We carried out a review of the data available to us about Whitebriars Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Whitebriars Care Home, you can give feedback on this service.
Whitebriars care home is a residential care home providing care, support and accommodation for up to 25 people. People living at the home were older people with a range of care and support needs that included Parkinson’s disease, diabetes and health conditions relating to old age. Some people living at the service lived with dementia. At the time of our inspection there were 24 people using the service.
People’s experience of using this service and what we found
People lived in a safe environment and were protected from harm. Staff had been trained in safeguarding and knew the steps to take if they suspected abuse or wrongdoing. Risk assessments were in place that covered all aspects of people’s care and support including for example the risk of falls and that of developing pressure sores. People received their medicines safely by trained staff who were subject to regular re-assessments. People were supported by staff who had been recruited safely and there were enough staff on every shift to meet people’s needs. Lessons learned following accidents and incidents and any learning was shared with staff to minimise recurrences. People were supported to have maximum choice and control of their lives and staff supported /did them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Managers and the staffing team worked well together and the registered manager was well thought of by people, relatives and staff. Auditing processes were in place with any patterns or trends identified and where necessary, interventions were put in place to support people and maintain safe practices. People, relatives and staff had been given opportunities to feedback about the service and the registered manager and the management team listened to and acted on feedback. The registered manager complied with the duty of candour and had a clear vision for developing the service further. Positive working relationships were developed with other health and social care professionals.
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 24 July 2018)
Why we inspected
We carried out an unannounced focussed inspection on 20 December 2022. This inspection was prompted by a review of the information we held about the service.
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.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Whitebriars care home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Whitebriars Care Home is a residential care home providing personal care for older people, most of whom were living with dementia. The service can accommodate up to 25 people and at the time of the inspection there were 22 people living at the home.
People’s experience of using this service and what we found
People were protected from harm. People told us they felt safe, a person said, “I know I’m safe here.” Staff had completed safeguarding training and were able to tell us what action they would take to protect people and report wrongdoing. Accidents had been recorded and investigated appropriately with lessons learned being shared with all staff.
A new computerised system for managing care plans was being introduced. Previous paper care plans often lacked specific detail relating to people’s needs and associated risks. The new system was person centred and had reference to risk assessments, for example contingencies for people at risk of falls. Staff knew people well and responded to their support needs. For example, a staff member told us that several people liked to walk but that lockdown had created restrictions. Instead they took people for garden walks which provided exercise and reduced anxiety.
Medicines were managed correctly. We saw medication administration records (MAR) completed correctly and staff were allocated dedicated time for medicine rounds to avoid distraction. Medicines were not kept in locked cupboards but this was immediately addressed by the registered manager. We suggested using a trolley to reduce the time taken for medicine rounds and to minimise the time between medicine administration and recording on MAR charts. This was similarly addressed by the registered manager.
The service managed infection prevention and control well with appropriate use of personal protective equipment and compliance with the latest government guidelines.
The registered manager was responsible for three services but maintained management oversight of auditing, assisted by the support manager. We looked at safeguarding, accidents and incidents and complaint files and were satisfied that issues were being recorded, acted on and audited to ensure learning could be carried forward.
Rating at last inspection
The last rating for this service was good (published 24 July 2018)
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The concerns were about people’s safety, management of risk, medicines, infection control and the governance of the service. We inspected using our targeted methodology developed during the Covid-19 pandemic to examine those specific risks and to ensure people were safe. 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 coronavirus and other infection outbreaks effectively.
CQC have introduced targeted inspections to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information.
Our inspections in December 2014, September 2015 and April 2016 found breaches of regulation and we took appropriate enforcement action in April 2016. This was because they had not sustained the necessary improvements needed to meet the breaches of regulation. We received an action plan from the provider that told us they would meet the breaches of regulation by December 2016. We carried out a comprehensive inspection on the 9 and 10 January 2017 and found that whilst there were areas still to embed in to everyday practice, there had been significant progress made and that they had met the breaches of regulation.
Whitebriars is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Whitebriars provides care and support for up to 26 older people some who are living with a dementia type illness or memory loss.
The service had a registered manager in place. 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.
We undertook this unannounced comprehensive inspection to look at all aspects of the service and to check that the provider had followed their action plan and confirm that the service now met legal requirements. We found improvements had been made in the required areas.
The overall rating for Whitebriars has been changed to good.
People spoke positively of the home and commented they felt safe. Our own observations and the records we looked at reflected the positive comments people made. Care plans reflected people’s assessed level of care needs and care delivery was person specific, holistic and based on people's preferences. Risk assessments included falls, skin damage, behaviours that distress, nutritional risks, including swallowing problems and risk of choking, and moving and handling. With preventive measures in place to reduce risk. For example, pressure relieving mattresses and cushions were in place for those who were susceptible to skin damage and pressure ulcers. The care plans also highlighted health risks such as diabetes. There were systems for the management of medicines and people received their medicines in a safe way. Staff and relatives felt there were enough staff working in the home and relatives said staff were available to support people when they needed assistance. All staff had attended safeguarding training. They demonstrated a clear understanding of abuse; they said they would talk to the management or external bodies immediately if they had any concerns. Pre-employment checks for staff were completed, which meant only suitable staff were working in the home.
People were supported to eat a healthy and nutritious diet. Food and fluid charts were completed when risk of poor eating and drinking had been identified and showed people were supported to eat and drink. Visits from healthcare professionals were recorded in the care plans, with information about any changes and guidance for staff to ensure people's needs were met. The service worked well with allied health professionals. Staff had received fundamental training and there were opportunities for additional training specific to the needs of the service. This included the care of people with specific health and mental health needs such as diabetes and dementia. People were supported to make decisions in their best interests. The provider assessed people's capacity to make their own decisions if there was a reason to question their capacity. Staff and the registered manager had a good understanding of the Mental Capacity Act. Where possible, they supported people to make their own decisions and sought consent before delivering care and support. Where people's care plans contained restrictions on their liberty, applications for legal authorisation had been sent to the relevant authorities as required by the legislation.
Staff had a good understanding of people's needs and treated them with respect and protected their dignity when supporting them. People told us care staff were kind and compassionate. Comments included, “Lovely friendly staff,” and “Very nice staff.” A range of activities were available for people to participate in if they wished and people enjoyed spending time with staff. Activities were provided throughout the day, seven days a week and were developed in line with people's preferences and interests.
The provider had progressed quality assurance systems to review the support and care provided. A number of audits had been developed, including those for accidents and incidents, care plans, medicines and health and safety. Maintenance records for equipment and the environment were up to date, such as fire safety equipment and hoists. Policies and procedures had been reviewed and updated and were available for staff to refer to as required. Staff said they were encouraged to suggest improvements to the service. Relatives told us they could visit at any time and, they were always made to feel welcome and involved in the care provided.
Staff said the management team was fair and approachable, care meetings were held every morning to discuss people's changing needs and how staff would meet these. Staff meetings were held monthly and staff were able to contribute to the meetings and make suggestions. Relatives said the management was very good; the registered manager was always available and they would be happy to talk to them if they had any concerns.
Coast Home Care (Whitebriars) combines a care home, known as Whitebriars and a Domiciliary Care Agency (DCA) known as Coast Home Care. The care home provides care and support for up to 26 older people some who are living with a dementia type illness or memory loss. People can also stay for short periods of time on respite (temporary) care. The staff team also supported three people who occasionally came for day care support. At the time of this inspection 21 people were living at the home.
The DCA provides home care services to people within the local area. Some need support with domestic arrangements. Most are living with some degree of memory loss and need a range of support with personal care. Visits range in number and time to suit individual need. At the time of the inspection, the DCA supported 41 people which included 20 people who received support with personal care. The DCA is run from a separate office within the care home with a separate staffing group.
We carried out an unannounced inspection on 03 and 10 December 2014 of both services where we found improvements were required in relation to the management of medicines in the care home. We received an action plan from the provider and returned to carry out a further inspection on 9 and 11 September 2015. At that inspection although some improvements had been made we also found that improvements were required in relation to risk management and record keeping. The provider sent us an action plan and told us they would address these issues by November 2015. We carried out an inspection of both the care home and DCA on 22, 25 and 26 April 2016 to check that the provider had made improvements and to confirm that legal requirements had been met. We found that the improvements had not been sustained and there were continued breaches of regulation. We took appropriate enforcement action at this time. We received an action plan from the provider that told us they would meet the breaches of regulation by December 2016.
This unannounced comprehensive inspection on the 9 and 10 January 2017 found that whilst there were areas still to embed in to everyday practice, there had been significant progress made and that they had met the breaches of regulation previously in breach.
Following the resignation of the registered manager, the provider had appointed a manager for both the care home and DCA. We received confirmation that the appointed managers had started the process to register with CQC. 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.
We have reported on the services provided by the care home and DCA separately under the evidence sections of the report.
Whitebriars
The provider had progressed quality assurance systems to review the support and care provided. A number of audits had been developed including those for accidents and incidents, care plans, medicines and health and safety. Maintenance records for equipment and the environment were up to date, such as fire safety equipment and hoists. Policies and procedures had been reviewed and updated and were available for staff to refer to as required. Staff said they were encouraged to suggest improvements to the service and relatives told us they could visit at any time and, they were always made to feel welcome and involved in the care provided.
Care plans reflected people’s assessed level of care needs and were based on people's preferences. Risk assessments included falls, skin damage, behaviours that distress, nutritional risks including swallowing problems and risk of choking and moving and handling. For example, cushions were in place for those that were susceptible to skin damage and pressure ulcers. The care plans also highlighted health risks such as diabetes and epilepsy. Visits from healthcare professionals were recorded in the care plans, with information about any changes and guidance for staff to ensure people's needs were met. There were systems in place for the management of medicines and people received their medicines in a safe way.
People were encouraged and supported to eat and drink well. One person said, “Tasty and there’s always a choice.” There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. People were advised on healthy eating and special dietary requirements were met. People’s weight was monitored, with their permission. Health care was accessible for people and appointments were made for regular check-ups as needed. Food and fluid charts were completed and showed people were supported to have a varied and nutritious diet.
Staff had a good understanding of people's needs and treated them with respect and protected their dignity when supporting them. People we spoke with were very complimentary about the caring nature of the staff. People told us care staff were kind and compassionate. Staff interactions demonstrated staff had built rapport with people and they responded to staff with smiles.
A range of activities were available for people to participate in if they wished and people enjoyed spending time with staff. Activities were provided five days a week and were in line with people's preferences and interests. People enjoyed the activities and there was a lively and fulfilling atmosphere in the communal areas.
Staff and relatives felt there were enough staff working in the home and relatives said staff were available to support people when they needed assistance. The provider was actively seeking new staff, nurses and care staff, to ensure there was a sufficient number with the right skills when people moved into the home. The provider had made training and updates mandatory for all staff, including safeguarding people, moving and handling, management of challenging behaviour, pressure area care, falls prevention and dementia care. Staff said the training was very good and helped them to understand people's needs.
All staff had attended safeguarding training and demonstrated a clear understanding of abuse. They said they would talk to the management or external bodies immediately if they had any concerns, and they had a clear understanding of making referrals to the local authority and CQC. Pre-employment checks for staff were completed, which meant only suitable staff were working in the home. People said they felt comfortable and at ease with staff and relatives felt people were safe.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The provider, registered manager and staff had an understanding of their responsibilities and processes of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.
Staff said the management was fair and approachable, care meetings were held every morning to discuss people's changing needs and how staff would meet these. Staff meetings were held monthly and staff were able to contribute to the meetings and make suggestions. Relatives said the management was very good; the manager was always available and, they would be happy to talk to them if they had any concerns.
Coast Home Care
People told us that they found the management team and organisation “Helpful, organised and knowledgeable.” One person told us, “Always polite and approachable.” Another said, “Always find a solution, nothing is too much trouble.” People told us they were happy to recommend the DCA to others.
Since our last inspection there have been changes to the management structure and the appointed manager was in the process of registering with the CQC. There had been a decision made to separate the care home and DCA and the provider was in the process of submitting applications for registering them separately.
At the last inspection there were shortfalls in the systems for auditing the service provision. This inspection found significant improvement in the quality assurance systems. Audits were carried out in line with policies and procedures. Areas of concern had been identified and changes made so that quality of care was not compromised. Areas for improvement were on-going such as care documentation.
Systems for documenting calls received in the office have been improved and each person has their own dedicated pages and this provided a clear audit trail for each person. This made it easier for staff to locate pertinent information.
People told us they were regularly consulted about their care and support. One person told us, “They always ask me if I’m happy with the support I get, I am, wouldn’t change a thing.”
Staff felt well supported. All of the care staff spoke of the DCA being a good company to work for with positive team work and good communication. They said they could call the DCA at any time for support if needed.
The DCA provides home care services to people within the local area. Some need support with domestic arrangements. Most are living with some degree of memory loss and need a range of support with personal care. Visits range in number and time to suit individual need. At the time of the inspection, the DCA supported 41 people which included 20 people who received support with personal care. The DCA is run from a separate office within the care home with a separate staffing group.
We carried out an unannounced inspection on 03 and 10 December 2014 of both services where we found improvements were required in relation to the management of medicines in the care home. We received an action plan from the provider and returned to carry out a further inspection on 09 and 11 September 2015. At that inspection although some improvements had been made we also found that improvements were required in relation to risk management and record keeping. The provider sent us an action plan and told us they would address these issues by November 2015. We carried out this inspection of both the care home and DCA on 22, 25 and 26 April 2016 to check the provider had made improvements and to confirm that legal requirements had been met. Our inspection was unannounced to the care home and announced to the DCA.
The home and the DCA had a combined registered manager. 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. An acting manager had been appointed to manage the DCA and they told us that it was their intention to register as manager for the DCA.
We have reported on the services provided by the care home and DCA separately under the evidence sections of the report.
Whitebriars
There was a lack of leadership and oversight of the home. Attempts had been made to improve auditing but this was done by four separate people in isolation with no oversight or analysis of the findings and no evidence that lessons had been learned when shortfalls were identified.
The management of medicines were not safe. The procedures for giving and signing of medicines were inadequate with lots of gaps in the recording of medicines so it was not always clear if they had been given. Medicines required in an emergency situation for one person were not held in the home.
When accidents and incident occurred these were not always explored fully to determine if care practices were safe and if further action should be taken to prevent further incidents.
Care documentation for people in receipt of day care was either not in place or provided very basic information. Record keeping in relation to fluid monitoring did not show that people had been adequately hydrated and equally there were gaps in the recording of the application of skin creams.
Despite the shortfalls and the fact that the home had been through an unsettled period with low staff morale, we found that the recent restructuring of the management team was still new and the provider, management team and staff were all committed to improving the shortfalls. Some staff told us that staff morale was slowly improving and although they thought there was a way to go they felt things were heading in the right direction. After our inspection we received information from the registered manager about improvements made to documentation. For example in relation to monitoring people’s fluid intake, monitoring of fire drills and medicines.
People were very positive about the care they received. One person told us, “The staff are lovely, I wouldn’t say a word against them. They come quickly if I call them and are very friendly.” There was a varied activity programme in place. Minibus outings were provided twice a week to various places such as garden centres, so that people had the opportunity to wander around the centre and then have a coffee. Entertainers were arranged regularly and in house activities were provided daily.
People told us that the food was good and that if they did not want what was on the menu they could have an alternative. Mealtimes were sociable and meals were served in a pleasant environment with soft music playing in the background and the mealtime was not rushed. When people required prompting this was done discretely.
There were enough staff employed to ensure that people’s needs were met. Staff received ongoing training and support, which included a mixture of online training and attendance at external training courses. They had access to health qualification training and specific training on caring for people living with dementia. There were safe recruitment systems to ensure that new staff were checked before starting to work in the home.
Coast Home Care
The new acting manager had been in post for four weeks. Since taking on the role they had identified the areas that needed to be improved and had divided tasks to be addressed by them and the coordinators. However, it was still too early to see improvement in some areas and it would take time to ensure that any progress made was sustained. The registered manager told us that they had no oversight of the DCA. However, they continue to be registered in this role and therefore they remain responsible for this part of the service.
As part of staff recruitment, gaps in employment histories had not been explored. The manager could not demonstrate that they had fully assessed the competence of new staff before they worked unsupervised.
The procedures to ensure that the support people received was audited regularly were not carried out in a timely manner. The on call procedure was not effective in that at times staff would not be able to respond to an emergency.
Despite the shortfalls we found that people received good care and were very happy with the service provision. They said there was consistency of carers and on the whole care staff arrived on time and care was not rushed. One person told us, “They’re so lovely and do lots of little things that mean a lot, like putting my phone on charge for me.”
Staff felt well supported. All of the care staff spoke of the agency being a good company to work for with positive team work and good communication. They said they could call the agency at any time for support if needed. They told us and were very happy with the training provided. They received a training newsletter that highlighted the training on offer from the organisation. Although most staff had attended dementia training, several staff spoke about a new opportunity to do more detailed dementia training that was to be introduced.
The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special Measures’ by CQC. The purpose of special measures is to:
• Ensure that providers found to be providing inadequate care significantly improve.
• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made. Services placed in special measures will be inspected again within six months. The service will be kept under review and if needed could be escalated to urgent enforcement action.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
Coast Home Care (Whitebriars) combines a care home and a Domiciliary Care Agency (DCA). The care home provides care and support for up to 26 older people who may be living with a dementia type illness or memory loss. People can stay for short periods on respite care or can attend the home for day care. Staff can provide end of life care with support from the community health care professionals but usually cares for people who need prompting and minimal personal care support. At the time of this inspection 24 people were living at the home.
The DCA provides home care services to people within the local area. This service is run from a separate office within the care home with a separate staffing group. The DCA provision was not included as part of this as no areas of concern have been raised about this service since the last inspection.
This inspection took place on 9 and 11 September 2015 and was unannounced.
The service had a registered manager in place. 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.
The provider had not ensured that robust health and safety checks were in place to ensure people’s safety. We found that windows were not restricted and all equipment did not have suitable safety checks completed. This meant that people may be at risk from injury from risks within the environmental and when using some equipment.
Information gathered about accidents and incidents was not used to review and respond to any trends within the home and the risks around people administering their own medicines were not managed to ensure associated risks were managed effectively. Staff knew people well and were able to tell us about the care they required. However, some care plans were missing or not up to date. This meant there was a lack of clear guidance for staff to follow to ensure consistent care. Some daily records were not completed in a consistent way others were poorly completed and did not promote safe and consistent care.
Systems for quality monitoring were not always effective to ensure the service was well managed in all areas.
Feedback received from people their relatives and visiting health professionals through the inspection process was positive about the care, the approach of the staff and atmosphere in the home. People told us they felt they were safe and well cared and had their choices respected. Staff treated people with kindness and compassion and supported them to maintain their independence. They showed respect and maintained people’s dignity. People had access to health care professionals when needed.
Medicines were stored safely, all medicines were administered and disposed of by staff who were suitably trained.
There was a variety of activity and opportunity for interaction taking place in the service. This took account of people’s preferences and choice. Visitors told us they were warmly welcomed and people were supported in maintaining their own friendships and relationships.
Staff were provided with a training programme which supported them to meet the needs of people. Staff felt well supported and able to raise any issue with the registered manager and provider.
People were very complementary about the food and the choices available. People were given information on how to make a complaint and said they were comfortable to raise a concern or complaint if need be.
There was an open culture at the home and this was promoted by the staff and management arrangements. Staff enjoyed working at the home and felt supported. People were encouraged to share their views though ‘residents meetings’ and satisfaction surveys.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
Coast Home Care (Whitebriars) combines a care home and a Domiciliary Care Agency (DCA). The care home provides care and support for up to 26 older people who may be living with a dementia type illness or memory loss. People can stay for short periods on respite care or can choose to live at the home. Staff can provide end of life care with support from the community health care professionals but usually care for people who need prompting and minimal personal care support. At the time of this inspection 24 people were living at the home.
The DCA provides home care services to people within the local area. Most are living with some degree of memory loss and need a range of support including care, prompting and monitoring. Visits range in number and time to suit individual need. At the time of the inspection 17 people were receiving personal care from Coast Home Care (Whitebriars). This service is run from a separate office within the care home with a separate staffing group.
This inspection took place 3 December 2014 and was unannounced with an announced follow up visit to meet with the registered provider and to gather further information on the 10 December 2014.
The home and the home care services had a combined registered manager. 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.’
We have reported on the services provided by the care home and DCA separately under the evidence sections of the report.
The management of medicines were not always managed safely within the care home. Records were not accurate and systems did not ensure that variable dosage medicines were given as required. This meant that medicines were not always given in accordance with prescriptions. The management of medicines within the home care service was organised and this ensured people received their medicines in accordance with individual prescriptions.
People’s views were obtained through a variety of sources and systems were in place to encourage feedback from people about the care home and the DCA. This information was recorded but not fully reviewed and reflected on. This did not allow for people’s views to be fully used when shaping the service or reflecting on its quality.
Feedback received from people and their representatives through the inspection process was positive about the care, the approach of the staff and atmosphere in the home. Some general comments included, “The staff care so very much,” and “It’s such a homely and friendly home.”
Feedback from people receiving a home care service and their relatives was very positive. They told us that staff were experienced, kind and caring.
People told us they felt they were safe and well cared for by staff working for Coast Home Care (Whitebriars). Staff undertook safeguarding training and knew the correct procedures for reporting any suspicion of abuse.
Staff recruitment processes ensured the registered provider employed suitable staff to work in the care home and DCA. Staff were provided with a full induction and training programme before they worked unsupervised. Staffing arrangements ensured staff worked in such numbers, with the appropriate skills that people’s needs could be met in a timely and safe fashion. Time allocated for home visits allowed for all support to be provided in a safe unrushed manner.
Care documentation included individual risk assessments in order to keep people safe. Staff knew and understood people’s care needs well and there were systems in place for all staff to share information. This ensured staff responded to people on an individual basis.
Senior staff explained their understanding of their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Relevant guidelines were available within the care home for all staff to reference. All staff had a basic understanding of consent and caring for people without imposing any restrictions.
Mealtimes in the care home were a social event that included visitors wishing to stay. People had a number of choices of food and extra portions were offered. Staff monitored people’s nutritional needs and responded to them.
Care records and discussion with staff confirmed that people had access and were supported to health care professionals when needed, for example, the doctor or district nurse. A healthcare professional told us staff referred people to them appropriately and followed their advice and guidance.
People were cared for by staff that knew them well and responded to their individual care needs and preferences.
People had access to the community, friends and relatives. There was a variety of activity and opportunity for interaction taking place in the care home. This activity and entertainment was also available to people receiving a home care service if they wanted to come to the care home. This included regular outings on the home’s own mini bus. Visitors told us they were warmly welcomed and felt they could come to the care home at any reasonable time.
People were given information on how to make a complaint and said they were comfortable to raise a concern or complaint if need be. Complaints were responded to positively and outcomes were used to improve the service in the care home and within the home care services.
The registered provider had quality assurance systems in place to audit the home and service provided by the DCA. This included regular audits on health and safety, infection control and medication. The culture in the home was open with the registered provider and registered manager readily available and willing to listen to anyone. The DCA was also run in an open way the provider and manager were available and listened to people and staff.
We found a breach of the Health and Social care Act 2008 (Regulated Activities) Regulation 2010
You can see what action we told the provider to take at the back of the full version of the report.
At the time of our inspections there were 22 people living at the home and 18 people who received personal care in their own homes. People we spoke with told us they were happy with the care they received. They told us staff were kind and they were well supported. One person who lived at the home told us, "It's very good, I'm happy living here." Another person said, "Staff are very good, I'm happy and the food is lovely." People who lived at home told us they felt safe and well looked after. One person said "Staff are absolutely reliable." Another person said, "It's about trust and we have trust."
We looked at care plans and saw that these reflected the assessed needs of people who used the services. We spoke with staff and saw that they demonstrated a good understanding of the safeguarding process and how to raise concerns appropriately.
We saw that appropriate checks were carried out before staff commenced work at the service. There was a complaint's process in place and we saw that concerns raised were addressed appropriately.