Credenhill Court Rest Home

Updated 24 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 10 January 2019 and was unannounced. The inspection team consisted of two inspectors.

Prior to our inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We took this information into account during the planning of our inspection of the service.

Before the inspection site visit, we reviewed the information we held about the service, including any statutory notifications received from the provider. A statutory notification is information about important events, which the provider is required to send us by law. We also contacted the local authority, the local clinical commissioning group and Healthwatch for their views on the service. Healthwatch is an independent consumer champion, which promotes the views and experiences of people who use health and social care services.

During our inspection visits, we spoke with five people who used the service, four relatives, a visiting community artist and three community health and social care professionals. We also spoke with the registered manager, deputy manager, head cook, activities coordinator, two senior care staff and four care staff.

We looked at a range of documentation, including four people's care and assessment records, staff induction and training records, medicines records, incident and accident reports and three staff recruitment records. We also looked at complaints records, certification related to the safety of the premises and records associated with the provider's quality assurance.

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.

Updated 24 January 2019

The inspection took place on 10 January 2018 and was unannounced.

Credenhill Court Rest Home 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. The home is registered to provide accommodation with personal care for up to 35 older people, some of whom are living with dementia. The accommodation is split across three floors within one large adapted building. At the time of our inspection, there were 30 people living at the home.

There was a registered manager in post who was present during our inspection. 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.

At our previous inspection in November 2017, we rated the service as 'Requires Improvement' and identified two breaches of the Regulations. These related to the need for consent and good governance of the service. At this inspection, we found the provider had made a number of improvements and was now meeting the Regulations. However, further improvements were needed in relation to the management of people’s medicines. These included the need for a clearer system for recording the application of people’s topical medicines.

People felt safe living at the home. Staff had received training in, and recognised, their individual responsibilities to protect people from any form of harm, abuse or discrimination. The risks to individuals had been assessed, recorded and kept under review. The provider maintained safe staffing levels at the home, to ensure people’s needs could be met safely. They completed pre-employment checks on prospective staff to ensure they were safe to work with people. Measures were in place to protect people, staff and visitors from the risk of infections.

Before people moved into the home, the management team carried out a formal assessment of their individual needs and requirements to ensure these could be effectively met. Staff and management understood the need to avoid any form of discrimination when planning or delivering people’s care. Staff received induction, training and ongoing support to help them fulfil their duties and responsibilities. They helped people to choose what they ate and drank on a day-to-day basis, and promoted a positive mealtime experience for people. Staff played a positive role in monitoring people’s general health and helping them to access healthcare services. The provider had taken steps to adapt the home’s environment to meet people’s needs. Staff and management understood and promoted people’s rights under the Mental Capacity Act 2005.

Staff treated people with kindness and compassion, and had taken the time to get to know people well as individuals. People were supported to express their views about the service. Staff understood and promoted people’s rights to privacy and dignity, and helped them to maintain their independence.

The care and support provided was tailored to people’s individual needs and requirements. People's care plans were personalised and read by staff. The management team had assessed and addressed people's communication and information needs. People had support to pursue their interests and participate in a variety of stimulating and enjoyable activities. People and their relatives knew how to raise any concerns or complaints about the service, and felt comfortable doing so. People's preferences and choices for their end-of-life care were discussed with them and, where appropriate, their relatives, in order to meet these.

The provider carried out audits and checks to monitor the safety and quality of the service provided. The registered manager had a good understanding of the requirements associated with their registration with CQC, and spoke with commitment about people's care and quality of life. People, their relatives and community professional described positive relationships and open communication with the management team. Staff told us they had the management support and direction they needed to succeed in their roles. The management team took steps to maintain and develop links with the local community to benefit the people who lived at the home.