About the service The Croft (RCH) Limited is a residential care home that provides accommodation and care for older people and younger adults living with a mental health condition. The service is registered to accommodate up to 21 people. At the time of our inspection, there were 16 people living at the service.
People’s experience of using this service and what we found
Although the service had a good supply of PPE to meet current and future demand, not all staff were wearing the correct type of face masks. Some staff were noted to be wearing fabric face coverings, not fluid resistant masks as required by best practice guidance. Immediate action was taken when we identified this to the management team.
Following the inspection, the provider updated their COVID – 19 policy. We received a copy of this which now reflected current best practice guidance. An infection control audit had not been completed since the previous inspection in November 2020. This meant the provider could not be assured that infection prevention and control measures were being followed by staff and procedures would protect people and others.
Staff had received training in the correct use and disposal of PPE. Staff had also received training in infection control practices.
There were procedures in place to support safe visiting by family members or professionals. Staff undertook temperature checks and asked questions to determine risks posed by visitors. Rapid response lateral flow tests (LFT) were undertaken for visitors before they entered the home. Visitors were provided with Personal Protective Equipment (PPE) and guided to its safe use.
New admissions or people returning from hospital were supported in line with best practice guidance. They were expected to provide recent COVID-19 test results, were further tested by the service following admission and isolated upon arrival for 14 days to minimise the risk of potential infection to existing people. These procedures were also followed if the service became aware that people had not followed safe practices when out of the home in the local community.
People and staff were regularly tested for COVID-19. Staff had LFT testing twice a week as well as standard Polymerase Chain Reaction (PCR) tests weekly. The manager understood the actions they needed to take should any tests return a positive result.
The home was kept clean. A program of frequent cleaning of high touch surfaces, such as light switches, handrails and door handles was in place.
The provider and manager understood good recruitment procedures and the requirement for pre-employment checks to be undertaken.
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 previous comprehensive inspection resulting in a rating for this service, was Requires Improvement (published 24 August 2019). There were two breaches of regulation.
In November 2020 we undertook a targeted inspection of this service. We looked at the parts of the key question ‘Is the service safe’ we had specific concerns about. This identified areas for improvement. We issued the provider with a warning notice and told them they must make improvements.
At this targeted inspection we followed up the warning notice and looked at recruitment and infection prevention and control procedures. Some improvements had been made however, the service remains rated requires improvement and we did not assess all areas necessary to change the ratings for this service.
Why we inspected
We undertook this targeted inspection to check whether the Warning Notice we previously served in relation to Regulations 12 (infection prevention and control) and 19 (recruitment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The overall rating for the service has not changed following this targeted inspection and remains Requires Improvement.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
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.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Croft (RCH) Limited on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the 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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified a breach in relation to Infection prevention and control at this inspection. We have found evidence that the provider needs to make improvements. Please see the safe section of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure people and others are safe. standards of quality and safety. We will work alongside the provider and 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.