Cockington House

About the service

Cockington House is a residential care home providing personal care to up to 6 people living with a learning disability. Accommodation is provided over 2 floors. A communal lounge with a dining room, and kitchen are based on the ground floor. At the time of our inspection there were 4 people using the service.

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

People were not supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

Care was not always person-centred. Staffing levels were not always adequate to ensure people received the right care. Staff ensured they respected people’s dignity, privacy and human rights. People were supported by caring staff.

Right Culture:

Governance systems were not effective, and the provider lacked an oversight of the service. Concerns had been raised but were not always investigated and action had not been taken to improve the service. People, staff and relatives had not been asked to provide feedback about their views. There was a new management team in place, who promoted a positive culture and led by example.

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

Rating at last inspection

The last rating for this service was good (Published 30 November 2017).

Why we inspected

We received concerns in relation to a closed culture and restrictive practice being used. Concerns were shared about restraint being used by untrained staff, People’s health care needs not being appropriately met and staffing levels which were not safe. Also, we heard about concerns of the management of incidents and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cockington House on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice:

Cockington House ensured current government guidelines in relation to COVID-19 were being followed by staff and visitors to reduce the risk of infection to people living at the home. This included:

Comprehensive checks for visitors on arrival.

Residents were supported to safely meet with family and friends.

Changes to daily routines helped minimise close physical contact and risks to residents when social distancing could not easily be achieved.

Cleaning schedules included frequent cleaning of ‘touch points’ or high contact areas to minimise the risk of spreading infection.

Staff and residents were vaccinated and underwent regular COVID-19 testing to help keep each other safe.

There were areas where we were somewhat assured that the service met good infection prevention and control guidelines as a designated care setting. This included staff consistently wearing masks appropriately and the storage of cleaning equipment when not in use.

People continued to receive safe care and the risks to people’s safety were continually assessed and reviewed. Staff were recruited safely and there were enough staff in place to support people. People medicines continued to be managed safely and effectively.

Staff received a detailed induction and training programme. Refresher training had been booked for those staff that needed it. The principles of the Mental Capacity Act 2005 (MCA) were used when decisions were made for people who lacked mental capacity to make specific decisions for themselves. Some best interest documentation required more detail. People were supported to lead a healthy lifestyle and where needed to lose or to gain weight. People’s day to day health needs were met by the staff.

People and staff enjoyed each other’s company and staff treated people with respect, dignity and compassion. There was a calm and positive atmosphere within the home, with people encouraged to do as much for themselves as possible. People’s independence was encouraged. People were provided with information about health services and their own care needs in a format they could understand. There were no restrictions on people’s friends or relatives visiting them.

People’s care records were detailed and personalised which enabled staff to support people in line with their personal preferences. Staff used a variety of methods to communicate effectively with people. People were provided with an ‘easy read’ complaints process that supported people who had a learning disability to understand. Effective systems were in place to manage any complaints that the provider may receive.

The service was now well-led. The new registered manager had made improvements since the last inspection. The registered manager was well liked by all and they carried out their role enthusiastically and professionally. There was a positive ethos and an open culture at the home resulting in an enjoyable working environment for staff, and a calm and friendly atmosphere for people living there. People and staff were encouraged to contribute to the development of the service and effective auditing processes were in place to monitor the quality of the service.