The Croft

Updated 14 May 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by one inspector.

Service and service type

The Croft 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 service had a manager registered with the Care Quality Commission. This means that they 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 unannounced.

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 commissioning and safeguarding teams. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected The Croft and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke about The Croft with two people, one employee and the registered manager. We walked around the building to carry out a visual check. We did this to ensure The Croft was clean, hygienic and a safe place for people to live.

We looked at records related to service management. We did this to ensure the provider had oversight of the home, responded to any concerns and led The Croft in ongoing improvements. We checked care records of two people and looked at medication, staffing levels, recruitment and quality oversight.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at their policies, quality assurance systems and recruitment records.

Updated 14 May 2021

About the service

The Croft is a care home providing personal care to three people at the time of our inspection. The service can support up to six adults who may have a learning disability or autistic spectrum disorder or mental health condition. Bedrooms are of single occupancy with ensuite facilities, with various communal spaces for people’s comfort.

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

The provider did not always ensure people were adequately protected from unsafe recruitment of staff. They did not always reduce the potential risk of mistakes by ensuring staff were well-rested. Staff understood correct procedures to follow to safeguard people from harm or abuse. The registered manager mitigated the risks of an unsafe environment to maintain everyone’s welfare. Staff followed correct procedures in the safe management of people’s medication.

Although there were extensive policies and procedures to underpin safe care delivery, these were not always customised to the needs of the service.

We have made a recommendation about service policies and procedures.

The registered manager regularly checked each person’s experiences of living at the home. People’s survey responses were consistently positive. The provider developed The Croft as an inclusive service to help people and staff feel safe and comfortable.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right Support, Right Care, Right Culture.

Staff supported people to make their own decisions and lead discussions on what they wanted to do. Staff were consistently kind and respectful, ensuring each person maintained their independence and privacy. People confirmed they were happy and settled at The Croft.

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 good (published 09 March 2018).

Why we inspected

The inspection was prompted in part due to concerns received about risk management, medication, staffing and governance. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections and what action we have asked the provider to take at the end of this full report.

Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

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.

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

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 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 staff recruitment and the continuous deployment of sufficient staffing levels.

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