Whitwood House

Updated 16 June 2022

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Day one of the inspection was carried out by an inspector and day two of the inspection was completed by a member of the CQC medicines team. On day three, two inspectors visited the service. Following these days, an Expert by Experience made telephone calls to people’s representatives to gather further feedback. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Whitwood House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Whitwood House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The first day of this inspection was unannounced. The second and third days of the inspection were announced. This was because it is a small service and we needed to be sure that the registered manager would be in the office to support the inspection.

Inspection activity started on 4 April 2022 and ended on 14 April 2022. We visited the office location on 6, 11 and 12 April 2022.

What we did before inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We also contacted Healthwatch for their feedback. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

Two of the people living at this home were able to verbally communicate with us. We spoke with these people and four relatives about their experience of the care provided. We observed other people communicating through their body language.

We spoke with nine members of staff including the registered manager, area manager, office manager, deputy manager, a team leader and four support workers.

We reviewed a range of records. This included two people’s care records and 12 medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 16 June 2022

About the service

Whitwood House is a residential care home which was providing accommodation for 12 people on each of the three days of our inspection. The service can support up to 16 people.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right Support

• Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.

• Staff supported people to achieve their aspirations and goals.

• The service worked with people to plan for when they experienced periods of distress so their freedoms were restricted only if there was no alternative.

• Staff did everything they could to avoid restraining people. The service recorded when staff restrained people, and staff learned from those incidents. The use of restraint had significantly reduced due to the way people were supported.

• People had a choice about their living environment and were able to personalise their rooms.

• Staff enabled people to access specialist health and social care support in the community.

• Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

• Staff supported people to play an active role in maintaining their own health and wellbeing.

Staff shortages and a lack of drivers had impact on support for people to access the community.

The provider had not taken sufficient action following our last inspection to ensure the living environment had been maintained to a suitable standard.

Right care

• Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.

• People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

• Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

• People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

• Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

• People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.

People were protected from abuse and poor care. The service had appropriately skilled staff the provider employed to keep people safe. People’s risks were assessed regularly and managed safely. People’s care, treatment and support plans, reflected their needs.

Records showed that medicines were well managed and people received their medicines as prescribed.

The service provided care, support and treatment from trained staff and access to specialists able to meet people’s individual needs.

Right culture

• People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes.

• Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.

• People and those important to them, including advocates, were involved in planning their care.

• Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.

• The service enabled people and those important to them to work with staff to develop the service.

• Staff ensured risks of a closed culture were minimised so people received support based on transparency, respect and inclusivity.

Leadership from the registered manager was positive, and governance processes helped the service to keep people safe, protect their human rights and provide good care, support and treatment.

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

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

This service has been in Special Measures since 7 July 2021. During this inspection, the registered manager demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Enforcement

We have identified breaches of regulation in relation to insufficient action being taken in response to the last inspection findings and insufficient staffing levels.

Follow up

We will meet with the provider and request an action plan to understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.