Cromwell Court Also known as Cromwell Court Care Home

Cromwell Court is a care home providing accommodation, nursing and personal care for up to 67 younger and older adults and people who are living with dementia. At the time of the inspection 64 people were living at the home.

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

Overall governance and quality assurance measures were in place, although further improvements were required. The quality and safety of care was monitored and assessed although records and documentation were not always completed as required. We continue to make a recommendation around quality assurance measures.

People received care and treatment that was centred around their support needs, areas of risk were routinely managed, and people told us they felt safe living at Cromwell Court. One relative told us, “Most definitely [person] is kept safe because of the care [they] receive, you have a feel for a place, they [staff] are all amazing.”

An electronic care planning system meant that people’s care reviews were completed in a timely manner and staff responded when further risks were identified. An external healthcare professional told us that staff knew people well, people were well looked after and there were no concerns around the provision of care people received.

Safeguarding and whistleblowing procedures were in place. Staff were supported with the necessary training and knew how to raise their concerns. One relative told us, “I do think [person] is safe, can’t stress to you how much we feel that [person] is safe, clean and happy.”

Safe medication arrangements were in place. People received support with their medicines from staff who were fully trained and complied with the provider’s medication administration policy. Medicines were routinely ordered, safely stored and administered in accordance with administration instructions.

Staffing levels were routinely monitored, and safe recruitment procedures were in place. Staff told us they felt thoroughly supported and were able to complete training to enhance and develop their skills, qualities and experience.

We were generally assured that safe and effective infection prevention and control procedures (IPC) were in place. We observed staff wearing the appropriate PPE, they were engaged in a routine testing regime and were aware of the different IPC measures that needed to be complied with. We did offer some signposting in relation to enhanced cleaning schedule documentation that needed to be in place.

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

A new provider for this service was registered with CQC on 10 March 2020. The last rating for the service (under the previous provider) was 'requires improvement', published on 4 September 2019.

A focused inspection took place and the service was ‘inspected but not rated’ (published 26 October 2020). We only inspected against the safe and well-led key questions and we identified a breach of ‘safe care and treatment’ regulation. 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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

Although a focused inspection was conducted, we needed to inspect against all key questions, including effective, caring and responsive. This was a planned comprehensive inspection following the new providers registration with CQC.

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.

Follow up

We will continue to monitor information we receive about the service until we return to our inspection programme. If we receive any concerning information we may inspect sooner.

Cromwell Court is a residential ‘care home’ providing accommodation, nursing and personal care to 67 younger and older adults and people who are living with dementia. At the time of the inspection 52 people were living at the home.

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

Risk management procedures and support measures were in place. However, these had not been effectively embedded and were not always monitoring and managing risk.

People had individual risk assessments and care plans, but these did not always contain the most up to date, consistent information.

Medication administration procedures needed to be strengthened to ensure safe practices were consistently being followed.

Governance systems and processes were in place to monitor, assess and improve the quality and safety of care people received. However, further focus and development in this area is encouraged. We have made a recommendation regarding this.

Staff received safeguarding training and were familiar with reporting procedures they needed to follow. The manager had systems in place to review and monitor safeguarding incidents and referrals. One relative told us, “[Quality of care] is absolutely brilliant.”

Staffing levels were monitored. Levels of staff were reviewed and determined in relation to people’s dependency needs.

Safe recruitment practices were followed, meaning that people received care by staff who were suitable to work in health and social care environments.

Infection prevention control (IPC) measures were in place. The manager and staff followed COVID-19 advice and guidance to minimise risk and to keep people safe. Control measures, policies and procedures were followed; the environment was, clean and well maintained.

Rating at last inspection and update:

The last rating for this service, under the previous provider was ‘requires improvement’ (report published September 2019). This service was registered with The Care Quality Commission (CQC) in March 2020 and this is their first inspection.

Why we inspected

We have made changes to the way we work due to COVID-19. We received concerns in relation to the management and leadership of the service; as a result, we undertook a focused inspection to review the key questions of ‘safe’ and ‘well-led’ only. Our report is only based on the findings in those areas at this inspection. We did not look at all the five key questions during this focused inspection. Therefore, the service was not given an overall rating.

We also looked at infection prevention and control (IPC) 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 assurances that the service can respond to coronavirus and other infection outbreaks effectively.

We found evidence that the provider needs to make improvements. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We identified a breach of regulation in relation to ‘safe care and treatment’ at this inspection.

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

Follow up

We will continue to monitor information we receive about the service until we return to our inspection programme. If we receive any concerning information we may inspect sooner.

We will also request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.