This inspection was carried out on the 22, 28 November 2017. The first day was unannounced. We continued the inspection on the 08 December 2017. This was because the registered manager was not available on the first two days of our inspection and we needed to speak with them. Croft House Rest Home can accommodate up to 22 older people. It is located in the centre of the Freckleton Village, close to the shops and public transport. Bedroom accommodation is situated over two floors and there is a stair lift for people who require support with mobility. There are three lounges and a dining area. There are gardens to the front of the home and a paved area to the rear. On the day of inspection there were 21 people living at the home.
We last inspected Croft House Rest Home in October 2016 and identified two breaches in Regulation. We found risks to people who lived at the home were not always assessed. This was a breach of Regulation 12 of the Health and Social Care Act (Regulated Activities) Regulations 2010 (Safe care and treatment.) We also found audit systems used by the registered provider to identify shortfalls had not identified the shortfalls we had found on the inspection. This was a breach of Regulation 17 of the Health and Social Care Act (Regulated Activities) Regulations 2010 (Good Governance.)
You can see what action we told the provider to take at the back of the full version of the report.
Following the inspection in October 2016, the registered provider sent us an action plan outlining how they intended to make the required improvements. The action plan indicated improvements would be made by May 2017.
At this inspection carried out in November and December 2017 we found some improvements had been made. We found a range of individual risk assessments were in place to support people’s safety. Documentation reflected the action staff were expected to take and staff were knowledgeable of the assessments in place. However, we found the registered provider had not ensured the premises were safe for use and used in a safe way. We found the home was not always secure. We noted the back door was not always secured. We also saw some ground floor windows did not have restrictors in place. This posed a risk of illicit entry. We found cleaning products were not secured, a fire door was propped open and a floor was damaged. This was a breach of Regulation 12 of the Health and Social Care Act (Regulated Activities) Regulations 2010 (Safe care and treatment.) We discussed this with the deputy manager and prior to the inspection concluding we saw action had been taken to minimise the risk of harm occurring. We also received written documentation confirming this.
At this inspection carried out in November and December 2017 we found a range of audits were in place to identify shortfalls in the service provided. These included accident and incident audits, weight management audits, care planning audits, medication audits and training audits. However, we noted the audits had not identified some of the concerns we had identified on inspection. This was a breach of Regulation 17 of the Health and Social Care Act (Regulated Activities) Regulations 2010 (Good Governance.)
You can see what action we told the provider to take at the back of the full version of the report.
During the inspection we spoke with six people who lived at the home. The people we spoke with described staff as ‘busy’ and ‘rushed.’ One person told us they had to wait for personal care and said, “They need more staff here.” A further person told us they saw staff, “rushing.” We spoke with staff who told us people sometimes had to wait for help as they were busy supporting other people. This was a breach of Regulation 18 of the Health and Social Care Act (Regulated Activities) Regulations 2010 (Staffing.)
You can see what action we told the provider to take at the back of the full version of the report.
During the inspection we saw alert sensors were used to minimise the risk of people falling. We also saw one person had a bed with bedrails in place to ensure their safety. We asked the deputy manager if an application to the supervisory body had been made to ensure people were being lawfully deprived of their liberty. The deputy manager told us they had not and they would complete the applications as required. This was a breach of Regulation 13 of the Health and Social Care Act (Regulated Activities) Regulations 2010 (Safeguarding service users from abuse and improper treatment.) We discussed this with the deputy manager and prior to the inspection concluding we saw action had been taken to ensure people were lawfully deprived of their liberty.
You can see what action we told the provider to take at the back of the full version of the report.
During the inspection we saw people’s personal details were displayed in a communal area, bathroom locks were not working and a communication book, containing personal details of people who lived at the home was left on a table in a communal area. We discussed this with the deputy manager and prior to the inspection concluding we saw action had been taken to address this. We have made a recommendation regarding this.
There were systems in place to manage medicines safely. People told us and records we viewed; indicated people received their medicines as prescribed. We found best practice guidance was not always followed. We noted two bottles of prescribed medicines had not been dated on opening. We have made a recommendation regarding this.
People told us they were happy living at Croft House Rest Home and the care met their individual needs. We were told, “I think my care is excellent. And, “I’m well looked after.” People described staff as, “thoughtful” and “wonderful” and told us they were involved in their care planning.
There were systems in place to protect people at risk of harm and abuse. Staff were able to define abuse and the actions to take if they suspected people were being abused.
We found medicines were managed safely. We saw people were supported to take their medicines in a dignified manner. We found medicines were stored securely.
We found appropriate recruitment checks were carried out. This helped ensure suitable people were employed to work at the home. We found there were sufficient staff to meet people’s needs. People were supported in a prompt manner and people told us they had no concerns with the availability of staff.
Staff told us they received regular supervisions and appraisals to ensure training needs were identified. Two staff told us they felt they would benefit from a one to one meeting with the registered manager at the point of their appraisal. We passed this to the registered manager for their consideration. Staff told us, and we saw documentation which evidenced that staff received training and development opportunities to maintain their skills.
We viewed the kitchen and saw it was well stocked with a variety of tinned, frozen and fresh produce. All the people we spoke with told us they were happy with the meals provided and they were given an alternative if they did not like the meals offered to them.
People were referred to other health professionals for further advice and support when assessed needs indicated this was appropriate. Documentation reflected the advice of health professionals.
Our observations during the inspection showed staff treated people with respect and kindness. People told us they considered staff were caring and we saw a positive rapport between staff and people who lived at the home.
Staff knew the likes and dislikes of people who lived at the home and delivered care and support in accordance with people’s expressed wishes. People spoke positively of the activities provided at the home and we saw people laughing and smiling as they joined in a quiz.
There was a complaints policy which was understood by staff. Information on the complaints procedure was available in the reception of the home. It is a legal requirement that the home conspicuously displays its last CQC rating. We noted this was available in the reception area of the home and was also displayed on the registered provider’s public website.
The registered provider had taken steps to improve the environment at the home. We saw a wet room had been installed and decoration had taken place in some areas of the home.
People who lived at the home were offered the opportunity to complete surveys and meetings were available for people to participate in. People and relatives also told us they found the registered manager approachable if they wished to discuss any matters with them.