Coldwells House

Coldwells House is a residential care home providing accommodation for persons who require nursing or personal care to up to 41 people. The service provides support to older people, some of whom may live with dementia, mental health support needs or physical disabilities. At the time of our inspection there were 38 people using the service.

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

People’s lives continued to be enriched because staff ensured they understood what mattered to them and supported them as they wished.

Relatives were extremely complimentary about the way their family members care was planned and provided. Relatives consistently told us the actions taken by staff promoted their family member’s physical health and mental well-being, because staff celebrated them as individuals.

People were empowered by staff to do a wide range of interesting things such as participating in choirs, gentle exercise, practice their faith and to keep in touch with others who were important to them. Peoples individual communication and support needs were sensitively supported by staff, so their opportunities to enjoy life were maximised.

People were supported at the end of their lives in ways which reflected their choices and wishes. Relatives told us the level of dedication and support from staff at this key stage in their family member's lives had had a profoundly positive impact on their family members and them.

People had built extremely trusting and caring bonds with the staff who supported them. This gave people the confidence to ask for support when they wanted it. Relatives highlighted these bonds had a very positive impact on their family member's wellbeing. Staff ensured they promoted people’s rights to dignity, privacy and independence.

The culture at the home encouraged and nurtured people. Relatives told us the way the home was run meant their family members received exceptional care.

Suggestions made by people, relatives and other professionals were listened to and used to inform how the home was developed. Staff were positive about working at the home and told us they were well supported by an approachable management team. The registered manager and provider were committed to ensuring opportunities were taken for driving improvements at the home. This included acquiring quality accreditation based on best practise standards which promoted exceptional care.

People were involved in decision's about how they preferred their safety to be managed. Staff understood risks people experienced and took action to help them to stay as safe as possible. Regular checks were made on the environment to ensure the risk of infections were reduced. This included appropriate use of PPE by visitors and staff. Recruitment checks were undertaken on the suitability of staff before they were allowed to work with people.

Peoples needs were assessed and regularly reviewed. Staff worked with other health and social care professionals so people’s physical and mental health needs would be promoted. Relatives told us staff were skilled at assisting their family members and promoting their rights.

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 premises was used in ways which supported people to orientate round the home and promote their well-being.

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 outstanding, (published 28/12/2018).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

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. This included checking the provider was meeting COVID-19 vaccination requirements.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Coldwells House accommodates up to 41 older people with dementia in one adapted building. The service also provides specialist care for people living with dementia, mental health needs and physical disabilities and older people. There were 39 people living in the home when we inspected.

At the last inspection in January 2016 the service was rated as Good overall, and outstanding in Caring. At this inspection we found the service had improved to Outstanding overall.

Why the service is rated Outstanding.

People consistently received very supportive and compassionate care which they said made it a pleasure to live at the home. People showed us they had developed exceptionally strong bonds with the staff who supported them.

Staff were passionate about providing warm and considerate care. To facilitate this, staff had developed an in-depth knowledge of people’s unique histories, interests and communication preferences. Staff skilfully and imaginatively used this knowledge when caring for people; people were empowered to make their own decisions and to enjoy the best well-being possible. Staff were proactive in promoting people’s dignity, privacy and independence.

People enjoyed a very wide range of interesting things to do. Staff very thoughtfully devised tailored opportunities for people to creatively express themselves. These were based on people’s individual histories and preferences, and built on people’s links with the local community. This ensured people were connected with their past, their relationships with people who mattered to them were promoted, and their achievements were celebrated.

Systems supported people to make any complaints they wished to. People and their relatives advised us they would be confident to make any complaints, but had not needed to because the quality of care provided was very good.

We found relatives had been very positive about the compassionate action taken by staff at the end of their family member’s lives.

People’s care needs were comprehensively and sensitively assessed by staff, who focused on finding solutions to people’s complex support needs. Staff were exceptionally skilled at supporting people so they enjoyed an enhanced quality of life.

People highlighted how much they enjoyed their meals, which were pleasurable, social occasions with relatives and staff. People enjoyed improved health because their nutritional and hydration needs were fully met.

There were very good systems for working across staff teams and with external specialists, with clear evidence of people achieving greatly improved physical and mental health. A healthcare professional who regularly visited the home commended staff for their commitment to improving people’s health and well-being.

The needs and wishes of people were central to how the home was used. People and their relatives enjoyed using the onsite café and benefited from meeting up in quieter or more lively areas of the home and gardens.

Staff had used discreet symbols to let people know they would be valued for themselves, and their lifestyles would be respected. Staff were proactive in promoting people’s freedoms and respected their rights. 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 told us they loved living at the home and staff felt very supported. The culture in the home was open, and all staff teams consistently focused on improving and further developing people’s care. The management team had developed ways of working across organisations to support staff to provide excellent care, so people’s care expectations were exceeded. This reflected the best practice standards used within the home. The registered manager and provider also shared their knowledge with external health and social care providers, so all people in Herefordshire would benefit from initiatives developed in the home to enhance people’s health and well-being.

People and their relatives found the management team to be very approachable, and this encouraged people to contribute their suggestions for continually developing the home. These suggestions were listened to so people had an exceptional quality of life. Regular checks were undertaken on the quality of care provided, so the registered manager and provider could be assured people had an excellent level of care.

Staff were available to meet people’s needs; people and their relatives highlighted people were always supported by staff who knew them and their safety needs well. People benefited from living in a home where staff understood risk to their safety and knew how to protect people from abuse. Systems had been put in place to promote the safe administration of medicines. Staff told us about the checks undertaken by the management team prior to them coming to work at Coldwell’s House. These helped to ensure recruited staff were suitable to work with people living at the home.

Further information is in the detailed findings below.

Staff understood the importance of people making decisions for themselves as far as they were able. Some people were living with dementia and were not able to make some decisions for themselves. There were clear procedures in place to ensure that decisions were made in people's best interests.

We saw that people appeared well cared for. Staff were attentive to people's needs. People told us, "the staff are fantastic" and, "they'll do anything for you". Records were detailed and fully completed.

People told us that they enjoyed the food provided at the home. One person described it as, "as close to home-cooked as you can get". Staff supported people to eat in a sensitive and gentle manner.

The provider had effective systems in place for monitoring the quality of the service. People were encouraged to express their views and opinions about the home. Any concerns were acted upon promptly.