Whitwood Hall

Updated 16 October 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 two inspectors. Following the site visit, an Expert by Experience made phone calls to people’s relatives to gather feedback. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Whitwood Hall 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 did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided. A manager from another home run by the registered provider was temporarily in day-to-day charge of the service. Two area managers were providing support to the manager.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

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 service and made the judgements in this report.

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We also contacted Healthwatch for their feedback. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

We spoke with five people who lived in the home and seven relatives. We also spoke with the home manager, two area managers, the deputy manager and 11 support workers.

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.

We reviewed a range of records. This included two people’s care records in full and multiple medication records. We looked at the recruitment of two staff members as well as staff supervision records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 16 October 2021

About the service

Whitwood Hall can accommodate up to 16 people across three separate houses, each of which have separate adapted facilities. These houses are known as Saxon, Moore and Lodge. The home supports people with autism, learning disabilities, complex needs and behaviours which may challenge others. On the day we inspected, 11 people were living in the home.

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

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.

Right support:

• Model of care and setting maximises people’s choice, control and independence

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people

using services lead confident, inclusive and empowered lives

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, Right care, Right culture. People were not being supported to access the local community in line with their assessed needs. We found there was confusion about whether agency workers were allowed to support people away from the home. This meant people were not empowered to have full control over the day-to-day routines. The provider has taken action since our inspection.

People were not supported to have maximum choice and control of their lives and staff were not enabled to support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

There had been a lack of robust oversight at this home in the lead up to our inspection. At the beginning of July 2021, a home manager from a ‘sister’ service had been asked to take day-to-day control of Whitwood Hall. They were being supported by two area managers who were providing intensive support.

Training completion levels were found to be low in some areas. The provider was addressing this following our inspection. Staff received formal support through supervision.

Soap dispenser units in some people’s bathrooms did not have soap in them and a cover. This was addressed on the day of inspection. Staff largely wore their PPE correctly.

The premises were not in a good state of repair. The provider had identified this prior to our inspection and was taking action. However, it was evident that a regular programme of maintaining the three houses had not been suitably managed.

There were sufficient numbers of staff to meet people’s needs. However, we had concerns regarding the suitable deployment of staff to ensure there was an appropriate skills mix. Staff had been safely recruited with relevant background checks.

Relatives knew how to complain if they were dissatisfied. There was no record concerning the only complaint we became aware of and how it was dealt with, although we are aware this was resolved.

People and relatives felt the service was safe and that people were protected from harm. Staff received safeguarding training to ensure they knew how to recognise and report abuse. People received sufficient amounts to eat and drink. Healthcare support was provided for people when they needed this.

People and relatives were mostly positive about the care their loved ones received. We witnessed caring interactions between staff and people living in the home. Staff were familiar with people’s care needs and people’s privacy and dignity was being maintained.

Medicines were mostly well managed, with staff receiving training and a competency check for this. Medication audits were being completed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was outstanding (published 19 March 2019).

Why we inspected

The inspection was prompted due to concerns received about staffing levels, the state of the premises, staff not receiving training, people’s safety, leadership and an over reliance on take away foods. 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, effective and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report. The provider was taking action to address these areas at the time of inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Whitwood Hall 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 the suitable deployment and training of staff as well as a lack of oversight of the home.

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 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.