Archived: Withy Grove House

Updated 27 April 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: This inspection was carried out by three 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, in this case, older people and people living with dementia.

Service and service type: Withy Grove House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection.

The service had an interim manager in post who was not registered with CQC. This means that the registered providers are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection: The inspection was unannounced.

What we did:

Before to our inspection we looked at the information we held about the service. This included safeguarding investigations, incidents, accidents and feedback about the service provided. We looked at statutory notifications that the provider is required to send to us by law. We looked at issues raised in complaints and how the service had responded to them We also contacted service commissioners who provided feedback about their experiences of the service. We used a planning tool to collate all this evidence and information prior to visiting the service.

During the inspection we spoke with eight people who lived at the service and four relatives. We also spoke with four members of care staff including a senior carer, a member of maintenance staff, a member of domestic staff the interim manager and the deputy manager

We looked at a range of records which included the care files for six people who used the service and seven new staff recruitment files. We looked at a selection of medicines and medicines administration records. We also looked at records relating to the quality monitoring, maintenance and operation of the home.

Updated 27 April 2019

About the service:

Withy Grove House is registered with CQC to accommodate up to 54 people on two units, each of which have separate adapted facilities. One of the units specialises in providing nursing care to people living with dementia. At the time of the inspection there were 31 people living in the home.

At the last comprehensive inspection 24 and 27 July 2018 inspection we found that Withy Grove House was in breach of six regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to safe care and treatment, safeguarding service users from abuse and improper treatment, staffing, the need for consent, person centred care and good governance. The service was rated inadequate and placed in special mwithin this time frame. During this inspection the service demonstrated to us that improvements had been made and it was no longer rated as Inadequate overall or in any of the key questions. Therefore this service is now out of special measures.

After the last inspection we asked the provider to complete an action plan to show what they would do and by when to improve the key questions to at least good. We found improvements had been made in all domains and the six breaches of regulation from the previous inspection had been met. Work needs to continue to show all the improvements can be sustained in the long term.

People’s experience of using this service

•Relatives told us the home had “improved immensely” since the last inspection. People told us they were aware of and appreciated the improvements that had been made to their home to improve their environment and care.

•People commented positively on the improvements in the standard of care and the quality of staff. Everyone felt they or their relative were safe and that the home was meeting their needs.

•The environment had been improved to support people living with dementia. There was signage to help people to find their way about their home and promote their independence.

•Staff were more aware of people's life history and preferences and they used this information to develop positive relationships and deliver person centred care.

•People received their medicines when prescribed and these were stored safely. However, medicine allergies were not consistently recorded. This could put people at risk of receiving inappropriate medicines. We have made a recommendation about this.

•Staff had received training on safeguarding people from abuse and knew how to raise concerns to keep people safe. Risks to people were assessed and action was taken to address them. There were enough suitable staff working to support people safely.

•Care plans had been improved to provide more detailed information about people and their care needs and behaviour management. Risk assessments were being done and recorded in care plans along with the action to be taken to try to mitigate identified risks.

•Assessments obtained from other health and social care professionals were being used to plan care for people.

•Accidents and incidents were monitored to see if lessons could be learned and changes made to help keep people safe.

•The cleanliness of the home had improved. Effective infection control procedures were in use.

•Staff were receiving training appropriate to their roles and supervision was being given to support staff development and performance.

•People enjoyed the meals and their dietary needs and nutritional risks were being assessed and monitored. Pureed diets were provided but not well presented in an appetising way. We made a recommendation about this

•Weights were monitored but there were some people whose weight monitoring had been inconsistent. We made a recommendation about this.

•People told us they were given choice over their day to day lives and supported to maintain their independence.

•Staff were knowledgeable about people and their needs and care plans had been reviewed and updated

•There was a limited range of activities on offer but staff encouraged people to participate in things of interest to them.

•The service displayed the latest rating at the home and on the website. When needed notifications had been completed to inform us of events and incidents and this helped us to monitor the action the provider was taking.

•We could see the registered provider interim management team and staff had been working hard to complete the action plan they had for improvement.

Rating at last inspection: Inadequate. (The report was published 5 September 2018).

Why we inspected: This was a planned comprehensive inspection based on the rating of Inadequate at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit asper our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk