Cockington House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good.

This meant people were safe and protected from avoidable harm.

The service was in breach of legal regulation in relation to people’s safe care and treatment at the last inspection. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a positive culture of safety. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

There had not been any reportable incidents for the service recently. The covering management supporting the service showed action had been taken in response to the concerns raised by CQC at the last assessment. Staff were aware of the changes within the service which had been made to improve the quality of life people received. There was a positive culture on lessons that had been learnt.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The provider had reported safeguarding concerns to the appropriate authorities and took action to safeguarding the people living at the service.

At the last assessment, people were not being supported to access the community and did not have a choice on where they would like to go. During this assessment, we found people were able to choose daily what activities they would like to do both in the home and in the community. People told us they enjoyed going out with their support team.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

At the last assessment, the provider acknowledged that there were gaps in the team’s knowledge and stated a commitment to improving this. This did not form part of the enforcement action we took after the last assessment. However, during this assessment we found no evidence of action taken to enhance staff skills or knowledge to support safe, informed risk management. Additional training and support had not been implemented. This remains a shortfall in care delivery.

Staff did know people’s needs well and understood people’s preferred communication styles in order to offer support.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

Improvements had been made to the service since the last assessment. The issues found previously had been met, for example, the garden had been cleared and secured. However, at his assessment we found new issues such as damaged and unlocked window restrictors, topical creams in rooms, cleaning products in a cupboard that could not be locked and a fire door held open.

We raised these concerns with the provider who took immediate action.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff we spoke with told us they cared about the people they supported and wanted to deliver safe, high‑quality care.There were adequate staffing levels from a core staff team. People at the service knew staff well and understood who was there to support them.

Although there was not a registered manager in post at the time of the assessment, staff told us they were well supported by the provider and covering manager. One staff member told us, “It has got better. Staff look out for one another. We support each other. The [Service Users] are happier and going out more. There are some days when it can be hard, but we all help each other. I feel able to speak to management and that things would be dealt with straight away.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The property was clean and tidy. The garden area had been cleared and was well maintained. The inside was clean and homely.

The provider had taken action on hygiene concerns raised since the last assessment. Staff supported with cleaning as a whole.

Staff told us they completed daily walk arounds and supported individuals to carry out independent living skills where possible. They had not recorded the daily walk around; however, a record was implemented following the assessment.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were well managed and stored safely. PRN (as required) medicine protocols were person-centred and contained detailed information for staff to follow. One person still had a PRN protocol in place for a medicine which had been changed to a regular prescription, however we saw evidence the medicine has been administered as prescribed. When inspectors raised this with the provider they took immediate action.

There were adequate stock levels in place at the time of the assessment. Senior staff were confident with the stock and ordering of medicines.

Staff were aware of STOMP (Stopping Over Medication of People with a Learning Disability, Autism or both) initiative and it was embedded at the service. The implementation of this initiative protected people from being over medicated.