About the service Whittington House is a residential care home providing personal and nursing care to up to 66 people. The service provides support to older people predominantly, some of whom live with dementia. At the time of our inspection there were 38 people using the service.
Whittington House is a purpose built care home and people are accommodated in one building. There are four named units, although at the time of our inspection, people were only living in three of the four units. One of those units specialises in providing care to people living with dementia.
People’s experience of using this service and what we found
People told us they felt safe and there were processes in place to safeguard people from abuse. People confirmed they received their medicines and support to take these as prescribed. Monitoring arrangements were in place to reduce the risk of medicine errors. Risks to people’s health were assessed and action taken to reduce or mitigate risks. Environmental risks were assessed and managed, so these were reduced or mitigated. Arrangements were in place to maintain the safety and upkeep of the building as well as the outside spaces. Maintenance and servicing arrangements ensured the service’s equipment, utilities and emergency systems remained in working order.
The provider had experienced significant challenges in retaining and recruiting staff, but some progress had been made with the recruitment of new staff. The provider used agency staff to support safe staffing numbers and to support the running of the service overall.
At the time of the inspection the manager and deputy manager were providing leadership and support to the staff. The provider had arrangements in place to support this management team. Just prior to the inspection, the manager had resigned so the provider had organised for further management support arrangements to be in place once the manager had left.
There were systems and processes in place to assess and monitor the quality of the services provided to people, including to assess and monitor the service’s compliance with necessary regulations. The provider had sought and acted upon feedback from people, their representatives and staff to improve the service. Improvements had been made to monitoring clinical and environmental risks, records systems and care plans, the management of concerns and complaints, people’s food choices and support for nursing.
Progress against ongoing areas for improvement was monitored through the provider’s quality monitoring process. For example, this included the current continued monitoring of the cleaning and support for the housekeeping team whilst waiting for the recruitment of additional housekeepers. Staff who wished to be dementia ambassadors had been identified and were due to start their training as part of the provider’s new dementia strategy.
People and relatives told us they had appreciated the improved communication and engagement arrangements which the manager had put into practice. They described the manager as being visible and approachable; willing to listen to their concerns and take action to try and resolve them. Lessons had been learnt from the feedback provided from relatives about the previous lack of response in relation to their concerns and complaints.
Nurses and senior care staff were being empowered and supported to develop their leadership and supervisory skills. Processes were in place to improve communication between departments and to ensure all departments worked together to support people who used the service.
Managers and staff worked with various health and social care professionals to support people’s access to the service when needed and to ensure their health and social care needs were met.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 15 November 2019).
Why we inspected
We received concerns in relation to staffing numbers, staffs communication skills, the management of people who live with dementia and who have behaviours that can cause distress or potential harm to others, the management of medicines and complaints and the cleanliness of the care home. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
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.
For those key questions not inspected, we used the ratings awarded at the last inspection these were rated to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Whittington House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.