We carried out an unannounced comprehensive inspection at Whitegates Retirement Home on the 19 and 20 May 2016 and we rated the service as requires improvement. We carried out this inspection on 15 August 2017 to ensure the provider had taken appropriate action and we found that improvements had been made.

Whitegates Retirement Home provides accommodation and support for up to 24 older people. Situated on the outskirts of the village of Westfield in East Sussex the home offers single rooms, two communal areas and a separate dining room. A lift enables people to access all parts of the building and there is a large garden with seating areas that is accessible to people using wheelchairs and walking aids. Some people were independent and needed only need minimal assistance; others needed support with personal care and moving around the home safely. There were 17 people living at the home during the inspection.

The registered manager was present during the inspection. 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.

This inspection took place on the 15 August 2017 and was unannounced.

The provider had a quality assurance and monitoring system in place and a number of audits were used to assess the services provided. Such as audits of medicine records and care plans. However, these audits had not identified the areas where improvement was needed that we found during the inspection. There have been a lot of changes since the last inspection and although these have improved the care and support provided for people living at the home, additional work is needed to embed these into practice and ensure people’s individual needs can be met.

A robust recruitment system was in place to ensure only suitable staff were employed. Staff attended relevant training, they had an understanding of people’s needs and there were enough staff working at the home to provide the support people wanted. Staff had attended safeguarding training; they were clear about how to protect people from abuse and the action they would take if they had any concerns.

The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The management and staff had attended training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and were aware of current guidance to ensure people were protected.

People said the food was good, choices were offered and staff assisted people if required. A range of group and individual activities were provided, based on people’s preferences, to participate in if they wanted to.

Staff supported people to see health and social care professionals when required. Records were kept of any visits, care plans updated with guidance for staff to follow to ensure any changes in support was provided.

Feedback was sought from people, relatives and staff through ongoing discussions, regular meetings and satisfaction questionnaires.

Whitegates Retirement Home is a small home that provides personal support for up to 24 older people. It is situated on the outskirts of the village of Westfield and there is parking on site. The building provides single rooms, a lift enables people to access all parts of the home and the gardens are accessible to people who use walking aids and wheelchairs.

There were 21 people living at the home during the inspection and they had a range of support needs. Some people needed minimal support and care, other people needed support with personal care and assistance moving around the home, due to physical frailty or medical conditions, and some people were living with dementia.

A registered manager was responsible for the day to day management of the home. 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.

This inspection took place on the 19 and 20 May 2016 and was unannounced.

People were assessed before they moved into the home to ensure staff could meet their needs, and care plans, including risk assessments to ensure their safety, were developed from this information. However, records did not consistently reflect people’s specific needs and daily records did not evidence the support and care that staff said they provided.

People said there was not always enough staff working in the home to spend time with them to talk in addition to when they provided support and care. Staff told us there was not always enough staff working in the home during the afternoons. We saw staff supporting people to have a walk around the garden and the registered manager said staffing levels were based on people’s needs and were flexible depending on the support needed day by day. Appropriate recruitment procedures were in place to ensure only suitable people were employed at the home.

The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The management and staff had attended training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and were aware of the procedures to follow if a person needs changed and safe systems needed to be introduced to protect people.

Systems were in place to ensure people were protected. This included safeguarding training, staff had a good understanding of abuse and how to raise concerns if they had any. Staff were trained in giving out medicines and they gave them out safely and signed the administration records after they had been taken.

People, relatives and staff said the management were very approachable, and were involved in decisions about how the service developed with on going discussion on a day by day basis and during residents meetings. In addition feedback was sought from people, their relatives, healthcare professionals and other visitors to the home, through satisfaction questionnaires.

People told us the food was very good. Staff asked people what they wanted to eat, choices were available for each meal, and people enjoyed the food provided. People told us they decided what they wanted to do, some joined in activities while others chose to sit quietly in their room or communal areas. One person said, “I have never joined in group activities so I prefer to remain in my room.”

People had access to health professionals as and when they required it. The visits were recorded in the care plans with details of any changes to support provided as guidance for staff to follow when planning care.

A complaints procedure was in place. This was displayed on the notice board near the entrance to the building, and given to people, and relatives, when they moved into the home. People said they did not have anything to complain about, and r

In this report the named managers were Mr Daniel Keith Rickaby and Mrs Bridget Sullivan. These people were not in post and not managing the regulatory activities at this location at the time of the inspection. Their names appear because they are still the registered managers on our register.

A single inspector carried out this inspection. The focus of the inspection was to follow up on a compliance action issued at our last inspection in November 2013, to look at additional outcomes and to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People received medicines from staff that had been trained and assessed as competent to do so.

There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available on call in case of emergencies.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Whilst no applications had needed to be submitted, there were clear procedures in pace. In addition, staff confirmed that they were familiar with the procedure should an application need to be submitted.

Is the service effective?

People told us that they were happy with the care they received and felt their needs had been met. We saw that when people needed specialist advice and support, arrangements were made for this to happen. People told us that there were opportunities to maintain links with their local community by attending a, ‘Hub and pub’ event held locally each week. They said there were enough activities arranged in the home and they could join in if they wanted to.

Is the service caring?

Staff were seen to treat people with respect. They explained to people what they were doing at each stage and gave people reassurance. For example, when assisting people with moving they explained where they were going and what they were going to do. One person told us, “They’re a good group of people (the staff), they look after us well.”

Is the service responsive?

People’s needs had been assessed before they moved into the home and they were kept under regular review. Records confirmed that people’s preferences, interests and diverse needs had been identified. People had access to a wide variety of activities and they received a monthly newsletter that kept them up to date with matters important to them.

Is the service well led?

We saw that the organisation had a range of measures in place to monitor the quality of the service provided at Whitegates Retirement Home. Records seen by us showed that where shortfalls were identified they had been addressed promptly. People told us that they had regular meetings and that they were given an opportunity to share their views about the home. They had also been asked to complete customer satisfaction questionnaires and the home was due to provide feedback on this process.

In this report the named managers were Mr Daniel Keith Rickaby and Mrs Bridget Sullivan. These people were not in post and not managing the regulatory activities at this location at the time of the inspection. Their names appear because they are still the registered managers on our register.

There were 19 people living at Whitegates Retirement Home at the time of this inspection visit.

People spoken with told us that they were well looked after and were free to do as they wished in the home. One person said, “The home is very good. It is relaxed and you are listened to.”

We found that before people received any care or support they were asked for their consent and agreement and the staff acted in accordance with their wishes.

Care plans were personalised and contained instructions on how people should be cared for and supported.

We looked at the systems and processes in place for the safe management of medicines. We found that some record keeping and practices within the home had not always ensured the safe administration of medicines.

We reviewed the recruitment practice and associated documentation. We found the home followed robust recruitment processes for the recruitment of new staff.

We saw that complaints were taken seriously and there was an effective complaints system available. These processes ensured complaints raised were resolved to people's satisfaction.

People told us what it was like to live at this home and described how they were treated by the staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector and joined by a practicing professional.

We were able to speak to twelve people who lived in the home, the feedback was positive and included, “Very good home”, The food is always tasty, but it’s a bit repetitive”, “The food’s good”, and “My room is beautiful. I love to be able to walk in the gardens”, “It’s lovely to see the squirrels and the birds out of my window”.

During the inspection, we spoke with two visitors who told us, "The staff are always very friendly, I come once a week and eat with my friend” and “I’m always welcomed warmly and enjoy visiting”.

People told us that they were given the care and support they needed and they were involved in their personal care planning. They said staff supported them well, were aware of how they liked to be cared for and were kind, friendly and respected their privacy and dignity.

People could decide how to spend their day and could choose to be involved in a variety of planned activities if they wished. They had opportunities to be involved in the day to day running of the service and to offer their views on it.

Any concerns were addressed and people said staff and the manager were approachable.

People liked their accommodation, they said that the home was clean, their rooms were comfortable and they were happy with them.

People were very complimentary about the food at the home, they said meals were well cooked and presented, there was variety and plenty of choice and they were nutritious.