Crowlin House

Updated 6 August 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

The inspection was carried out by two inspectors.

Service and service type

Crowlin House 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. None of the people using the service at the time of this inspection required personal care.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last 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 used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager and two members of staff. We reviewed a range of records. This included four people’s support records, risk assessments and multiple medicines records. We looked at staff files in relation to recruitment, training and supervision. 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 further training data, quality assurance records and support records. We received feedback from a person who used the service and from 14 members of staff and three professionals who had regular contact with the service.

Updated 6 August 2021

About the service

Crowlin House is a rehabilitation unit for people with severe and enduring mental health issues. The unit offers care for up to 18 people across three houses each of which accommodate six people. There were 16 people using the service at the time of this inspection.

The registered manager confirmed that none of the people currently using the service received personal care. This is help with tasks related to personal hygiene and eating. This inspection considered the wider social care provided.

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

On our arrival staff did not follow the procedure for admitting visitors, therefore we were not fully assured that the provider was preventing visitors from catching and spreading infections. The registered manager undertook to make sure the procedure was being followed in future. We were assured about other areas of infection control. The home had remained free of COVID-19 during the pandemic.

Health and safety checks were completed consistently to ensure the safety of the environment.

We received feedback that staffing levels had been low; however, the provider and registered manager were addressing this concern and improvements had been made. Staff were recruited safely, received a range of training and had access to supervision.

People had access to information and support about safeguarding and how to stay safe. Staff completed safeguarding training and safeguarding matters were investigated. Feedback from some staff indicated that they were not always clear on what happened with concerns that they had raised.

Some staff did not feel well supported to manage risk and did not feel that management were communicating clearly what they were doing. Other staff reported feeling confident about using their training and the risk assessments that were in place. We saw evidence that learning from incidents took place and that this process was being developed further.

Medicines management systems were robust and we were assured that people received the right medicines at the right time from staff who had received appropriate training. People were supported in becoming more independent and confident in managing their own medicines.

Staff involved people in the review of their support plans and risk assessments. People’s support plans were mostly detailed and person-centred and also addressed any risks identified. In one person’s support plan where we identified this was not the case, the registered manager took immediate action to address the issue.

There are issues the provider needs to address in order to support the registered manager in working to create a more positive culture and atmosphere within the service. Feedback from staff and the leadership team showed a sharp division of views. Some staff did not feel valued or listened to by the management. Other staff felt well supported by their colleagues and managers.

The service promoted people’s independence and there was evidence of good outcomes for people moving back into the community.

The leadership team was committed to driving improvements to the service and had a detailed action plan in place to facilitate this.

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 25 September 2019).

Why we inspected

We received concerns in relation to the management of risk, staffing levels, preventing and controlling infection and governance of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has not changed. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe section of this full report. The provider has a clear action plan to continue to make improvements to the service.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Crowlin House on our website at www.cqc.org.uk.

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.