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Cullum Welch Court Care Home Good

Reports


Inspection carried out on 24 April 2018

During a routine inspection

This unannounced inspection took place on 24 April 2018. Cullum Welch Home is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home is registered to accommodate up to 60 people across three separate units over two floors, each of which have separate adapted facilities including dining rooms and sitting areas. There were 45 people living at the home when we visited.

When we inspected Cullum Welch Court in March 2017, we found two breaches of regulations relating to the management of medicines and quality assurance systems.

We then undertook a focused inspection on 16 August 2017 in relation to the breaches of regulation we identified at the March 2017 inspection. We found that the service had followed their action plan and had met statutory requirements.

At this inspection the service continued to meet the regulations and we have therefore rated the service as Good overall.

The service had a registered manager in post. 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 and associated Regulations about how the service is run.

People told us they were safe at the service. People knew how to report any concern or abuse. Staff also had knowledge and understanding of the various types of abuse. They knew how to report any concerns and felt confident that any concerns they raised will be thoroughly investigated and addressed.

Risks to people were managed in a way that promoted their health and well-being. Staff knew the risks associated with people and actions to reduce such risks. Incidents, accidents and near misses were reported, investigated and actions put in place to prevent them from happening again. The home was well maintained, clean and free from unpleasant odour. Health and safety checks were conducted regularly to ensure the home complied with health and safety regulations.

People received their medicines as prescribed. Only trained and competent staff administered medicines to people. Medicines administrations records were correctly completed. Medicines were stored safely.

People received support from sufficient number of staff with suitable skills and experience to meet their needs. Appropriate recruitment procedures were followed to recruit staff to ensure only suitable applicants worked with people.

People’s needs were thoroughly assessed and planned for. People received care from staff who were effectively trained, supported, supervised and appraised in their role. Staff had completed a range of training to do their jobs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People gave consent to the care and support they received.

People’s care was delivered in line with the requirements of the Mental Capacity Act 2005 (MCA). People were asked for their consent before care was provided and staff respected their decisions. Relatives and healthcare professionals were involved in the best interest process to support people who were unable to make decisions about their care. People’s rights were safeguarded under the Deprivation of Liberty Safeguards (DoLS). DoLS authorisations were in place and valid where required.

People had access to a range of healthcare services and to maintain their well-being and good health. The service ensured people’s care was well arranged when they moved between services. There were suitable facilities and adaptations for people to use. The facilities available within the service include bedrooms with en-suite wet

Inspection carried out on 16 August 2017

During an inspection to make sure that the improvements required had been made

This unannounced focused inspection took place on 16 August 2017. This inspection was planned to follow up on the breaches of regulation in relation to medicines and aspects of quality monitoring in relation to the premises, equipment and staff records found at the comprehensive inspection of the service carried out on 20, 22 and 23 March 2017. Following that inspection the provider took immediate action to start to address the issues and sent us an action plan to tell us what further action they were taking to improve the quality monitoring at the home.

Cullum Welch Court Care Home is owned by the charity Morden College and is within the grounds of Morden College and part of its community. The home provides residential, nursing and dementia care for up to 60 older people and respite care to members of its community and the wider local community. On the day of the inspection there were 50 people living in the home.

There was an established registered manager in post who had worked at the home for several years. 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. They were aware of their responsibilities as registered manager.

At this inspection we found considerable improvements had been made. The provider had reviewed their quality monitoring systems and added to them to oversee quality improvements and communication across the charity. The previous concerns in relation to medicine storage and administration had been addressed, the clinical rooms had been refurbished and reorganised. The auditing process strengthened. Medicines were safely managed across the service.

At the last inspection in March 2017 we had found that, although there were some health and safety checks in place, they were not comprehensive to cover all areas of equipment and the premises in order to reduce risk. At this inspection we found the provider had appointed a new maintenance staff member with responsibility for premises and equipment checks. There was a full range of equipment and premises checks completed and where issues were identified these were rectified. An audit of staff files had been completed and action taken in relation to any missing records. There were systems to ensure that new staff records were kept up to date.

The home has a structure to keep an effective overview of risks and safety and there was a culture of learning from mistakes.

In view of the improvements found and that there were no other issues noted at the comprehensive inspection of March 2017 we have changed the rating of the key questions safe and well led to good and this has changed the overall rating to good, in line with our characteristics for providing ratings.

Inspection carried out on 20 March 2017

During a routine inspection

This unannounced inspection took place on 20, 22 and 23 March 2017. At the last inspection, on the 06 and 07 October 2015 the service was rated as good overall and requires improvement in effective.

Cullum Welch Court Care Home is owned by the charity Morden College and is within the grounds of Morden College and part of its community. The home provides residential, nursing and dementia care for up to 60 older people and respite care to members of its community and the wider local community. On the day of the inspection there were 53 people living in the home.

There was a registered manager in place. 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.

At this inspection we found the previous concerns about staff supervision had been addressed. However there were other breaches of regulations as medicines were not always administered or disposed of safely. The system for monitoring the quality and safety of the service had not identified the need for an audit of staff recruitment records or checks on the safety of some aspects of the premises. The checks had not always been sufficiently robustly operated. You can see the action we have asked the provider to take at the back of the full version of this report.

We discussed the issues we found with the provider and registered manager and immediate action was taken to address them. However we were not able to judge the effectiveness of the improvements made at the inspection.

People told us they felt safe and well looked after living at Cullum Welch Court. Staff knew how to identify and respond to any safeguarding concerns. There were enough staff to meet people’s needs and we observed that staff were able to spend some time talking with people during the day.

Possible risks to people were identified and monitored to reduce risk of the occurring.

There was a strong emphasis on staff training and development. Staff told us they received training on a wide range of areas to help them develop their skills. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s dietary needs were met and a range of health professionals including physiotherapists and a mental health nurse were available at the home to support their health needs. The home was committed to delivering dignified end of life care.

People spoke with a sense of community and belonging. There was a person centred culture at the home; care was provided with sensitivity and kindness. Staff spoke with enthusiasm about their work. They spoke with people respectfully and were aware of people’s needs and preferences. The management team worked to ensure the nursing home was part of the Morden College community. The home also had links with the local community and people were active inside and outside of the home. There was a strong focus on delivering a range of personalised activities for people and for people to remain as independent as possible.

Some aspects of the home were very well-led. The home was proactive in looking for ways to improve the care provided. Developments included a falls awareness group whose work was aimed to reduce the incidents of falls and increased knowledge for staff about how to support people living with dementia through involvement in a research project. The home also made use of consultancy to drive improvements for example increasing awareness of signs of sepsis. There was a range of meetings to support communication across the home. People were consulted for their views about the service through residents meetings, surveys and involvement in a food committe

Inspection carried out on 06 and 07 October 2015

During a routine inspection

This inspection was carried out on 06 and 07 October 2015 and was unannounced. At our last inspection on 13 August 2013, we found the provider was meeting the regulations we inspected.

Cullum Welch Court Care Home provides accommodation with nursing and dementia care for up to 60 older adults. At the time of our inspection 53 people were living at the home. The home had a registered manager in post. 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.

People said they felt safe living at the home. Before staff began working at the home appropriate recruitment checks took place to ensure people were safe. The provider had robust safeguarding protocols in place and staff knew how to protect people who use the service from abuse. Staff were aware of the whistle blowing procedure and had followed it when needed. Where allegations of abuse were raised this was investigated and prompt actions taken to protect people. People were supported to take their medicines as prescribed as part of their treatment plans.

There were sufficient and suitable staff available to ensure people’s needs were met. Each care record we looked at had relevant risk assessments in place and where people were found to be at risk, there were plans in place to ensure the risk was prevented or minimised. People had care plans in place and the care delivery was in line with the care that was planned for.

We found a breach of legal requirements in relation to the way staff were supervised. Staff supervisions were not always being carried out in line with the provider’s three monthly policy. All staff did not received supervision at the frequency it should be occurring to ensure their competencies were maintained to perform their roles effectively. We found a breach in the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. You can see what action we told the provider to take at the back of the full version of the report

Staff training records we looked at were up to date and were in line with the support people required. People had been consulted about their care needs when they first started using the service and the management team and staff we spoke with had an understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. People had access to relevant healthcare professionals such a general practitioner (GP) when required. People were supported to have sufficient food and drink for their wellbeing. People were engaged in various activities of their choice to ensure they were stimulated.

People were aware of the complaints procedure and said they were confident their complaints would be listened to, investigated and action taken where necessary. People’s views were sought through annual surveys and residents meetings. The provider had systems in place to regularly assess and monitor the quality of service that people received. All staff we spoke with said they enjoyed working at the home.

Inspection carried out on 13 August 2013

During a routine inspection

11 People who used the service and a visiting relative we spoke with were complementary about Cullum Welch Court Care Home. One person told us that �the home is in a class of its own�. Another person said �it is the best nursing care home that I have ever known�. People told us that they were given enough information about the home before they moved in and after they started using the service. People said they were well looked after and one person commented �I find the care excellent�. All the people we spoke with told us that they felt their privacy and dignity were respected.

We found that people who used the service were happy living at the home and had various choices available to them. Each person had a care and treatment plan with relevant risk assessments which was reviewed monthly to meet people�s changing needs. We found that staff knew what constituted abuse and their responsibility to protect people from abuse. Staff were supported through induction, training and supervision to deliver care that was safe and to an appropriate standard. The provider used regular surveys, audits and complaints from people, their relatives and staff to monitor the quality of the service provided

Inspection carried out on 1 August 2012

During a themed inspection looking at Dignity and Nutrition

People told us what it was like to live at this home and described how they were treated by 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 joined by an Expert by Experience, people who have experience of using services and who can provide that perspective. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

People who used the service told us they were treated with dignity and respect. People told us their care arrangements suited their needs and they were invited to contribute and review their care plan. People told us they were given choices.

People told us they enjoyed the food provided at the home, and they had a good choice of meals. One person told us �the food is nutritious�, and another said �I think the food is very good�.

People we spoke with told us they had never had cause to complain but knew how to do so if they had any concerns. One person told us �they look into anything� when referring to how the provider deals with any issues raised.

People who used the service told us the staff were good, one mentioned �some of the staff are particularly nice�. One person told us �there are plenty of staff�, another added staffing levels were �on the whole pretty good; occasionally not enough�. People told us they felt staff had the necessary skills and experience. One person said �on the whole staff are very good�.