Cressington Court Care Home

Updated 21 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Three inspectors carried out the inspection.

Service and service type

Cressington Court is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Cressington Court is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. However, the provider had recently recruited a home manager who was in post at the time of the inspection and in the process of registering with the CQC.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with five people who used the service and three relatives about their experience of the care provided. We spoke with nine members of staff including the manager, director of quality, clinical lead, senior care workers and care workers.

We reviewed a range of records. This included four people's care records, and seven people's medication records. We looked at staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 21 September 2023

About the service

Cressington Court Care Home is a residential care home providing personal care to 43 people, including people living with dementia and physical disabilities. The service can support up to 53 people. The service is a domestic style property and accommodation is over two floors.

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

At this inspection we identified concerns with the management of risk, care planning, the management of medicines and governance.

Risk was not always effectively mitigated. Care plans reviewed were not updated following reviews by professionals and changes to peoples care needs. Advice and guidance from professionals had not always been acted upon or implemented and care plan reviews were inconsistent.

Medicines were not always managed safely. There was a high volume of medication errors being reported and a number of actions identified following quality audits. Covert medications were not being administered safely for a person and the covert care plan was not being followed.

The governance arrangements in place were not robust and records were not always adequately maintained. There were gaps in auditing, and some audits were not effective. The audits for the medicines and the environment had failed to identify the issues found during the inspection.

There were systems in place to determine safe staffing levels. People and their relatives told us staff were kind, caring and respectful. The majority of people we spoke with felt there were enough staff on duty to support people's needs. Mixed feedback was received regarding agency staff, the provider was open and transparent regarding the barriers they were facing with regards to

recruitment of staff.

People received support from a range of health and social care professionals including dieticians; social workers, community nurses, community mental health teams, speech and language therapy and their local GP.

The culture of the service was open and transparent. The acting manager and CEO engaged with the inspection positively and were committed to making any necessary improvements.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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 last rating for this service was Requires improvement (published 10 October 2022).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the domains of 'safe’, effective, ‘caring’, 'responsive' and' well-led’.

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.

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

Enforcement and Recommendations

At this inspection we found breaches of regulations 12 and 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The breaches related to the failure to ensure people received safe care and treatment and a failure to ensure the service was always governed and managed adequately.

You can see what action we have asked the provider to take at the end of this full 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 will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for the service has remained at requires improvement based on the findings of this inspection.