Archived: The Croft

Updated 19 May 2018

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.

This inspection took place on 25 and 27 September 2017. The first day of our inspection was unannounced.

The inspection team consisted of one adult social care inspector, a specialist advisor in nursing care and an expert by experience. 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 we visited the home we checked the information we held about this location and the service provider. For example we looked at the inspection history, safeguarding notifications and complaints. A notification is information about important events which the service is required to send to the Commission by law. We contacted professionals involved in caring for people who used the service; including local authority commissioners. We also spoke to the police who had experienced a significant reduction in the number of call outs to the home.

We did not ask the provider 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. We used the opportunity of the inspection to explore the plans for the service with the management team.

During the inspection we spoke with five people who used the service. We reviewed seven people’s care files. We spoke with nine staff including the operations director, the regional manager, the manager consultant, senior care staff, care staff and the cook. We also reviewed other records maintained by the provider required to demonstrate regulatory compliance.

Updated 19 May 2018

This inspection took place on 25 and 27 September 2017. The first day of our inspection was unannounced. The Croft is registered to provide accommodation for up to 21 people who require nursing or personal care. At the time of our inspection there were twelve people using the service.

At the last inspection in March 2017 we found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.The breaches were:-

Regulation 9 Person-centred care

Regulation 11 Need for consent

Regulation 12 Safe care and treatment

Regulation 13 Safeguarding service users from abuse and improper treatment

Regulation 14 Meeting nutritional and hydration needs

Regulation 17 Good governance

Regulation 18 Staffing

Following our last inspection we asked the provider to take action to make improvements. During this inspection we found improvements had been made and there were no continued or new breaches of regulations.

There was not 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 provider had secured the services of a manager consultant with a background in mental health. Arrangements were in place to appoint a new manager and candidates were due to be interviewed on 28 September 2017.

People had care plan documents which were accurate, up to date and regularly reviewed. We found these described people’s individual needs and provided staff with a profile of people’s mental health needs. Where risks to individual people had been identified we found staff had been given guidance and advice on how to mitigate these risks.

Staff had been trained in safeguarding vulnerable adults. They told us they felt able to speak to the manager if they had any concerns

There were enough staff on duty. A new board on the wall told people who used the service who were their staff member for the day.

Staff provided appropriate support to people with dignity and respect. We found changes had been made in the service which promoted people’s independence.

Pre-employment checks were carried out on staff to ensure they were of suitable character and had the necessary skills to care for vulnerable people. Staff completed an induction when they first started work which supported them to get to know the home and people who used the service. Staff received regular supervision, appraisals and training. Staff had recently registered to undertake training in mental health.

The provider had used the knowledge and skills of a manager from another service to implement a programme of checks which ensured people were protected from living in an unsafe environment. These included, for example, fire safety and water temperature checks.

Accidents and incidents were recorded by staff. These were monitored by managers to ensure the right actions had been taken and prevent the same type of accident happening again.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Some people in the service were provided with additional staff hours to support them to carry out activities of their choice. Staff had begun to engage with people about the type of activities they would like to see provided.

Staff had completed food and fluid charts to monitor the food and fluid intake of people were at a nutritional risk. People made positive comments about the meals and we found people had a menu choice. Alternatives were available if people preferred other options.

We saw discussions had taken place with mental health professionals. The staff had made referrals to other health care professionals when they assessed people required addition support. We saw referrals had been made to dieticians, the speech and language therapy team (SALT), GP’s, community nurses and community psychiatric services. Systems and processes were in place to monitor and improve the quality of the service. We saw the senior management team had visited the service and carried out audits of the home which resulted in actions being required to improve the service.

A recent survey had been put in place and some survey returns were still expected by staff. The responses received at the point of our inspection were largely positive.

Since our last inspection there had been no complaints made about the service. We saw people had been given information on how to make a complaint. People told us they felt able to make a complaint to staff should the need arise.

People’s medicines were administered by staff who had been trained to carry out these tasks. Staff were required to undertake training before being assessed as competent to give people their medicines. We found people’s medicines were stored securely and regular audits were in place to ensure medicine counts were correct.

Since our last inspection improvements had been made to both the internal and external property. Following our last inspection a fire officer had visited the premises and recommended improvements to fire doors. We found these improvements had been carried out.