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Inspection carried out on 18 January 2021

During an inspection looking at part of the service

The Whitebeach care home provides accommodation and support for up to 39 older people some of whom live with dementia. At the time of the inspection there were 29 people living at the home.

We found the following examples of good practice.

There had been an outbreak of covid-19 at the home and people had been supported to isolate in their bedrooms. At the time of our inspection the home had finished its isolation period but had not yet opened to visitors.

The registered manager told us that some residents were not able to fully understand the need for isolation but they were supported by staff. One to one support was provided, with time spent reassuring people and explaining the need for having to remain in their bedrooms. Loved ones were able to support their relatives using iPads to video call.

The service was regularly deep cleaned and items such as plastic toilet seats were regularly replaced. External training had been provided to all staff and specialist training had been provided to the cleaning staff and night staff who also had daily cleaning responsibilities. Following isolation, the service slowly opened its communal areas whilst maintaining social distancing. For example, just four people could use the dining area at any one time.

The service had zoned areas during the outbreak and staff and residents remained in their particular part of the building. Staff had separate entrances to help facilitate this. Visitors to the service passed through a closed reception area where they had temperatures taken and were required to don full personal protective equipment (PPE). There were PPE stations throughout the service.

Staff were wearing PPE in line with government guidelines. There were two main PPE storerooms and staff had been given zip-up bags to carry a daily supply. Pedal bins were in place throughout the service to dispose of used PPE safely.

Inspection carried out on 6 September 2018

During a routine inspection

This inspection was carried out on 6 and 12 September and was unannounced. The Whitebeach is a residential care home for up to 39 people with a diagnosis of dementia or needs related to older age. There were 33 people living in the home at the time of our inspection.

At our last inspection we rated the service good overall but requires improvement in safe. This was because people were not always supported to move safely and accidents and incidents were not always fully investigated. At this inspection we found the registered manager had taken the right action to make sure people were safe and the evidence continued to support the overall rating of good in all areas. 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.

People were protected from harm and abuse and staff knew what to do if they thought someone was a risk. The home was clean, and people were protected from the risks of poor infection control. There were enough experienced and suitable staff to support people to stay safe and to meet people’s identified needs and preferences. Staff reported incidents and accidents properly, and if these did occur, the registered manager made sure they were properly investigated. Risk assessment and risk management practices were robust.

People were supported to eat and drink enough. Food was nutritious and well prepared, and people gave us positive feedback about the quality of the food. People could access the healthcare they needed to remain well, such as the GP or district nurse, and their medicines were managed safely.

People were able to express their choices and preferences and these were respected and promoted by staff. People led the lives they wanted to and staff supported people to go out or join in activities in the home in the least restrictive way possible. People maintained contact with those people that were important to them, such as family members or friends.

People experienced compassionate care that met their needs, and were supported by kind, caring staff. People had their privacy and dignity respected, and staff knew what to do to make sure people’s independence was promoted. Staff were supported with training, supervision and appraisals to help them develop the skills they needed to provide good quality care. People experienced person centred care and were supported to make their end of life care wishes known.

People were involved in their care reviews and had their care needs regularly assessed. The building and environment was suitable to meet the needs and preferences of the people who lived there and there was programme of re-decoration in progress.

People were asked for their consent before any care was given, and staff made sure they always acted in people’s best interests. 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.

There was a complaints process and people they would be happy to raise a complaint if they ever needed to. There had been no recent formal complaints, but the registered manager and staff knew what action to take if a complaint was made.

The registered manager was well regarded and passionate about providing good quality care for people. Staff felt supported and people’s views were asked for and acted on to improve the service. Regular checks and audits were carried out to make sure people experienced good quality care and staff provided good support.

Inspection carried out on 18 and 21 December 2015

During a routine inspection

We carried out an unannounced focused inspection at The Whitebeach on the 30 July 2014.

A breach of Regulation was found. As this inspection on the 18 and 21 December 2015 we followed up on whether the required actions had been taken to address the previous breach identified. We found improvements had been made and the breach of Regulation met.

The Whitebeach is a care home situated in St Leonards on Sea and provides personal care and support for up to 39 older people with a dementia type illness. The service also provides day care for people in the community. Care and support was provided to people living with dementia, diabetes, mental health needs, sensory impairment and long term healthcare needs.

Accommodation was provided over three floors with passenger lifts connecting all floors. The property is a detached Victorian building with gardens at the back for people to access. The home is centrally located in St Leonards on Sea with good public transport links to the town centre, which enabled people to go out and about independently. People spoke highly of the home. One person told us, “It’s a really good place where you can have a laugh.”

At this inspection there were 29 people living at the home on the days of our inspections.

At the inspection in July 2014 people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

After our inspection of July 2014, the provider wrote to us to say what they would do to meet legalrequirements in relation to medicine management.

We undertook this unannounced inspection to check that they had followed their plan and to confirm that they now met legal requirements. We found significant improvements had been made and they had met the breach in the regulations. However we found some areas that required improvements to ensure that risks to peoples safety were mitigated.

Whilst risks to people’s safety were assessed, managed and reviewed. Moving and handling risk assessments considered people’s physical and mental condition, mobility and comprehension of instruction. However further guidance was needed if normal moving and handling techniques were not safe.

The manager had introduced an accident and incident analysis, however these were not fully analysed and cross referenced in to peoples care plans to prevent a reoccurrence.

Medicines were now managed safely in accordance with current regulations and guidance by staff who had received appropriate training to help ensure safe practice. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

There was a manager was in post, who has submitted their application to the CQC to be registered as manager within the organisation. 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 and associated Regulations about how the service is run.

Robust systems were in place to analyse, monitor or review the quality of the service provided. Formal feedback was obtained from people and their relatives. The provider was completing formal audits and there were mechanisms to assess the standards of care. Staffing levels were sufficient, and additional staff were used when required to accompany staff to appointments or social events.

Safe recruitment procedures were followed and appropriate pre-employment checks had been made including evidence of identity and satisfactory written references. Appropriate checks were also undertaken to ensure new staff were safe to work within the care sector.

People received care and support from dedicated staff who were appropriately trained, confident and highly motivated to meet their individual needs. They were able to access health, social and medical care, as required.

With compassion and pride, the management team and staff spoke about people, their likes, dislikes, personality and life history. It was clear staff had spent time getting to know people and delivering care in line with people’s needs. People looked at ease in the company of staff. Staff spent time chatting with people and laughter was heard throughout the inspection.

People’s needs were assessed and their care plans provided staff with clear guidance about how they wanted their individual needs met. Care plans were extremely person centred and contained appropriate risk assessments. They were regularly reviewed and amended as necessary to ensure they reflected people’s changing support needs.

There were systems in place to protect people from abuse and harm. Staff had a clear knowledge of how to protect people and understood their responsibilities for reporting any incidents, accidents or issues of concern.

People’s nutritional needs were assessed and records were accurately maintained to ensure people were protected from risks associated with eating and drinking. Where risks to people had been identified, these had been appropriately monitored and referrals made to relevant professionals, where necessary.

There was a friendly, relaxed atmosphere at the home. There was an open and honest culture within the home. Staff had a clear understanding of the vision and philosophy of the home. Staff spoke passionately about how The Whitebeach was run as a family home with family values embedded into practice.

Inspection carried out on 30 July 2014

During an inspection in response to concerns

Our inspection team was made up of one adult social care inspector and a CQC pharmacy inspector. We visited this service as we had received some concerning information regarding the safety of medicine management. The inspector gathered evidence to answer the question, Is the service safe?

On this inspection we looked at the arrangements in place for the management of medicines and only assessed whether the service was safe in this regard.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with the staff and from looking at records. If you want to see the evidence supporting our summary please read our full report.

We found that the provider did not have appropriate arrangements in place to manage medicines in relation to controlled drugs.

Inspection carried out on 17 June 2014

During a routine inspection

A single adult social care inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People told us that they felt safe in the care of The Whitebeach. People were safeguarded from the risk of abuse or harm. Staff demonstrated a sound understanding of safeguarding vulnerable adults and knew how to report any concerns of abuse or harm.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards. We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).

Systems were in place for staff to learn from incidents, accidents and near misses. People had been cared for in an environment that was safe and well-maintained. Equipment at the home had been well maintained and serviced regularly. There were enough staff on duty with the appropriate skills and experience to meet the needs of the people living at the home. There were arrangements for senior staff including the manager to be on call out of hours. This was to provide support for staff in case of emergencies.

Is the service effective?

People told us that they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people�s care and support needs and that they knew them well. One person told us "The staff help me with being more independent.� Staff had received specific training to meet the needs of the people living at the home.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers were patient and gave encouragement when supporting people. People told us they were able to do things at their own pace and were not rushed. Our observations confirmed this. One person told us, �The staff are lovely, I can talk to them at any time.� Another person told us "The staff look after me very well.�

Is the service responsive?

People�s needs had been assessed before they moved into the home. Staff told us that they discussed any changes to do with care delivery with the person and their family or care giver regularly. We were also told that regular handovers and meetings were held that highlighted any concerns or issues. Records seen confirmed people�s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided that met their wishes. People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives. One person told us, �We have trips out regularly, I hate being indoors all the time.� This person�s care plan and activities showed that they went out nearly every day on a bus trip or shopping.

Is the service well-led?

Staff had a good understanding of the ethos of the home and quality assurance processes were in place though not fully implemented as the home had only opened in October 2013. The people who used the service and visitors confirmed they felt listened to and as a result changes had been made to their satisfaction. Staff told us they were clear about their roles and responsibilities. They said the management had consulted with them before implementing changes to the management of the home and their views had been taken into consideration.