Archived: Whitworth House

Updated 10 December 2020

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.

This was a targeted inspection to check whether the provider had taken sufficient action in relation to Regulation 12 (Safe care and treatment), Regulation 17 (Good governance) and Regulation 20A (display of performance assessments) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 18 (notification of other incidents) of the Care Quality Commission (Registration) Regulations 2009.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted as part of our Thematic Review of infection control and prevention in care homes.

Inspection team

This inspection was undertaken by two inspectors.

Service and service type

Whitworth House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Whitworth House is not registered to provide nursing care.

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

We gave a short period notice of the inspection due to the risks associated with the covid-19 pandemic.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with the registered manager, the deputy manager and a care worker. We reviewed the care records for the person using the service and documentation relating to the management of the service. We undertook observations to review the safety of the environment and review compliance with infection prevention and control procedures. We spoke with one relative and obtained feedback from two representatives from the local authority.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 10 December 2020

About the service

Whitworth House is a residential care home providing accommodation and personal care. The home accommodates up to nine people in one house. At the time of our inspection five older people, some of whom were living with dementia, were living at Whitworth House.

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

At our last inspection we found breaches relating to staff recruitment, safe care and treatment, consent, staff support, good governance and notifications. We served the provider warning notices in relation to safe care and treatment and good governance. At this inspection we found the provider had improved sufficiently and was no longer in breach of the regulation relating to staff support. However, the provider remained in breach of all other regulations and was also in breach of the regulation relating to displaying their CQC rating. We are taking enforcement action against the provider and will report on this as soon as our processes are complete.

A registered manager had been in post for over 20 years and was also the owner. The registered manager had not taken sufficient action to make the improvements that were needed. Their oversight of the service was inadequate. During our inspection the registered manager was unable to show us many key records including care plans, risk assessments, staff records and some health and safety records. This was because the registered manager did not have access to these key records. The registered manager did not provide us with the documents we requested in a timely manner after the inspection so we used our powers under section 64 of the Health and Social Care Act 2008 to require the provider give these to us. However, the registered manager did not provide us with all the requested documents by the given date.

The registered manager had a poor understanding of their responsibilities and had not submitted notifications relating to deprivation of liberty applications and their outcomes to CQC. The registered manager also had not ensured the most recent CQC rating was displayed in the service, as required by law, to ensure people were openly informed about quality and safety at the service.

The provider did not always assess risk to people's care to ensure they were doing everything possible to reduce the risks. The provider did not always ensure recruitment was robust so only suitable staff were employed. The provider had not carried out robust checks of the premises and equipment to ensure risks were identified and reduced. The service was sufficiently clean although some food hygiene practices required improvement. There were enough staff to support people safely. People received medicines safely.

The provider did not ensure staff training records were always in place and stored securely. Staff received supervision to support them sufficiently in their roles. The provider did not always follow the Mental Capacity Act (MCA) in ensuring best interests’ meetings were held to make decisions in people’s best interests when they were assessed to lack capacity. Most people enjoyed the food although one person would like more choice. People’s day to day healthcare needs were met.

A care plan was not in place for one person. For the other people care plans did not contain sufficient guidance for staff relating to oral health but were otherwise sufficient. People were cared for by staff who were kind and knew them well. Staff treated people with dignity and respect. People were provided with enough activities to occupy themselves. The provider had a suitable process in place to respond to any concerns or complaints.

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

Rating at last inspection (and update)

The last rating for this service was requires improvement (inspected May 2019, report published July 2019) and there were multiple breaches of regulation. The provider did not complete an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had not been made and the provider remained in breach of regulations.

Why we inspected

This was a planned inspection to follow up on the actions we told the provider to take at our last inspection.

Enforcement

We have identified breaches in relation to staff recruitment, safe care and treatment, consent, good governance, displaying their rating and notifications at this inspection. We are mindful of the impact of COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We met with the provider to discuss how they will make changes to ensure they improve their rating to at least good. We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner. We will work with the local authority to monitor progress.