Archived: The Crest Care Home

Updated 27 May 2015

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.

We inspected the home on 24 February 2015. The visit was unannounced. At the time of our inspection there were 28 people living in the home. We spent some time observing care in the lounge and dining room areas to help us understand the experience of people who used the service. 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.

The inspection team consisted of two inspectors and an expert by experience whose expertise was in adult health and social care. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection the provider is asked to complete 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. This document should be returned to the Commission by the provider with information about the performance of the service. We were unable to review a Provider Information Record (PIR) as one had not been requested for this service.

During our visit we spoke with the registered manager, deputy manager, and nine members of care staff including the activity co-ordinator and three ancillary staff including the chef. We spoke with nine people who used the service. We also spoke with seven visitors. We looked at all areas of the home including people’s bedrooms, the kitchen, laundry, bathrooms and communal areas. Owing to people’s complex care needs we were not able to ask everyone directly about their care. However we observed the care and support people received in the communal areas of the home which gave us an insight into their experiences. We reviewed records relating to the management of the home including the statement of purpose, surveys, the complaints procedure, audit files and maintenance checks. We looked at four people’s care plans and observed how medication was being given to people. We checked the medication administration records (MAR) for four people including a random check of controlled drugs stock against the register for one person and we observed a medicines round.

We also reviewed the information we held about the service, such as notifications we had received from the registered provider. We planned the inspection using this information.

We contacted the commissioners from the local authority and Healthwatch to ask for their views and to ask if they had any concerns about the home. From the feedback we received no one raised concerns.

Updated 27 May 2015

We undertook this unannounced inspection on the 24 February 2015. We last inspected The Crest on the 9 September 2013. At that inspection we found the home was meeting the regulations that were assessed.

The Crest is owned by BUPA Care Homes. The home is situated in a residential area of Harrogate a short distance from the town centre. The Crest provides residential care for 31 people some of whom live with dementia. The home comprises of 31 rooms, many of which have en-suite facilities. The accommodation is provided over two floors, which are all accessed by a passenger lift or stairs. There are a range of communal, garden and patio areas for people to use.

The home employs a registered manager who had worked at the home for over two years. 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 service was safe. People spoke positively about the care they received at The Crest and they said they felt safe. We saw there were systems and processes in place to protect people from the risk of harm. Staff were recruited safely and they were trained appropriately to be able to support people. People medicines were managed safely.

People who lacked capacity were protected under the Mental Capacity Act 2005 as the provider was meeting the requirements of the Deprivation of Liberty Safeguards. Applications had been submitted to the local authority, appropriate policies and procedures were in place. Staff had received training to understand and ensure safeguards would be put in place to help to protect people.

People were provided with nutritious food. Assistance and prompting was given by staff where necessary to assist people. Adapted cutlery and crockery were available to people for them to use to help maintain people’s independence.

People’s physical health was monitored. This included the monitoring of people’s health conditions and symptoms, so that appropriate referrals to health professionals were made.

Staff were kind and caring and we observed this throughout our visit. Staff were seen to be attentive and kind to people and they respected people’s individuality, privacy and dignity. Staff we spoke with knew people they were caring for well. People’s care needs were recorded in detail in their individual care records.

The home was well led as the culture at the home was open and transparent with staff working together as one large team. The manager was pro-active and was committed to improving the service. This ensured that the home remained a pleasant place for people to live. The registered manager had an effective quality assurance system in place which ensured that the home remained a safe place for people to live. People living at the home, their relatives and staff working at the home told us that the home was well run and described the manager as ‘dynamic, knowledgeable about dementia care, experienced and listened to people’ were just a few of the comments made to us during our visit.

We received information from Healthwatch. They are an independent body who hold key information about the local views and experiences of people receiving care. CQC has a statutory duty to work with Healthwatch to take account of their views and to consider any concerns that may have been raised with them about this service. We also consulted the Local Authority to see if they had any concerns about the service, and none were raised.