Archived: Whitegates Retirement Home

Whitegates Retirement Home provides accommodation and support for up to 24 older people. Situated on the outskirts of the village of Westfield in East Sussex the home offers single rooms, two communal areas and a separate dining room. A lift enables people to access all parts of the building and there is a large garden with seating areas that is accessible to people using wheelchairs and walking aids. Some people were independent and needed only need minimal assistance; others needed support with personal care and moving around the home safely. There were 17 people living at the home during the inspection.

The registered manager was present during the inspection. 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.

This inspection took place on the 15 August 2017 and was unannounced.

The provider had a quality assurance and monitoring system in place and a number of audits were used to assess the services provided. Such as audits of medicine records and care plans. However, these audits had not identified the areas where improvement was needed that we found during the inspection. There have been a lot of changes since the last inspection and although these have improved the care and support provided for people living at the home, additional work is needed to embed these into practice and ensure people’s individual needs can be met.

A robust recruitment system was in place to ensure only suitable staff were employed. Staff attended relevant training, they had an understanding of people’s needs and there were enough staff working at the home to provide the support people wanted. Staff had attended safeguarding training; they were clear about how to protect people from abuse and the action they would take if they had any concerns.

The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The management and staff had attended training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and were aware of current guidance to ensure people were protected.

People said the food was good, choices were offered and staff assisted people if required. A range of group and individual activities were provided, based on people’s preferences, to participate in if they wanted to.

Staff supported people to see health and social care professionals when required. Records were kept of any visits, care plans updated with guidance for staff to follow to ensure any changes in support was provided.

Feedback was sought from people, relatives and staff through ongoing discussions, regular meetings and satisfaction questionnaires.

There were 21 people living at the home during the inspection and they had a range of support needs. Some people needed minimal support and care, other people needed support with personal care and assistance moving around the home, due to physical frailty or medical conditions, and some people were living with dementia.

A registered manager was responsible for the day to day management of the home. 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.

This inspection took place on the 19 and 20 May 2016 and was unannounced.

People were assessed before they moved into the home to ensure staff could meet their needs, and care plans, including risk assessments to ensure their safety, were developed from this information. However, records did not consistently reflect people’s specific needs and daily records did not evidence the support and care that staff said they provided.

People said there was not always enough staff working in the home to spend time with them to talk in addition to when they provided support and care. Staff told us there was not always enough staff working in the home during the afternoons. We saw staff supporting people to have a walk around the garden and the registered manager said staffing levels were based on people’s needs and were flexible depending on the support needed day by day. Appropriate recruitment procedures were in place to ensure only suitable people were employed at the home.

The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The management and staff had attended training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and were aware of the procedures to follow if a person needs changed and safe systems needed to be introduced to protect people.

Systems were in place to ensure people were protected. This included safeguarding training, staff had a good understanding of abuse and how to raise concerns if they had any. Staff were trained in giving out medicines and they gave them out safely and signed the administration records after they had been taken.

People, relatives and staff said the management were very approachable, and were involved in decisions about how the service developed with on going discussion on a day by day basis and during residents meetings. In addition feedback was sought from people, their relatives, healthcare professionals and other visitors to the home, through satisfaction questionnaires.

People told us the food was very good. Staff asked people what they wanted to eat, choices were available for each meal, and people enjoyed the food provided. People told us they decided what they wanted to do, some joined in activities while others chose to sit quietly in their room or communal areas. One person said, “I have never joined in group activities so I prefer to remain in my room.”

People had access to health professionals as and when they required it. The visits were recorded in the care plans with details of any changes to support provided as guidance for staff to follow when planning care.

A complaints procedure was in place. This was displayed on the notice board near the entrance to the building, and given to people, and relatives, when they moved into the home. People said they did not have anything to complain about, and relatives said they were aware of the procedures and who to complain to, but had not needed to use them.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

A single inspector carried out this inspection. The focus of the inspection was to follow up on a compliance action issued at our last inspection in November 2013, to look at additional outcomes and to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People received medicines from staff that had been trained and assessed as competent to do so.

There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available on call in case of emergencies.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Whilst no applications had needed to be submitted, there were clear procedures in pace. In addition, staff confirmed that they were familiar with the procedure should an application need to be submitted.

Is the service effective?

People told us that they were happy with the care they received and felt their needs had been met. We saw that when people needed specialist advice and support, arrangements were made for this to happen. People told us that there were opportunities to maintain links with their local community by attending a, 'Hub and pub' event held locally each week. They said there were enough activities arranged in the home and they could join in if they wanted to.

Is the service caring?

Staff were seen to treat people with respect. They explained to people what they were doing at each stage and gave people reassurance. For example, when assisting people with moving they explained where they were going and what they were going to do. One person told us, 'They're a good group of people (the staff), they look after us well.'

Is the service responsive?

People's needs had been assessed before they moved into the home and they were kept under regular review. Records confirmed that people's preferences, interests and diverse needs had been identified. People had access to a wide variety of activities and they received a monthly newsletter that kept them up to date with matters important to them.

Is the service well led?

We saw that the organisation had a range of measures in place to monitor the quality of the service provided at Whitegates Retirement Home. Records seen by us showed that where shortfalls were identified they had been addressed promptly. People told us that they had regular meetings and that they were given an opportunity to share their views about the home. They had also been asked to complete customer satisfaction questionnaires and the home was due to provide feedback on this process.

There were 19 people living at Whitegates Retirement Home at the time of this inspection visit.

People spoken with told us that they were well looked after and were free to do as they wished in the home. One person said, 'The home is very good. It is relaxed and you are listened to.'

We found that before people received any care or support they were asked for their consent and agreement and the staff acted in accordance with their wishes.

Care plans were personalised and contained instructions on how people should be cared for and supported.

We looked at the systems and processes in place for the safe management of medicines. We found that some record keeping and practices within the home had not always ensured the safe administration of medicines.

We reviewed the recruitment practice and associated documentation. We found the home followed robust recruitment processes for the recruitment of new staff.

We saw that complaints were taken seriously and there was an effective complaints system available. These processes ensured complaints raised were resolved to people's satisfaction.