Whitehaven Care Home

Whitehaven Care Home is a residential care home providing personal care to up to 23 people. The service provides support to older people, people with a physical disability, sensory impairment, dementia and mental health requirements. At the time of our inspection, there were 22 people using the service.

Whitehaven Care Home is a former domestic property laid out over two floors. Each floor provides bedroom accommodation, and communal bathrooms and toilets. The ground floor offers communal dining areas and lounges. There is level access to the garden and at the time of this inspection, the registered manager’s office was located on the ground floor.

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

Although improvements had been made since our last inspection, we found improvements were still needed to ensure a consistent approach to infection prevention and control (IPC), risk assessment, and management. There were processes in place to share potential safeguarding concerns with the local authority safeguarding team. We received mixed comments about staffing levels.

We found improvements had been made since our last inspection, and people now received care that was effective. Peoples’ needs were assessed, and care was provided in line with their assessed needs and choices. Some staff had not completed their required training or supervision; the registered manager was aware of these requirements and working to improve compliance.

People were supported towards the end of their lives and care plans reflected peoples’ individual communication requirements. People were supported to maintain relationships with loved ones and the registered manager was working with the provider to improve activities provision.

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.

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 requires improvement (Published April 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

The inspection was prompted in part due to concerns received about medicines management and staffing levels. A decision was made for us to inspect and examine those risks.

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 and well-led sections of this full report.

In response to our feedback during the inspection, the registered manager acted immediately to rectify some of the shortfalls we found, for example updating protocols for ‘as required’ medicines and covering radiators in communal areas.

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

For the key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Whitehaven Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

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 will take further action if needed.

We have identified breaches in relation to safe care and treatment 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 from the provider to understand what they will do to improve the standards of quality and safety. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

These breaches were followed up as part of our inspection. You can read the report from our last comprehensive inspection, by selecting the 'All reports' link for Whitehaven Care Home, on our website at www.cqc.org.uk. The service was rated requires improvement.

Whitehaven Care 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 is provided by ARTI Care Homes (South West). It is registered with the Care Quality Commission (CQC) to provide care and support for up to 23 older people, some of whom are living with the early signs of dementia. Respite beds are also provided. Accommodation was provided on both the ground and first floor. The service had a communal lounge and dining area and accessible secure gardens.

At the time of our inspection, there was a registered manager in post. 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 registered manager was also registered at another service owned by the provider.

At this inspection we found there were still shortfalls around accurate and consistent record keeping, medicines, and effective systems to monitor and review the quality of the service. The service has been rated as requires improvement for the second time. The Care Quality Commission will be monitoring improvements by the service.

We looked at systems in place to ensure people received their medicines in a safe way. We found staff who administered medicines were appropriately trained to do so. However, the quality of the recording of medicines management were inconsistent. Not all areas of care and support were included in care plans and the audits in place were not sufficiently detailed to identify the shortfalls.

Not all windows and wardrobes had been safely secured to minimise risk of injury to people. The provider rectified this immediately but these risks had not been identified through the provider’s audit processes.

The service ensured people had an assessment before moving into the home. Care plans contained important information relating to people’s like and dislikes, their previous occupation, families and routines. Care plans contained support plans which confirmed people’s individual needs. However, these were not always accurate in reflecting people’s changing needs. Some risk assessments had not been updated.

Accidents and incidents were recorded. However, these had not been analysed to identify patterns and trends or identify areas of learning. Peoples hydration and nutritional needs were not consistently managed. However, staff knew people well and spoke positively about the support they provided to people.

People said they were stimulated by activities led by staff. We received mixed feedback from people with regards to staffing levels. Staffing was kept at the level deemed safe by the provider.

People’s dignity and respect were upheld. Communication systems were in place to ensure people’s views were heard. People who lacked capacity had their rights protected under the Mental Capacity Act 2005.

Staff were supported through induction, supervision and training. We made one recommendation with regards to the recording systems around staff supervision.

The provider had systems in place to monitor the quality and safety of the service. However, these were not effective and had failed to identify the risks and shortfalls where improvements were required.

People were encouraged and supported to remain independent. Visitors were welcomed at the service. People spoke positively about the registered manager and their relationships with staff. Staff felt valued and supported.

People and staff felt the registered manager was accessible and approachable. People and staff felt comfortable in raising any issues or concerns and these were listened to and responses given. Different systems were in place to effectively communicate and gain feedback from people and staff through meetings and surveys.

We found three 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 this report.

The inspection took place on 15 January 2018 and was unannounced.

Whitehaven Care Home is a care home situated in Midsomer Norton near Radstock, which is registered to accommodate up to 23 people. The service is provided by ARTI Care Homes (South West). Accommodation was provided on both the ground and first floor. The service had a communal lounge and dining area and accessible secure gardens.

At the time of our inspection, there was a registered manager in post. 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 registered manager was also registered at another service owned by the provider.

This was the first inspection undertaken since the service was taken over by ARTI Care Homes (South West) Limited

We looked at systems in place to ensure people received their medicines in a safe way. We found staff who administered medicines were appropriately trained to do so. However, we found some concerns with the storage and recording of medicines administered.

We looked at care plans and found they lacked a person centred approach or sufficient information to make sure staff were given the most up to date information. People's interests and preferences were not always identified and recorded.

The provider had a system in place to monitor the quality and safety of the service. However, these were not effective enough to identify the failings or improvements required.

The basic principles of the Mental Capacity Act 2005 had been followed to ensure people's rights were upheld. Deprivation of Liberty Safeguards applications had been made and the registered manager kept these under review.

We observed staff interacting with people and found there were enough staff to meet people's needs. The service had a safe recruitment system in place. Staff received an induction when they commenced employment at the service. This included shadowing other staff so they could get to know the people who lived at the home.

People told us they felt safe living at the home. Staff were confident they could approach the registered manager with any safeguarding concerns and that their concerns would be addressed. There were enough staff available who had been suitably recruited to help protect people living at the home. Staff told us they had received sufficient training and felt supported in their role. Some people were living with dementia and were supported by staff who had some knowledge of how to support people living with this condition.

People told us they felt cared for and were happy with the support they received from the staff team. Staff enjoyed working with the people who lived at the home and knew people's preferences for how their care needs were to be met. Individual interactions with staff were kind and compassionate; people consistently receive a caring service.

People were treated with dignity and respect and wherever possible people were encouraged to retain their independence.

People had the opportunity to partake in some activities in the home based on their interests. People who lived at the home and their relatives were encouraged to share their opinions about the quality of the service.

We saw that the provider had a system in place for dealing with people's concerns and complaints. People and their relatives said they knew how to raise any concerns and most were confident that these would be taken seriously and looked into.

People who used the service, their relatives and staff, were complementary about the registered manager and felt the management team were approachable.

We identified 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.