Archived: Whitby House

Whitby House is a residential care home providing personal and nursing care to 27 people at the time of the inspection. The service can support up to 40 people across two floors, each of which has separate adapted facilities.

We found the following examples of good practice.

The service had a dedicated staff team. People were supported in the service in accordance with national guidance.

The registered manager and staff supported people and their relatives to understand the policies and procedures surrounding protection against COVID 19, the isolation processes and how the service could help them to keep people safe.

During our visit we observed the staff using Personal Protective Equipment, (PPE) safely. There were sufficient stocks of PPE available.

People living in the home and staff were tested regularly for COVID-19. Staff had been vaccinated as required.

The home was clean and hygienic. Cleaning schedules were in place and PPE stations placed around the home. Additional cleaning protocols were in place to ensure all areas of the building were regularly sanitised.

Relatives spoke positively about visiting and the communication from the service. Comments included; "Staff have supported with keeping contact during the pandemic and have done really well at protecting everyone" and "I do an LFT test before visiting then put on full PPE. I visit [Name] in their room and use the call bell if I need anything rather than leaving the room."

It is registered to provide accommodation and personal care to up to 36 people. At the time of this inspection there were 30 people living at the home. Some of the rooms had been adapted for different use in the COVID19 pandemic, for example, staff testing station and staff changing room.

We found the following examples of good practice.

• The service had procedures and protocols in place which ensured people were safely admitted into the service and relatives could visit safely in accordance with national guidance. A visiting pod had been installed for use when guidance and legislation allows.

• People and their relatives were supported to understand the isolation processes and how the service could help to alleviate them feeling lonely, such as video calls with friends and loved ones and dedicated support time from their assigned staff member and activities coordinator.

• Staff were supported in isolation/sickness absence by the provider. Staff support and wellbeing was considered and enhanced during the pandemic.

• Personal protective equipment (PPE) was widely available and used correctly and there was an extensive testing program in place for staff, residents and relatives.

• The home was clean and hygienic throughout. Areas in the home had been redesigned to enable good social distancing.

• Staff were trained in infection prevention and control (IPC) and had frequent refresher training and guidance in COVID-19 guidelines. They had good links with the local community trust IPC team for guidance and support.

• There was an IPC policy and procedures in place, supported by local and national guidance specific to the pandemic

• Regular meetings took place remotely or through a cascade system to minimise staff contact. Staff were responsible, did not socialise and were very cautious of their behaviour outside of work, in order to minimise risks to colleagues and people.

• The registered manager was proud that they and the staff had kept people living at the home as safe as possible throughout the pandemic.

Whitby House is a residential care home providing personal and nursing care to 28 people at the time of the inspection. The service can support up to 40 people across two floors, each of which has separate adapted facilities.

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

Although there were sufficient staffing levels at Whitby House we received some feedback that people felt the home was understaffed at key times of the day. There had been a significant change in the needs of some of the people living at the home and the registered manager needed to ensure that people always receive timely care.

The home was clean and risk assessments were in place to identify and safely manage the needs of people, however we did find some issues that required improvement. We found evidence of toiletries not always being stored hygienically and also some rooms unlocked which should be kept locked for the health and safety reasons. These issues were addressed straightway when we raised them with the senior team and the registered manager.

Other systems were in place to ensure the safety and wellbeing of people. These included systems to protect people from the risk of abuse, receive their medicines safely and to ensure that people could share their views on the service being provided at Whitby House.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were offered choices and involved in decision making relating their care and care plans contained sufficient person-centred information to meet people’s preferences.

People had access to healthcare and the registered manager worked closely with other agencies to ensure successful outcomes were achieved.

All people we spoke to during the inspection spoke positively about Whitby House and the care they received. Staff were described as caring and attentive to people’s needs.

Staff were committed to deliver a high standard of care. They were well trained and felt supported in their role.

There was a wide range of leisure activities available to people and staff worked hard to ensure people who were unable to get out of bed due to ill health were engaged in the activities on offer.

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 good (published 26 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Whitby House is a care home providing nursing care for up to 40 older people who require nursing support and/or have a physical disability. The home is a purpose built, two-storey building set in its own grounds in the Whitby area of Ellesmere Port.

Our last visit on 23 and 24 March 2016 identified that improvement was needed in relation to care planning. Because of this, we rated the responsive domain as 'requires improvement'. Despite this, the rating for the service had been assessed as good overall. This inspection identified that the required improvements had been made. The service met the all the relevant fundamental standards and the rating remains Good.

Care plans had been improved and provided a good overview of the person’s health and care needs. Risks to people's health and safety had been identified and care plans contained appropriate risk assessments and risk management plans to guide staff. Plans were person centred and regularly reviewed.

People continued to be supported in a safe way and where risks to people were identified they were managed effectively. Staff knew what abuse was and how to recognise and report it.

There were enough staff available to offer individual support to people and recruitment processes ensured they were suitable to work at Whitby house.

Medicines were managed safely. People received their medicines as prescribed.

Staff knew the people they cared for and had received an induction and training and supervision to help in their role.

People are 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 support this practice.

People told us that staff were kind and caring. Observations showed staff approached and spoke with people kindly and with respect. There was an activities organiser employed at the service and staff assisted in organising activities for people which reduced the risk of social isolation.

There was a complaints policy and procedure and people knew how to make complaints.

The quality assurance system in place used audits in each area of the service so that there was a consistent approach to improvement. Accidents and incidents were recorded, analysed and trends identified. The registered provider understood the importance of gaining feedback from people using the service. Regular residents meeting were held and surveys used to gain feedback to help improve the service provided.

Further information is in the detailed findings below.

Whitby House is a care home providing nursing care for up to 40 older people with dementia and/or physical disabilities. The home is a purpose built, two-storey building set in its own grounds in the Whitby area of Ellesmere Port. At the time of our inspection there were 34 people living at the service.

The service has a registered manager. 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.

We last inspected this location in May 2014 and we found that the registered provider met all the regulations we reviewed.

During this inspection we found a breach of the Health and Social Care Act 2008 (Regulated Activities) 2014. You can see the action we have told the provider to take at the end of the report.

People’s needs were assessed and planned for and information was available for staff. Risk assessments were in place for people which identified potential areas of risk. However we found that care plans did not always record people’s needs accurately. Records were not always personalised to reflect people’s individual preferences about how they would like their care and support to be provided. Food and fluid charts were not always completed in detail to reflect what people had consumed on a daily basis.

People said they were happy with the service that they received and that they felt safe. Staff had a good understanding of how to protect people from the risk of harm or abuse. The registered provider had clear policies and procedures in place for reporting any concerns they had about the safety and well being of people they supported.

There were sufficient levels of suitably trained staff to support people and ensure they received their medicines in a safe and timely way. When new staff were appointed robust recruitment checks were carried out to make sure they were suitable to work with vulnerable people.

People were supported to access health care professionals to make sure they received appropriate care and treatment for their needs.

The registered manager and staff had a good knowledge and understanding of the Mental Capacity Act 2005 and their role and responsibility linked to this. Records were in place to show how best interest decision making had been completed when people were unable to make decisions themselves.

Staff received support through supervision and team meetings which enabled them to discuss any matters, such as their work, training needs or areas of development. There was a well-developed programme of planned training which was relevant to the work staff carried out and the needs of the people who used the service.

People told us that staff always treated them with kindness and respect. They told us that staff were mindful of their privacy and dignity and encouraged them to maintain their independence. Relatives and visitors told us that they always felt welcome when they visited the service.

People and family members we spoke with said they knew how to complain but they hadn't needed to. Staff said the registered manager was supportive and approachable. People were consulted and asked their views about aspects of service provision.

The provider had quality assurance systems in place to audit the service provided. Records we saw were regularly completed in line with the registered provider’s own timescales.

This is a summary of what we found.

Is the service safe?

CQC monitors the operation of the Deprivation of Liberty Safeguards (DOLs) and the Mental Capacity Act 2005. While no DOLs applications have needed to be submitted, proper policies and procedures were in place. We discussed this with the manager who understood when an application should be made, and how to submit one.

All of the people we spoke with said they felt safe living at Whitby House. Comments from them included; "I feel safe I have never been afraid of anything here" and "I have never had anything to be concerned about here. I'm quite safe".

Is the service effective?

We spoke with five people who used the service. They all told us they were happy at Whitby House and had no concerns with the care provided. Comments from them included; "I get plenty to eat and drink here. I've got no complaints" and "When I press the call bell they come very quickly".

We spoke with five members of the staff team. They demonstrated a clear understanding of people's care needs and their role and responsibility to maintain people's safety.

Is the service caring?

We observed how people were cared for at Whitby House. Staff were always present in the communal areas throughout our visit and promptly answered calls for assistance. We saw that staff spoke to people in a caring and compassionate manner. People were seen to be comfortable with the staff that supported them. A person who lived at the home told us; "They always come in to check on me in the night".

Is the service responsive?

We saw that before a person started to use the service, an assessment of their needs and abilities was undertaken. The care plans showed how the needs of the people who used the service were to be met, including any risks to their well-being.

Records and discussions with staff showed that where there was a concern about a person's health needs the advice and support of health professionals such as GP's, specialist nurses had been sought. Records suggested that any instruction given had been followed.

Is the service well led?

The management team had been in place for a long period of time at the home. Staff and people who used the service spoke highly of them and said they were listened to when concerns or suggestions were made.

We saw the service carried out monthly audits of various aspects of the service's operations such as medication management, care planning, people's finances and the homes environment. Where concerns were identified, processes were in place to enable appropriate changes to be made.

We saw that staff were very respectful towards people who used the service. For example, we observed staff bend down to the person's level to speak to them. They explained what they were going to do and ask permission.

We saw that the home had been recently refurbished and was clean and tidy throughout.

We saw that the provider had effective recruitment policies and procedures in place. This also ensured that people were not discriminated against during the recruitment process.

We found that people who used the service and their representatives were asked for their views about the care and treatment that was received. We examined the provider's statement of purpose which was given to a person who used the service and/or their advocates. It was clear that people were given the right information of who to complain to if they were not happy or had any concerns about the service.

We contacted the Local Authority prior to our inspection. They had no concerns about Whitby House.