Whitehatch

Updated 25 February 2022

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 Care Act 2014.

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 team consisted of two inspectors.

Service and service type

Whitehatch is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return. 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 reviewed information that we held about the service and used all of information to plan our inspection.

During the inspection

We spoke with three people who live at the service about their experience of the care provided. We spoke with three members of staff including the registered manager. We observed care and support, and a lunch time meal. We looked around at the environment. We reviewed documents including two care plans, management records, staff files and policies and procedures.

After the inspection –

We spoke with six relatives of people who live at the service and four members of staff. We reviewed records of staff training and a further three care plans and daily care notes. We continued to review documents, policies and audits of the service.

Updated 25 February 2022

About the service

Whitehatch provides accommodation and personal care for up to 11 people with complex physical and learning disabilities within a large detached house. At the time of the inspection, there were 11 people living at the service.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support:

The model of care did not always maximise people's choice, control and independence. Regular staff knew people well but did not always involve them where possible in decisions about their daily lives or in reviews of their care and support plan. The staff team were not consistent in their support for people and in creating opportunities for engagement and occupation.

Right care:

People were sometimes exposed to risks within the environment due to inadequate maintenance and disrepair. Staff were not knowledgeable about what action they should take to keep people safe in the event of an emergency such as fire. Care was not always person-centred and did not always promote people's independence and preferences.

Right culture:

The registered manager had a good relationship with staff who told us they felt supported. Not all staff demonstrated a person centred approach when supporting people, and were seen to be more focussed on tasks, rather than spending time alongside the people they supported.

Mental capacity assessments had been completed but were not always decision specific, and did not always involve the person in the process.

We have made a recommendation in relation to carrying out mental capacity assessments.

The provider had completed appropriate checks when recruiting staff and medicines were managed well.

Staff training was not always effective in giving staff the knowledge and skills to support people.

We have made a recommendation in relation to training of staff.

When we observed staff interacting with people they support, they were kind and caring. However, there were many missed opportunities by staff to engage with people.

Staff felt that they were well supported by the registered manager, and although the registered manager had many ideas for improvement of the service, these had not been embedded due to the pressures of staffing and recruitment during COVID-19.

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

Rating at last inspection

This service was registered with us on 21 September 2020 and this is the first inspection. The last rating for the service under the previous provider was Good, published on 3 October 2019.

Why we inspected

This was a planned inspection based on when the service registered with us.

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 have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Caring, Responsive and Well Led sections of this full report.

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

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to governance and quality audits 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.