Whitegates Care Centre Limited

Updated 4 May 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 2 inspectors and a specialist nursing advisor.

Service and service type

Whitegates Care Centre Limited 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. Whitegates Care Centre Limited is a care home with 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

The inspection was unannounced.

Before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return in February 2023. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people who lived at the home and 3 visiting relatives. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with the registered manager, the deputy manager, the provider’s regional manager, 2 nurses, 2 team leaders, 3 care assistants and the activities co-ordinator.

We looked at care records for 7 people, including their assessments, care plans and risk assessments. We checked records of accidents and incidents, 4 staff recruitment files, quality checks and audits, and the arrangements for managing medicines.

Updated 4 May 2023

Whitegates Care Centre Limited is a care home with nursing for a maximum of 51 people, including people with physical disability, sensory impairment, and people living with dementia. There were 50 people living at the home at the time of our inspection.

People’s experience of using this service:

Where risks had been identified to people’s health and wellbeing, measures had not always been implemented to mitigate these. For example, pressure-relieving mattresses designed to reduce the risk of people developing pressure ulcers were not always set correctly. People’s medicines were not always managed safely.

Governance systems were not always effective in identifying shortfalls. For example, medicines audits had not identified the concerns we found in relation to medicines management. Guidance for staff about the care people needed and records of the care people received were held on a number of different systems, which meant we could not be assured people were receiving safe and effective care. Some guidelines about people’s care was inconsistent or lacking in clarity, which meant we could not be sure people were being supported in a consistent way.

The provider had an arrangement with the local health trust to admit people being discharged from hospital when they were fit for discharge. This was called the Discharge to Assess scheme. People were admitted to the home with the aim of having a short stay before returning to their own homes or moving to another care setting. The hospital had a responsibility to provide information to the home about people’s needs and the care they required before they were discharged.

Managing admissions under the scheme presented challenges for the home, as information provided by the hospital was sometimes inaccurate or insufficient for staff to plan their care. Additional challenges were presented by poor communication from the hospital, frequent changes of plan, and people being discharged to the home without the correct medicines. The provider recognised the pressure this placed on the home and had scheduled a meeting with the hospital and the local authority to discuss their concerns and ways in which the scheme could be coordinated safely and effectively.

There were enough staff on duty to meet people’s needs. Staff were recruited safely and understood their role in safeguarding people from abuse. The home was clean and hygienic, and people were protected from the risk of infection.

People who lived at the home and their relatives had opportunities to give their views and these were acted upon. Relatives told us communication with them from the home was good. Staff received good support from the management team and worked well together as a team.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; 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

The last rating for this service was good (published 7 July 2021).

Why we inspected

We received safeguarding concerns in relation to the quality of information held about people needs and the care they required and the potential impact of this on people’s care. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

We shared feedback about our findings with the provider at the end of our inspection. The following day, the provider sent us details of how they planned to address the shortfalls we had identified.

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

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.