Littlecroft

Updated 4 April 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 checked 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 was a comprehensive inspection, which took place on 14 February 2018 and was unannounced.

The inspection was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using similar services or caring for family members.

We reviewed the information we held about the service. Before the inspection, we asked 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 looked at notifications about important events that had taken place in the service, which the provider is required to tell us by law. We used all this information to plan our inspection.

People’s ability to communicate was limited, so we were unable to talk with everyone. The expert by experience observed staff interactions with people and observed care and support in communal areas.

We spoke with the registered manager, one team leader and four support staff.

We looked at the provider’s records. These included two people’s care records, which included care plans, health records, risk assessments and daily care records. We also looked at medicines administration records. We looked at two staff files, a sample of audits, staff rotas, and staff training records.

Updated 4 April 2018

The inspection was carried out on 14 February 2018, and was an unannounced inspection.

The service Littlecroft 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 was not registered to provide nursing care. The service provides accommodation for up to nine people who have learning disabilities. There were five people living at the service at the time of the inspection. The service Littlecroft is a residential care home located in New Romney and consists of two neighbouring chalet bungalows in a residential area.

At the last Care Quality Commission (CQC) inspection on 05 and 06 October 2016, the service was rated ‘Good’ in the Caring and Responsive domains: ‘Requires improvement’ in Safe, Effective and Well Led domains. The overall judgement rating for the service was ‘Requires Improvement’ and there were five breaches of regulation. There were areas that required improvement. These included, personal emergency evacuation plans that were not in place for people to inform staff about the support they would need to leave the service in the event of an emergency; fire drills had not been completed as required; maximum hot water temperatures, set by the Health and Safety Executive were marginally exceeded. Although checks had identified this, action had not been taken to rectify it; local authority safeguarding protocols had not always been followed; some 'as and when needed' medicines were administered, staff had not always recorded the quantity given; applications to meet the requirements of the Deprivation of Liberty Safeguards had not been made as needed., and quality monitoring systems were in place, but were not effective enough to enable the service to highlight the issues raised at the last inspection.

At this inspection, we found that improvements have been made.

Systems were in place to enable the provider to assess, monitor and improve the quality and safety of the service and these were being followed.

Effective procedures were in place to keep people safe from abuse and mistreatment.

The registered manager had applied the principles of MCA 2005 within the service in a person centred manner which involved people in decisions about meeting their needs effectively.

Medicines were managed safely and people received them as prescribed, including as and when required medicines.

Each care plan now contained information of an individual Personal Emergency Evacuation Plan (PEEP). The fire safety procedures had been reviewed and were regularly monitored in line with the provider’s policy. A water management plan was in place to reduce the risks

This service had a registered manager in post. A registered manager is a person who is 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 registered manager was also responsible for looking after other services owned by the same provider. Although always in contact with staff, when the registered manager was not present at the Littlecroft sites, team leaders oversaw the running of the service.

Most people were able to indicate to us they liked living in the services, they appeared happy, relaxed and contented in a comfortable living environment, interacting readily with staff and without hesitation.

There were enough staff to keep people safe. The registered manager continued to have appropriate arrangements in place to ensure there were always enough staff on shift.

Staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. Staff recognised the signs of abuse and what to look out for.

Staff received regular training and supervision to help them to meet people's needs effectively.

Healthcare needs had been assessed and addressed. People had regular appointments with GPs, health and social care specialists, opticians, dentists, chiropodists and podiatrists to help them maintain their health and well-being.

People were supported to eat and drink enough to meet their needs.

Staff treated people with kindness and respect for their privacy and dignity. Staff knew people well and remembered the things that were important to them so that they received person-centred care.

People had been involved in their care planning and care plans recorded the ways in which they liked their support to be given. Bedrooms were personalised and people's preferences were respected.

Independence was encouraged so that people were able to help themselves as much as possible.

Staff encouraged people to actively participate in activities, pursue their interests and to maintain relationships with people that mattered to them.

The registered manager ensured the complaints procedure was made available in an accessible format if people wished to make a complaint. Regular checks and reviews of the home continued to be made to ensure people experienced good quality safe care and support.

The registered manager provided good leadership. They checked staff were focused on people experiencing good quality care and support.

The provider had a set of values, which included treating everyone as an individual, working together as an inclusive team and respecting each other. Staff were aware of these and they were followed through into practice.