Archived: Whitbourne House

Updated 18 December 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 unannounced inspection was carried out on 27 October 2015 by two adult social care inspectors and an Expert by Experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. We obtained people’s views by speaking with people who lived at the service, their relatives and staff members. We also observed the delivery of people's care within the home. The second day of this inspection was carried out on 29 October 2015 by two adult social care inspectors.

Before the inspection we reviewed the information we held about the service. This included the notifications we had received from the provider. A notification is information about important events, which the service is required to send us by law. Before the inspection, we asked the provider to complete a Provider Information Return (PIR). The provider had completed and submitted their 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 also contacted the local authority commissioners of the service for feedback.

As part of this inspection we spoke with 12 people who used the service and three people’s relatives. We also spoke with four professionals who were in regular contact with the service. We spoke with five care staff, a member of the kitchen staff and the registered manager. We also made observations through the day including Short Observational Framework for Inspection (SOFI) observation. SOFI is a way of observing the experiences of people that may not be able to speak with us verbally.

We looked at records, which included six people’s care records, the medication administration records (MAR) for people living at the home and eight staff files. We also looked at other information related to the running of and the quality of the service. This included quality assurance audits, environment maintenance documentation, staff training and support information, staff duty rotas, meeting minutes and the arrangements for managing complaints.

Updated 18 December 2015

We inspected Whitbourne House on the 27 and 29 October 2015 and the inspection was unannounced. Whitbourne House provides care for up to 41 older people, all of whom are living with dementia. On the day of our inspection 39 people were living at the service and one person on a respite (temporary) stay.

There was a registered manager in post. 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.

Risks in relation to people’s needs were not always recorded accurately and staff we spoke with gave conflicting information to what had been recorded. Medicines were stored and administered safely but protocols for ‘as required’ (PRN) medication, were not in place.

People were protected from the risk of harm and abuse by staff that understood their responsibilities in relation to safeguarding and systems and procedures that were used effectively. People were protected by effective infection control procedures and the environment was clean.

People received a choice of good quality food which they enjoyed. However we found that the nutritional risks were not always assessed accurately.

People were supported by staff that felt confident in their roles and felt supported. The registered manager and staff were aware of their responsibilities under the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The MCA is the legal framework that protects people’s right to make their own choices. DoLS are in place to ensure that people liberty is not unlawfully restricted and where it is, that it is the least restrictive practise.

People were supported by caring staff who respected their privacy and dignity and promoted their independence. Staff were described as caring by the people we spoke with and we also observed a number of caring interactions.

The staff were aware about the people’s needs but records were not always updated clearly to reflect care needs and the level of assistance required to meet these needs. We found that peoples experience of activities had changed and many felt it could be improved.

There were a number of monitoring systems and processes to ensure that the service delivery was monitored. We found that some of the issues we found around the care documentation had not been identified prior to our inspection.

People spoke positively about the management. The manager was aware about the improvements required to the service. The manager and staff told us they wanted to provide good quality care for people. The registered manager explained she was looking at improving the environment to help promote the principles of dementia care. For example, better use of colour contrast.

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