Archived: Whitway House

Updated 6 October 2020

This was a targeted inspection to check on specific concerns we had about safe care and treatment of people, access to emergency health care, staffing levels, safeguarding processes and the oversight of safety.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Whitway House Nursing Home 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.

The service had a manager registered with the Care Quality Commission. This manager was no longer employed at the service but they had not cancelled their registration. The manager that had replaced them in January 2020 left the service the week before our visit. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We announced the inspection the day before we visited to discuss the safety of people, staff and inspectors with reference to Covid 19.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We had not requested the provider send us a 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 had been receiving monthly reports from the provider that gave us this information.

During the inspection

We spoke with three people who used the service about their experience of the care provided. We spoke with three care staff, two nurses, a housekeeper and the activities coordinator. One of the nurses was the acting manager of the home. We also spoke with social care professionals involved with the service.

We reviewed a range of records. This included four people’s care records and a medication record. We looked at three staff files. We also reviewed a variety of records relating to the management of the service including rotas and policies and procedures.

After the inspection visit.

We continued to seek clarification from the provider to validate evidence found. We spoke with the service’s nominated individual and two further representatives of the provider on 15 June 2020. The nominated individual is responsible for supervising the management of the service on behalf of the provider.We received evidence from the providers and staff until 15 June 2020.

Updated 6 October 2020

About the service

Whitway House Nursing Home is a residential care home providing personal and nursing care. The service can support up to 39 people. There were 24 people living in the service at the start of this inspection.

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

People were at risk of harm because the systems in place to ensure they received safe and appropriate care were not effective. Risks were not assessed, and care plans were not in place to direct staff to provide safe care and treatment. Risk management systems in place were not implemented consistently.

Staffing levels had been changed without reference to the dependency needs of people living in the home. Staff told us that the levels were currently better but that this had been very difficult to manage.

People did not always receive health care in a timely manner.

Staff understood how to identify and report abuse and spoke with care about the people they supported. However, the systems in place did not ensure that allegations were responded to robustly and appropriately. This meant people were at risk because potential abuse was not adequately investigated.

The governance of the home was not sufficient. Policies were not implemented. Improvements identified in action plans were not always reflected in practice.

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

Rating at last inspection (and update)

The last rating for this service was Inadequate. (published January 2020)

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about staffing, risk management, responses to safeguarding concerns and access to healthcare. A decision was made for us to inspect and examine those risks.

CQC have introduced targeted inspections to follow up on a Warning Notice or other 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.

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

We have been told by the providers that action has started to mitigate omissions found, and that communication is improved between the acting manager of the home and the provider organisation. The acting manager sent through care plans they had completed following the inspection site visit.

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 monitor the service and 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 safe care and treatment, safeguarding, and the oversight of safety and risk.

We varied the registration of the provider by removing regulated activities from this location. This meant the service was no longer registered. There were no people living in the home after 9 September 2020.