continue to monitor the service and ask for an action plan asking how they will immediately begin to improve.

Inspection carried out on 15 June 2016

During a routine inspection

The inspection took place on the 15 and 21 June 2016 and was unannounced.

The Whitecroft is registered to provide accommodation and care for up to 56 people some of whom may be living with dementia. There were 51 people living at the service at the time of our inspection. The home does not provide nursing care.

A registered manager was 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. The registered manager was supported by a deputy manager to ensure the daily management of the service.

People told us the service was a safe place to live. People were supported by staff who could explain what constitutes abuse and what to do if they suspected abuse. The registered provider’s recruitment procedures ensured that only suitable staff were employed. Staff had the skills and experience needed to provide effective care and there were enough staff to help keep people safe and meet their needs. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed. Medication was managed and administered safely and people received their medicines as prescribed.

Assessments of people’s capacity were carried out in line with the Mental Capacity Act 2005 (MCA). Staff understood and complied with the requirements of the MCA and the associated Deprivation of Liberty Safeguards (DoLS).

Staff knew people very well and understood how to meet their care and support needs. People and, where appropriate, their families were fully involved in the planning and review of their care; care plans were person centred and were regularly reviewed. Staff promoted people’s independence and encouraged people to do as much as possible for themselves.

Staff were kind and caring and treated people with respect and dignity. Feedback from people and their relatives about all aspects of the service was positive. People’s nutritional needs were assessed and met and people were supported to maintain a healthy and balanced diet. People were supported to access health and social care professionals and services when needed.

People living and working in the service had the opportunity to say how they felt about the service provided and their views were listened to. There was an effective system in place to respond to complaints and concerns.

There were effective systems in place to regularly assess and monitor the quality of the service. The registered manager was able to demonstrate how they measured and analysed the care and support provided to people to ensure the service was operating safely and was continually improving to meet people’s needs.

Inspection carried out on 22 October 2013

During a routine inspection

People told us that they were happy with the care and support provided at The Whitecroft. People felt that the service was responsive to their needs and caring. People said, "I am very happy here, the staff help you, the food is good and there is plenty of choice," and, "This is the best home I have been in. They are such wonderful people here."

We saw that people's care needs were assessed and planned for with any risks associated with their care being minimised as far as possible. The service was caring and responsive to people's changing needs. Staff sought support from other professionals or agencies when needed. Staff had a good knowledge of people's individual needs and offered them appropriate support. People had opportunities for activity and occupation.

People told us that they enjoyed the food provided at The Whitecroft. We found that people's nutritional needs were assessed and monitored to ensure their on-going wellbeing.

The service was kept clean and provided a hygienic place for people to live.

Staff were supported to be effective in their role through good levels of training and on-going supervision.

People told us that any concerns they had were listened to and acted on. We found that any complaints made were investigated and responded to.

Overall we found The Whitecroft to be an effective and well led service.

Inspection carried out on 14 December 2012

During a routine inspection

The majority of people who were using the service were living with some degree of age or dementia related memory loss, and as such were unable to tell us fully about some of their experiences of living at The Whitecroft. We spoke with relatives of people who were using the service and we observed how people were treated, cared for and supported by staff during our visit.

People told us that they were happy and well cared for. During our visit we saw that staff treated people with respect and maintained their dignity when assisting and supporting people for their personal care needs.

People told us that they felt safe living at the Whitecroft and that staff treated them kindly. Staff we spoke with were aware of their responsibilities to safeguard vulnerable people from abuse or harm.

People told us that staff looked after them well. Staff we spoke with had a good understanding of people's health care needs and the treatment including medicines that people received. During our visit we saw that staff were available to assist, support and supervise people so as to ensure that they received the care they needed and that risks to their safety were minimised.

There were enough suitably qualified and skilled staff available to meet the needs of people who were using the service.

There were suitable systems in place to effectively monitor and improve the quality of services provided by the home.