This unannounced inspection took place on 18 and 23 April 2018. It was the first inspection of the service since a change of registration in November 2017.Whetstone Hey is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home accommodates up to 42 people in purpose-built premises. The home does not provide nursing care.
The home is required to have a registered manager. 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. A new manager had been appointed in January 2018 and had started the process for registration with CQC.
People we spoke with believed the home was safe. Maintenance records showed that regular checks of services and equipment were carried out by the home’s maintenance person and testing, servicing and maintenance of utilities and equipment was carried out as required by external contractors.
The home had a manager, deputy manager, care team leaders, senior carers and care assistants. There was a care team leader on every shift and during the day there was also a senior carer. This ensured there was a senior person who was able to administer medication on each floor.
Ancillary staff covered cleaning, laundry and kitchen duties. They were managed by the home services manager and there was also a domestic supervisor who people spoke highly of. All parts of the premises looked clean. The home had received an excellent score following an infection control inspection in February 2018 and the kitchen had a five star food hygiene rating.
We looked at the recruitment records for three members of staff who started working at the home recently. Records showed that robust recruitment procedures had been followed to ensure staff were of good character.
We looked at the arrangements for people’s medication. We found that, in general, medicines were stored and handled safely, however there were some areas for improvement. Hand-written entries on MAR sheets had not been signed. These should be double signed, first by the member of staff making the entry, and second by another member of staff who has checked that it is correct. Prescribed creams and ointments were only signed for occasionally and this did not show they had been applied consistently as prescribed.
Risk assessments were recorded in people’s care notes but effective plans were not always in place to reduce the risks identified. A log of accidents and incidents was maintained and the records showed that appropriate action had been taken when accidents occurred.
Staff received training about safeguarding as part of their induction, with updates periodically. We spoke with staff who said they would have no hesitation in reporting any concerns. The manager had reported safeguarding incidents as required and full records were kept of safeguarding referrals that had been made.
The previous manager had made appropriate DoLS applications to the local authority. Some of these had been authorised but others were still awaiting consideration.
People could choose where they wanted to eat and who they sat with. The cook was aware of people’s preferences and told us they always made an alternative for people who did not want to have the meals on the menu. People told us they enjoyed their meals and had plenty to eat and drink.
There was a programme of on-line training for all staff to ensure that they knew how to work safely. This was supplemented by practical moving and handling, fire safety and first aid training. The manager told us all of the care staff were required to complete the Care Certificate.
People who lived at the home told us that the staff provided them with good care and support. One person commented “I love it here.” Another person said “It’s marvellous.” Everyone had their own bedroom and personal care was provided in a discreet way in the privacy of the person’s room. There was a sense of community within the home and one person who had lived there for a number of years told us “The staff are like my second family. They are all good to me from the cleaners to the higher ups.”
People’s personal information was kept securely in offices that were locked when unoccupied and this protected their confidentiality. We also noted the use of room numbers rather than names on files to protect confidentiality.
The care files we looked at showed that people’s care and support needs were assessed covering all aspects of their health and personal care needs. The assessments fed into a lengthy document called ‘My Health Needs’.
There was no planned programme of regular social activities. The manager told us that the home had been without an activities organiser for the last few weeks but two part-time activities organisers had now been appointed.
The home's complaints procedure was displayed and people we spoke with said they would tell the manager or another member of staff if they had any complaints.
We saw evidence of regular staff meetings which were well attended. The minutes of the staff meetings showed that staff felt able to express their views. People living at the home told us they attended resident meetings and records showed that these were held regularly.
There was a schedule of quality audits for the year and these had all been completed to date. We looked at the records and found evidence of regular checks of care plans, kitchen hygiene, meals, laundry, medication, infection control, health and safety, maintenance and gardens and finance. These were accompanied by action plans for improvement as needed.