14 February 2018
During a routine 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.