20 July 2021
During an inspection looking at part of 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.