CQC report explained · a residential care home
What the CQC found at Whitwood House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2022
Rated Requires Improvement; the home left Special Measures, but staffing, the building and management oversight still needed improvement.
Inspectors visited on 6, 11 and 12 April 2022. They spoke with people and relatives, staff and other professionals. They reviewed care records, medicines records, staff files and management records.
People were generally protected from abuse and received kind care. Medicines, risk assessments and infection control were managed well. Staff supported people's choices, health needs and personal goals. However, staff shortages affected activities and access to the community.
The home had improved from its previous Inadequate ratings, but was still rated Requires Improvement for Safe, Effective and Well-led. Problems remained with staffing, the condition of the living environment and checks on the quality of care. The home had been in Special Measures since 7 July 2021, but was no longer in Special Measures after this inspection.
Kind and respectful care
Inspectors found that staff provided compassionate care and respected people's privacy, dignity and individual needs.
“People received kind and compassionate care. Staff protected and respected people's privacy and dignity.” from the report
Safe medicines
The records checked showed that people received the right medicines at the right time. Records also explained the use of medicines given when needed.
“There were no gaps in medicines administration in the records we reviewed” from the report
Support for choice and goals
Staff focused on what people could do and supported their aspirations, choices and access to specialist healthcare.
“Staff focused on people's strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.” from the report
Learning from incidents
The manager reviewed accidents and incidents and shared learning with staff and the wider service. The use of restraint had also reduced.
“The registered manager carefully reviewed all accidents and incidents, looking at whether the action taken was appropriate and shared lessons learned with the whole team and the wider service.” from the report
Not enough staff
seriousStaffing levels were below the provider's own assessed requirements on several day and night shifts. This affected care records and people's planned activities and trips out.
“Staffing levels were not sufficient to meet people's needs.” from the report
Living environment not maintained
seriousSome problems from the previous inspection remained. Inspectors found chipped paintwork and furniture that needed replacing, despite these issues being on a refurbishment plan.
“The provider had not taken sufficient action following our last inspection to ensure the living environment had been maintained to a suitable standard.” from the report
Weak management checks
seriousThe provider did not have strong enough oversight of staffing and the building. Records of attempts to weigh people had significant gaps, and some area manager visits had not been recorded.
“The oversight of the service people received required improvement.” from the report
Some capacity records needed updating
needs fixingBest interest decisions had not been completed in two records checked, and some mental capacity assessments had not been reviewed recently. The manager said action was taken after the inspection.
“Mental capacity assessments we looked at had not always had a recent review.” from the report
- 01What is the current staffing level on each shift, and how does it compare with each person's assessed needs?
- 02How will you make sure people can take part in their chosen activities and community trips?
- 03Which repairs and furniture replacements from the refurbishment plan have now been completed, and what is the timetable for the rest?
- 04How are you now recording and reviewing attempts to weigh people, and what timescales have healthcare professionals agreed?
- 05What action has been taken to make sure best interest decisions and mental capacity assessments are completed and reviewed on time?
The inspection assessed the Right support, right care, right culture principles and reported ratings for Safe, Effective and Well-led; Caring and Responsive were not rated in this report. This explanation was written from the published report of 16 June 2022 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, July 2021
Rated Inadequate and placed in special measures; inspectors found serious failures in safety, staffing, consent and management.
This was an unannounced focused inspection on 13 May 2021. Inspectors reviewed the Safe, Effective and Well-led areas because of concerns about people's care. They spoke with one person, observed others, spoke with staff and managers, and checked care, medicine, staffing and management records.
Inspectors found that risks were not always assessed or managed. Behaviour support guidance was missing for some people, important care information had not always been transferred to new records, and incidents were not properly reviewed. Staffing levels were not always enough to provide planned one-to-one support.
People's rights were not protected when decisions were made on their behalf. Some people had restricted access to shared areas, without enough evidence of lawful best-interest decisions. The home also had maintenance problems and weak systems for checking the quality and safety of care.
The overall rating fell from Good at the previous inspection to Inadequate. The home was placed in special measures, meaning CQC will closely monitor it and normally reinspect within six months to check for significant improvement.
Medicines
Inspectors found that medicines were generally managed safely and people received them as prescribed.
“Overall Medicines were managed safely, and people received their medicines as prescribed.” from the report
Health assessments
The home assessed people's needs before they moved in. Staff also had information about dietary needs and referrals to health professionals were made when needed.
“The management team had completed an assessment before each person started to use the service to ensure they were able to meet their care and support needs.” from the report
Immediate response
After the inspection, the provider organised further training and additional management and specialist support.
“Following our inspection, we wrote to the provider and asked them to take urgent action to address the most serious risks outlined in this report.” from the report
Risk assessments and behaviour support
seriousSome risks were not assessed or kept up to date. Staff lacked guidance for responding safely to some behaviours, increasing the risk of harm.
“Despite this, there was no behaviour risk assessment or positive behaviour support plan with guidance for staff about strategies to reduce risk and de-escalate situations.” from the report
Staffing levels
seriousStaff reported regular shortages, and inspectors saw people without planned one-to-one support. Frequent agency use also meant some staff did not know people's needs and triggers.
“We observed people who were meant to be supported on a one to one basis with no support,” from the report
Rights and consent
seriousThe home did not consistently record or follow best-interest decisions. Some people had restricted access to lounges, kitchens or gardens.
“People were subject to restrictive interventions that did not respect their rights.” from the report
Premises
needs fixingParts of the building and furniture were damaged or in poor repair. This also made some areas harder to clean effectively.
“Some aspects of the living environment had become damaged and in need of replacement.” from the report
Incident learning
seriousIncidents were not examined in enough detail, and support plans were not always updated afterwards. This meant opportunities to prevent repeat incidents could be missed.
“There was no effective system for analysing, investigating and learning from incidents.” from the report
Leadership and records
seriousManagement oversight was not strong enough to identify and correct problems. Records did not always show what care people had received.
“The failure to ensure complete and contemporaneous records meant we were unable to identify if people had received the care and support, they required.” from the report
- 01How many staff are now on duty at weekends, and how do you guarantee planned one-to-one support is provided?
- 02Have every person's behaviour, choking, epilepsy and other risk assessments been reviewed and transferred into current care records?
- 03How are best-interest decisions recorded, and can people now use the shared lounges, kitchens and garden without unnecessary restrictions?
- 04What repairs have been completed to the radiators, flooring, furniture, doors, windows and kitchen units?
- 05How do you now review incidents, update support plans and check that lessons have been acted on?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and previous ratings for areas not inspected were carried forward. This explanation was written from the published report of 7 July 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.
Every inspection of Whitwood House
4 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- June 2022Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2021InadequateSafe: InadequateEffective: InadequateWell-led: Inadequate
- April 2021Inspected but not ratedSafe: Inspected but not rated
- April 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- October 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 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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