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Inspection carried out on 31 January 2020

During a routine inspection

About the service

Coniston House is a care home providing personal care up to 27 older people in one adapted building. At the time of our inspection there were 26 people living in the service, some of these people were living with dementia.

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

The provider and registered manager’s governance systems were not robust enough to give an overall view of the service and how it was assessed, monitored and how ongoing improvements were being implemented. The registered manager told us they were addressing this after our inspection.

People were receiving a service where the risks to their daily living were assessed and mitigated to reduce the risks of avoidable harm and abuse. There were systems in place to reduce the risks to people, this included with safe medicines management and infection control. There were enough staff working in the service to provide people with the care they needed.

Staff were safely recruited, trained and supported to meet people’s needs. People’s needs associated with their dietary and health needs were assessed and met. 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. The environment was suitable for people using the service.

People were provided with a caring service. Staff knew people well and spoke with and about people in a compassionate way. People’s rights to privacy, dignity and independence were promoted and respected.

People’s individual care needs were assessed, planned for and met. People’s decisions about how they wanted to be cared for, including their end of life decisions where people had chosen to discuss this, were documented. There was a complaints procedure in place and people’s concerns and complaints were acted on and addressed.

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 16 August 2018).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

Inspection carried out on 11 July 2017

During a routine inspection

Coniston House is a residential care home for 27 people. On the day of our inspection there were 21 people living in the service. The service catered for people with a range of needs from those living with dementia to people who were able to access the community independently.

At the last inspection, the service was rated Good. At this inspection we found the service remained good.

There was 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.

Staff knew how to respond to possible abuse and how to reduce risks to people. There were enough staff who had been recruited properly to make sure they were suitable to work with people. Medicines were stored and administered safely.

People were cared for by staff that had received the appropriate training and had the skills and support to carry out their roles. Staff members understood and complied with the principles of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People received a choice of meals, which they liked, and staff supported them to eat and drink enough. They were referred to health care professionals as needed and staff followed the advice professionals gave them.

Staff were caring and kind and treated people and each other with respect. People were listened to and were involved in their care and what they did on a day to day basis. People's right to privacy was maintained by the actions and care given by staff members.

People's personal and health care needs were met and care records guided staff in how to do this. There was a large variety of activities or events for people to do and take part in during the day, and people had enough social stimulation. Complaints were investigated and responded to and people knew who to speak with if they had concerns.

People liked living at Coniston House and staff supported them to maintain community links. Staff worked well together and felt supported by the management team. The monitoring process looked at systems throughout the home, identified issues and staff took the appropriate action to resolve these.

Further information is in the detailed findings below

Inspection carried out on 1 December 2014

During a routine inspection

Coniston House provides accommodation and personal care for up to 27 older people who require 24 hour support and care. Some people are living with dementia.

There were 25 people living in the service when we inspected on 1 December 2014. This was an unannounced inspection.

There was no 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. There was an acting manager in post, who was in the process of completing their registered manager application.

There were procedures in place which safeguarded the people who used the service from the potential risk of abuse. Staff understood the various types of abuse and knew who to report any concerns to.

There were procedures and processes in place to ensure the safety of the people who used the service. These included checks on the environment and risk assessments which identified how the risks to people were minimised.

There were appropriate arrangements in place to ensure people’s medicines were obtained, stored and administered safely.

There were sufficient numbers of staff who were trained and supported to meet the needs of the people who used the service. Staff were available when people needed assistance, care and support.

People, or their representatives, were involved in making decisions about their care and support. People’s care plans had been tailored to the individual and contained information about how they communicated and their ability to make decisions. The service was up to date with recent changes to the law regarding the Deprivation of Liberty Safeguards (DoLS) and at the time of the inspection they were working with the local authority to make sure people’s legal rights were protected.

Staff had good relationships with people who used the service and were attentive to their needs. Staff respected people’s privacy and dignity at all times and interacted with people in a caring, respectful and professional manner.

People were supported to see, when needed, health and social care professionals to make sure they received appropriate care and treatment.

People’s nutritional needs were being assessed and met. Where concerns were identified about a person’s food intake, or ability to swallow, appropriate referrals had been made for specialist advice and support.

A complaints procedure was in place. People’s concerns and complaints were listened to, addressed in a timely manner and used to improve the service.

Staff understood their roles and responsibilities in providing safe and good quality care to the people who used the service. The service had a quality assurance system and shortfalls were addressed promptly. As a result the quality of the service continued to improve.

Inspection carried out on 27 November 2013

During a routine inspection

We spoke with six people who used the service. They told us that they were happy living in the service. One person said, �I am happy here and ready to settle down here for good." Another person said, �I am very happy here, it is lovely.� Another said, �I am very happy."

People told us that the staff treated them with respect and kindness. One person said, �They (staff) are all lovely, very very kind.� Another person said, �They (staff) are always very gentle.� This was confirmed in our observations during our inspection. We saw that staff interacted with people in a caring, respectful and professional manner.

We spoke with one person's relative who told us they were satisfied with the service that their relative was provided with. They said, "I can't fault it."

We looked at four people's care records and found that they experienced care, treatment and support that met their needs and protected their rights. Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

We looked at the personnel records of four staff members and found that appropriate checks were made on staff before they started working in the service. We saw that staff were trained to meet the needs of the people who used the service.

There were systems in place to monitor and assess the service provided to people. We found that people were cared for in a clean and hygienic environment.

Inspection carried out on 3 January 2013

During an inspection looking at part of the service

Our inspection of 28 August 2012 found areas of non compliance. We completed a follow up visit on 03 January 2013 to check that improvements had been made.

We found that care records reflected that people had given consent to their treatment. The care records included information about people's health, nutritional needs and other conditions. There was information about accessing the community and healthy living displayed . The gardens had been landscaped and they offered a safe and secure location for all people using the service. We saw evidence of improvement in medication management, falls management and care plans that indicated people's health needs including improved nutritional screening and meals management.

During the inspection we spoke with two people who used the service as well as a visiting relative. People were complimentary about the staff. They told us they were happy with the care and support they received. One relative we spoke with told us, "The staff are good, I think they look after (service user) well." Another person told us, "I couldn't be in a better place."

We saw that the home had a robust maintenance programme in place and that all required checks for the safety of the premises was up to date. This meant that people who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.

Inspection carried out on 28 August 2012

During a routine inspection

We spoke with twelve people who used the service, they told us that they were looked after well and were treated with respect. All the people spoken with felt safe in the service.

One person told us � I like living here� and another person told us� They help me in what ever I want to do.�

Inspection carried out on 30 June 2011

During a routine inspection

The people that were spoken with during a visit to the home said that they are very safe and happy in the home and feel that they receive a good service and are well looked after.

They felt that the food was good with a good choice for all meals and lovely helpful staff that look after their needs.