Archived: Homecroft Residential Home

Updated 29 November 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 25 October 2018 and was unannounced. The inspection team consisted of two adult social care inspectors.

Before the inspection we reviewed information available to us about this service. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed safeguarding alerts; share your experience forms and notifications that had been sent to us. A notification is information about important events which the provider is required to send us by law. We also spoke with the local authority commissioning and safeguarding teams to gain their feedback about the service. We also received feedback from a healthcare professional who worked with the service.

During the inspection we spoke with eight people who used the service, two relatives and four care workers including senior carers. We also spoke with the new manager, deputy manager and cook/activities co-ordinator. We reviewed three care plans, medicine records, and other records relating to the management of the service such as training records, audits and checks. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We observed the mealtime experiences, activities and how staff interacted with people throughout the day.

Updated 29 November 2018

Homecroft Residential is a ‘care home’. People in care homes receive accommodation and 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 care home houses up to 26 people in one adapted building with a garden to the front of the property.

The inspection took place on 25 October 2018 and was unannounced. At the last inspection in November 2016 we rated the service Good. At this inspection we found the quality of the service had deteriorated. We found medicines were not consistently managed in a safe way and the quality and format of care plan documents and risk assessments needed improving. The service had had three managers in the last 12 months and needed stable management to ensure consistent policies, procedures and systems were established.

A registered manager was not in place. 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 in post for two weeks. We found the new manager to be open and honest with us. They had recognised many of the issues we found during the inspection and were in the early stages of improving the service. We felt assured that they would continue to improve the service over the coming months.

People and relatives said they felt people received good care and were safe. Systems were in place to protect people from abuse. Most risks to people’s health and safety were appropriately assessed although this was not consistently the case. The new manager was in the process of reviewing the risks each person was exposed to, to further improve the service. Medicines were not consistently managed in a safe way as all medicines were not robustly accounted for.

There were enough staff deployed to ensure safe and appropriate care, although improvements were needed to the availability of ancillary staff such as cleaners, cooks and activities staff to optimise the function of these roles. Some staff training was out of date although a plan was in place to address this.

Overall, people’s nutritional needs were met by the service. People had access to a choice of food and people told us it was tasty. Where the service was reviewing people’s fluid input, this needed reviewing on a daily basis to ensure people were getting enough to drink.

Overall, the service was compliant with the legal framework of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). People’s consent was sought before care and support was offered.

Staff were kind and caring and treated people well. Staff knew people well and engaged them in conversation. People’s views and choices were listened to.

People said they received appropriate care that met their needs. People’s healthcare needs were assessed and the service worked with a range of professionals to meet those needs. The quality and accessibility of care plans needed improving to fully evidence people had an up-to-date assessment of their needs. Some activities were provided but more interaction and stimulation was needed at times.

We made a recommendation relating to ensuring the service reviewed how accessible information was to people who used the service.

People said the management team listened to them. People’s complaints were responded to, but there was a lack of evidence that lessons were always learnt from complaints.

People and staff praised the new management team and said they were approachable and supportive. The new manager was aware of the areas that needed improving and had a plan in place to address. Audits and checks were undertaken, these needed further developing to ensure they were consistent and thorough.

We found one breach of regulation. You can see what action we asked the provider to take at the back of the full version of this report.