CQC report explained · a residential care home
What the CQC found at Whitwood Hall
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People and relatives felt safe, and staff knew how to report abuse. However, agency staff were not always deployed suitably, there were some premises and infection control problems, and one person's medicine records were incomplete.
- Effective?
- Requires improvement
- People received food, drink and healthcare support, and mental capacity records were in place. However, seven staff had not completed three or more training subjects, including restraint training for seven staff.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff knew people's needs and preferences, and inspectors saw caring interactions.
- Responsive?
- Requires improvement
- Care plans were mostly person-centred, but people did not always receive planned community access, walks or other activities. Some care plans were not updated when planned support had not happened.
- Well-led?
- Requires improvement
- The home had a temporary manager and support from two area managers. However, quality audits and service visit records were incomplete, and there was not enough oversight of risks, premises and incidents.
What inspectors found, October 2021
Rated Requires Improvement; inspectors found kind care, but staffing, activities and management oversight were not reliable.
The inspection was unannounced and took place on 20 July 2021. Two inspectors visited, spoke with people, relatives and staff, observed care, and checked care, medicine, recruitment and management records. Feedback was also gathered from relatives by telephone.
The home had enough staff on the rotas, but agency staff were used heavily and were not always deployed with the right skills or knowledge. This affected people's access to the community and planned activities. Training was incomplete for some staff, and the building and some furniture needed repair.
Inspectors found caring and respectful interactions. People were generally safe, received food, drink and healthcare, and medicines were mostly managed safely. However, management checks were not strong enough, one complaint was not properly recorded, and care records did not always show when planned support had not happened.
The overall rating was Requires Improvement. Safe, Effective, Responsive and Well-led were rated Requires Improvement, while Caring was rated Good. The previous overall rating was Outstanding, published in March 2019.
Kind and respectful care
Inspectors saw staff treating people kindly and respecting their privacy and dignity. Relatives were mostly positive about the care.
“Staff interacted with people in a kind and respectful manner.” from the report
People's safety needs understood
Care plans and risk assessments covered important needs, including nutrition, seizures, communication and behaviour. Most staff understood people's needs and risks.
“Appropriate risk assessments and comprehensive care plans were in place which included nutrition, risk of isolation, exercise, seizures and use of rescue medicines, behaviour that may challenge others and communication.” from the report
Food and drink
Fresh ingredients were available and fresh meals were prepared. People were offered frequent drinks on a warm day.
“We observed fresh meals being prepared on the day of inspection.” from the report
Healthcare support
People received healthcare when needed. Records showed GP and outpatient appointments and medication reviews.
“People received timely access to healthcare support.” from the report
Staff deployment and agency use
seriousAgency staff were used heavily, and staff were not always allocated with the right skills and familiarity for people's needs. This meant some people could not receive planned support safely.
“There was a high level of agency usage which was due to sickness and staff departures.” from the report
Incomplete staff training
seriousSeven staff had not completed three or more training subjects. Seven staff had not received restraint training, although only one person was assessed as needing restraint support.
“We found gaps where seven staff had not completed three or more subjects.” from the report
Missed activities and community access
seriousPeople did not always receive walks, car trips or community activities set out in their care plans. Inspectors found this was linked to staffing and confusion about agency workers' role.
“People were not always supported to access the community in line with their care plans.” from the report
Weak management checks
seriousQuality audits had not been completed throughout 2021, and service visit records did not clearly show findings or actions. Incidents were recorded but had not been reviewed for themes.
“The provider's 'Quality Audit Tool' was not completed throughout 2021.” from the report
Repairs and maintenance
needs fixingThe three houses and some furniture were not in good repair. The provider had identified the problems and refurbishment had started, but regular maintenance had not been managed well.
“The home was not in a good state of decoration and repair.” from the report
Complaint record missing
minorA complaint had been dealt with, but there was no record of what it concerned or how it was resolved.
“A complaint was responded to, although a record had not been maintained.” from the report
- 01How do you now make sure agency staff are deployed with the right skills and familiarity for each person?
- 02What training was outstanding at the inspection, and has it now been completed, including restraint training?
- 03How do you make sure each person receives the community trips, walks and activities in their care plan?
- 04What regular quality audits and management checks are now completed, and how are incidents reviewed for themes?
- 05Which repairs and refurbishment work identified in the report have now been completed?
This was an unannounced inspection that assessed all five key questions and included infection prevention and control; the previous inspection was rated Outstanding in 2019. This explanation was written from the published report of 16 October 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2019
Rated Outstanding overall; inspectors found exceptionally caring, responsive and well-led support, with safe and effective care rated Good.
Inspectors visited the home without warning on 14 January 2019. They spoke with four people and four staff, and reviewed care records, risk assessments, training files, medicines records, safeguarding records, complaints and quality checks.
They found high and flexible staffing, safe medicines management, detailed risk assessments and a clean home. Staff understood people's needs and supported them to take positive risks, make choices and become more independent.
The strongest findings were about kindness, personal choice and tailored support. People were helped to communicate, maintain family links, enjoy activities and achieve personal goals. The home had not received any complaints, but had a complaints procedure.
The overall rating was Outstanding. Safe and Effective were rated Good. Caring, Responsive and Well-led were rated Outstanding. The report says the service was meeting the relevant legal requirements.
Flexible staffing
Staffing was arranged around people's routines rather than fixed shifts. There were reserve staff to cover sickness, and the home had not used agency staff since May 2017.
“Staffing was arranged so there were always two staff on reserve who could be called in to cover for sickness.” from the report
Kind and respectful care
Staff knew people very well and supported them calmly and patiently. Inspectors saw privacy, dignity and personal choice being respected in everyday practice.
“Staff were extremely attentive, kind and compassionate.” from the report
Personalised support
Care plans included people's interests, communication methods, routines, goals and ways to support independence. Staff adapted activities and support to each person.
“All care records and daily notes demonstrated in-depth understanding of people and how best to support them based on their personalities.” from the report
Promoting independence
People were encouraged to do things for themselves and to take carefully considered positive risks. Inspectors found examples of people gaining new skills, travelling, going on holiday and moving into their own home.
“The provider truly embedded the ethos of registering the right support by helping people to reach their full potential.” from the report
Strong management and improvement
The manager encouraged staff to speak openly, reflect on incidents and suggest improvements. Audits, meetings and surveys were used to monitor the service.
“The registered manager and provider drove a culture of improvement, ensuring high-quality, person-centred care and the best outcomes for people.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you match the home's staffing and core staff arrangements to my relative's routines and support needs?
- 02How would you support my relative to take positive risks while keeping them safe and using the least restrictive approach?
- 03How would my relative communicate their choices, and do staff have the training needed to understand their communication method?
- 04How would you keep my relative's care plan, risk assessments and health information up to date?
- 05How would the home involve our family in reviews and help my relative maintain contact with us?
This was an unannounced inspection that assessed all five areas: Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 16 March 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Whitwood Hall
4 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- October 2021Requires improvementcurrent ratingdown from OutstandingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2019Outstandingup from GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- July 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Requires improvement
- September 2013
Report published without a new overall rating.
- September 2012
Registered with the Care Quality Commission on 10 September 2012.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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