27 and 29 October 2015
During a routine inspection
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.