Whitehaven Residential Care Home

We found the following examples of good practice.

The home was visibly clean throughout, and free from clutter and malodour. Cleaning schedules had been adapted to ensure frequently touched points within the home were cleaned several times throughout the day.

The provider and staff kept up to date with Government guidance in relation to COVID-19. The provider had set up a group text where they would send staff the latest guidance. One member of staff told us the provider checked they read the guidance to embed this information into their practice.

Staff took an additional lateral flow device test if they had a weekend off. This was in addition to the three tests they were required to take during the week. This was an extra precaution in place to ensure staff minimised the risk of infection.

The service had never had a COVID-19 outbreak.

Whitehaven Residential Care Home is a residential care home providing personal care to 10 people aged 65 and over at the time of the inspection. The service can support up to 14 people. The home is an adapted building and the providers live on site.

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

Although people were happy with the service they received, further improvements are required to enhance the service they receive and ensure regulatory requirements are being met.

Whilst no harm had occurred, people did not always receive their medications as prescribed and the service did not follow good practice guidance in relation to medicines management. The medicines audit the provider had in place had failed to identify and rectify these issues.

The home was small with a consistent staff team meaning people received a person-centred service in most areas of their lives. However, opportunities for social engagement and to follow interests were limited and the service relied on people’s friends and relatives for this rather than provide staff to accommodate this themselves. People enjoyed the food, ate well and were healthy. However, food and drink options were not presented to people at the time of consumption and we have made a recommendation about the mealtime experience.

People were well cared for and happy living in the home and this was evident. The providers were on shift most days and coordinated the this well. This meant, however, that should they be absent from the home, staff would not have the knowledge to deliver the care required. Staff did not have development opportunities nor were they given the chance to take on more responsibilities to aid the flexibility of the service.

Due to the providers being on shift most days, they had a good oversight of the service which enhanced the service people received. However, few formal quality monitoring audits were in place and there was a lack of formal opportunities for people to provide feedback on the service. Although the standard was being met, the registered manager was not aware of the Accessible Information Standard which ensures people receive information in a way they understand.

Processes in place helped to mitigate risks associated with avoidable harm, infectious diseases, the premises and abuse. Risks had been identified and managed and staff had received mandatory training including in the safeguarding of adults. There were enough staff to meet people’s day to day needs in a person-centred way and staff had received some pre-employment checks although their full employment histories had not been explored as required by law.

People’s needs had been assessed and care plans produced that gave staff person-centred information to help support people; these had been regularly reviewed. People had access to healthcare professionals which assisted their wellbeing. The home had a welcoming atmosphere and the layout straightforward which was appropriate to those people that lived there. There were, however, areas of the home that were not used to aid social engagement amongst people.

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 told us staff were kind and compassionate and that they were respected. We saw that staff upheld people’s dignity and independence and that they had formed trusting relationships. The registered manager was accessible and supportive and there was a friendly atmosphere in the home. Concerns were listened to and acted upon. People told us they would recommend the service.

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 (report published in November 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to medicines management 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.

Whitehaven provides accommodation, nursing and personal care for up to 14 people, including people who are living with a learning disability and/or autism. At the time of our inspection there were 10 people living in the home.

The registered manager had been in post since 2010. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People were not always supported to pursue their interests and there was a lack of activities in and outside of the home. People were supported to attend activities relating to their religion and cultural beliefs.

The service had processes in place to reduce the risk of harm to people. People lived in a safe environment because they were cared for by staff who had received training necessary for their role. There were enough staff to safely support people with their care needs. Appropriate recruitment checks were carried out for all new staff before they started working in the home. There were regular tests carried out for the utilities and fire safety equipment which ensured that the safety of the home was maintained.

Risks to people’s individual safety and wellbeing were identified. There was clear and detailed guidance for staff about how they could mitigate these risks and support people in the safest way possible.

Medicines were managed, stored and administered safely in the home and people received their medicines as prescribed.

People were supported effectively by staff who were knowledgeable and skilled in their work. All new staff were required to complete an induction programme and staff were supported by management and other senior members of staff.

People were supported to express their preferences and wishes. People’s mental capacity had been assessed so it was clear what choices people could make for themselves. People were also supported to access advocates who could act on their behalf.

People were supported to maintain a healthy dietary intake. People’s intake of food and fluid was monitored where necessary. People were consulted regarding the meal choices and people’s food was prepared according to their dietary needs. Timely referrals were made to other relevant healthcare professionals where concerns were raised regarding a person’s health or wellbeing.

Staff had developed a caring relationship with people and were aware of people’s care needs. People’s support plans were person centred and detailed how peoples care needs should be met. Support plans and risk assessments were regularly reviewed to reflect any changes in peoples support needs. However, the way that people’s care records had been written did not demonstrate that they had been written in a person centred way. People were consistently treated with dignity and respect. People were supported to be as independent as possible and people’s friends and relatives could visit without restriction.

There was a complaints procedure in place and people were able to raise a complaint if needed. Complaints were listened to and acted on.

The provider and manager were approachable and the service was well run. Staff felt supported and there was open and frequent communication between the management, staff and people who lived in the home. The provider was aware of the day to day culture of the home and worked alongside the staff.

There were a number of systems in place to monitor and assess the quality of the service being delivered. The provider carried out a number of audits to highlight potential areas for improvement. Whilst there were no action plans, the provider was able to demonstrate that they took remedial action where necessary.

Below is a summary of what we found. The summary describes the records we looked at and what people and staff told us to help us form our judgement. If you would like to see the evidence that supports the summary, please read the full report.

Was the service safe?

People were cared for in an environment that was safe, clean and hygienic. Equipment at the home had been well maintained and serviced regularly. Risk assessment and risk reduction plans were in place so that people were kept as safe as possible. There were safeguarding policies in place to help protect people from abuse.

We saw that sufficient staff were employed to meet people's needs. All staff were receiving training and supervision appropriate to their role. This meant that people received the care and support they needed to keep them safe.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to people living in care homes. Proper policies and procedures were in place so that people who could not make decisions for themselves were protected. Relevant staff had been trained to understand when an application to deprive someone of their liberty should be made and how to submit one.

Was the service effective?

People we spoke with told us they liked living at Whitehaven Residential Care Home. One person told us, 'The care here is very good. Staff are friendly and helpful.'

We spoke with a visiting health professional who said, 'If there is a problem they let us know and we get here as soon as possible.' This told us that the service liaised with visiting health and social care professionals in a timely way to ensure people received effective care and treatment.

We saw that people's care plans were reviewed frequently. Any changes to the care that people needed were clearly recorded within the person's care plan.

Was the service caring?

We spoke with one person, who told us, 'They treat you with respect and kindness.' We spoke with staff who demonstrated that they understood the specific needs of people living at the home. We observed the way staff interacted with people and saw that they were warm and friendly. Staff were attentive to people's needs and supported them to be as independent as possible.

Was the service responsive to people's needs?

The records we looked at showed that people's needs were assessed and care plans developed so that the risks to people were minimised. We saw that the service responded appropriately to the changing needs of people.

People told us that they could spend their day where and how they wished. However, some people stated that they would like to go out a bit more. They told us that their choices around daily living were respected by staff.

People knew how to make a complaint and who to speak to should they feel they needed to.

Was the service well led?

Staff told us that they felt well supported and were well trained to do their jobs. They were clear about their roles and responsibilities.

There were systems in place to ensure the provider captured feedback and learning and we saw that this was acted on appropriately. Regular audits were taking place and this meant that the provider ensured people were cared for in a safe environment.

During our visit we saw people were attending Holy Communion, a health professional who was assessing a person's nutritional changes with other people carrying out their own hobbies and interests.

People we spoke with were in general complimentary about the service, one person said: "The staff look after me very well, I am very comfortable here and I see the doctor quite often so I am well looked after." Another person said: "I get to do what I like, I go to see people in the dining room although I like being in my own room." "I have just had Communion, I always attended church and it is good to keep this going."

We looked at people's records, checked the medication, and looked at how infection control was managed. We checked staff recruitment records and saw how staff training was organised and supported by the manager. We looked at how people's nutritional needs were being met and saw a health professional during our visit who had been requested by the manager for advice for a person with changing needs. This showed us that people's health and welfare was reviewed on a regular basis.