We carried out a review of the data available to us about Colne House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Colne House, you can give feedback on this service.
Colne House is a residential care home providing personal care and accommodation for up to 38 older people, some of whom may have mental health needs and or may be living with dementia. The premises is set in extensive grounds is made up of one large adapted building, and an annex which accommodated five people. At the time of our inspection 30 people were living in the service.
People’s experience of using this service and what we found
There was a homely atmosphere, and people told us they were happy with the support provided and liked the staff. One person told us, “All the staff got a general sense of humour…can have a laugh and a joke and affection.” Another described the staff as, “Very nice,” and smiled as staff approached them.
Staff supported people to keep well and safe, and ensure they received their medicines as prescribed. One person told us, “If you’re not well they will get you into hospital.”
Improved infection control and risk management systems were in place to support people to live in a clean, safe environment. People told us they were supported in a clean environment. One person told us, “My room is spotless, it’s always fine.”
Risks were assessed and preventative action taken to reduce any risks of harm. We have made a recommendation about including the risk, where people used flammable skin creams in their fire risk assessments.
Staff were recruited safely to ensure they were able to work with vulnerable people. The management kept staffing levels under review to ensure there were enough to meet people’s needs.
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.
People and staff had confidence in the newly promoted manager, who they knew well.
The provider had systems in place to check on the safety and quality of the service people received and act on the information to drive continuous improvement.
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
The last rating for this service was requires improvement (published 15 April 2021). At that inspection, breaches of legal requirements were found in safe care and treatment and good governance. Following the inspection, the provider completed an action plan 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
This inspection was prompted by a review of the information we held about this service.
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.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Colne 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.
Colne House is a residential care home providing personal care and accommodation for up to 38 older people, some of whom may have mental health needs and or may be living with dementia. At the time of our inspection 25 people were living in the service.
Colne House is an adapted building, consisting of three floors with a separate annex.
People’s experience of using this service and what we found
Systems and processes in place were not effective enough to review and assess the quality of service provision. This meant the previously demonstrated good standard in well-led had not been maintained. In safe, shortfalls identified in risk management and infection control, meant it remained as requires improvement.
Risks to people had not been fully assessed and action. Improvements were needed to minimise the risk of people experiencing anxiety due to other people living with dementia entering their bedrooms by mistake. Staff monitored people’s temperature and oxygen levels as early indicators of infection and deterioration in health. However, staff had not been given effective training and guidance in the use of pulse oximeters and when to seek medical advice.
We found improvements were needed in the provider’s oversight and monitoring of the service to ensure staff feel valued through good communication.
Staff wore personal protective equipment (PPE) to keep people safe and reduce the risks of cross infection. However, we found shortfalls where staff were not always following safe practice, including hand hygiene, enhanced cleaning and management of risks.
The service continues to follow safe recruitment procedures to ensure only suitable staff were employed to work at the service. A relative described staff as being, “So loving and caring.”
Relatives provided examples of the good relationships they had built up with staff, who kept them updated on any incidents or health issues and systems. They praised the dedication of the new registered manager and staff during the pandemic, sending thank you notes to the service, one referring to staff as the ‘Kingsley Heroes.’
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 20 June 2019). At this inspection we found the rating had changed to requires improvement.
Why we inspected
We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about staffing, monitoring people’s oxygen levels, supporting people living with dementia and infection control. A decision was made for us to inspect and examine those risks.
We inspected and found there was a concern with oversight of the service to check the systems they had in place were effective to support people in a clean and safe environment. So, we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.
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. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement.
This is based on the findings at this inspection. You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Colne House 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 have identified breaches of regulation in relation to infection control, risk management and good governance at this inspection.
We found the following examples of good practice.
At the start of the outbreak, relatives told us the registered manager and a senior staff member moved into the service to provide management support and hands on care. They felt this showed a good commitment and provided them with reassurance.
National guidance was being followed to ensure staff and people living in the service were regularly tested for COVID-19. This included the quick tests, where results were known within 30 minutes and used for visiting relatives. Although the service was closed to family visitors at the time of the inspection, measures were in place to support visits to people receiving end of life care.
At the time of the inspection the service were not taking new admissions. However, once they started to, they confirmed they would be following the national admissions guidance including the 14-day isolation period.
People’s experience of using this service:
There was a new registered manager who had been in post since November 2018 having previously worked at the service as the deputy manager. The registered manager had a visual presence. People, their relative’s and staff were positive regarding the management of the service.
People were cared for by staff who knew how to keep them safe and protect them from avoidable harm. Sufficient staff were available to meet people's needs and available when they needed assistance, staff responded promptly.
The management team had systems in place to monitor the quality and safety of the service provided, and to drive improvements where this was required. The service considered people's feedback and was continuously trying to improve the service.
Further work was needed to ensure the current system for auditing medicines was robust at identifying all the medicines management errors we found.
Shortfalls we noted in relation to health and safety of the environment were acted upon immediately by the registered manager with evidence provided.
People received care from staff who knew them well. People told us staff were kind, caring in their approach and treated them with dignity and respect.
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.
We recommended work be carried out to enable people to express their end of life wishes, and further information gathered regarding people's life history. This is particularly important for staff when supporting people living with dementia.
The management team worked well to lead the staff team in their roles and ensure people continued to receive a good service. Staff and the registered manager showed a genuine interest and passion to deliver personalised care based on people's needs and wishes.
People had access to a variety of nutritious meals and snacks. People at risk of inadequate food intake were monitored and specialist advice sought when needed.
There was a varied range of personalised social activities on offer. Staff encouraged people to participate in group and one to one activities of interest to the individual.
Rating at last inspection: Good (report published on 7 December 2016).
Why we inspected: This was a scheduled inspection based on the previous rating.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Colne House provides accommodation and personal care for up to 38 older people, some of whom have dementia care needs.
At the time of our inspection the provider confirmed they were providing support to 32 people.
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 had a good understanding of abuse and the safeguarding procedures that should be followed. They knew how to report abuse use whistleblowing procedures. People had detailed risk assessments in place to support their safety whilst also enabling them to be as independent as possible.
Staffing levels were adequate to meet people's current needs. There were enough staff regularly on shift within the service and contingency plans were in place for any staff absence.
The staff recruitment procedures ensured that appropriate pre-employment checks were carried out so that only suitable staff worked at the service.
Staff received an induction training package when they joined the service, and on-going training was provided to ensure they had the skills, knowledge and support they needed to perform their roles. Staff felt confident in their roles because the training had equipped them well.
People told us that their medicines were administered safely and on time. We saw that the medication administration systems in place were accurate and up to date, and that all medication was stored securely.
Staff were well supported by the registered manager and senior team, and had regular one to one
supervisions. Staff were confident that they would receive the support they needed from management at all times. The management team were very knowledgeable about the people within the service and the staff team skills.
People's consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 (MCA) were met. We saw that where appropriate, best interests meetings had been held and capacity assessments had been completed in line with MCA.
People were able to choose the food and drink they wanted and staff supported people with this. Fresh food was prepared and cooked on site and any dietary needs were catered for. People were supported to access health appointments when necessary, and health professionals came in to the service to visit people when required.
Staff treated people with warmth, kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. All the staff had an excellent knowledge of people’s likes and dislikes, and were able to engage with everyone in a person centred manner.
People or their family were involved in their own care planning and were able to contribute to the way in which they were supported. Staff had keyworker responsibilities which included checking and reviewing care with people and their family.
The service had a complaints procedure in place to ensure that people and their families were able to provide feedback about their care and to help the service make improvements where required.
The people we spoke with knew how to use it.
Quality monitoring systems and processes were used effectively to drive future improvement and identify where action was needed. Audits were in place for many areas of the service and questionnaires were in use to collect opinions from people, family, and staff on the care received in the service.
Appropriate support plans were in place to provide person-centred care which met both the physical and emotional needs of people living at Colne House. Risk assessments had been completed to protect the health and welfare of people using the service.
People were supported to access adequate hydration and nutrition. Mealtime assistance was adequate to ensure that everyone requiring additional support received it.
Medicines were stored and administered safely and staff maintained accurate medication records.
There was an appropriate complaints policy in place. People we spoke with knew how to complain if they needed to.
We found that assessment and care planning was effectively managed so that care and treatment was provided according to people's wishes and needs. We saw that there were regular quality checks including gaining the views of people living in the service or their relatives.
Staff were trained appropriately and supervised regularly to maintain competence. Staff told us they had training to provide safe care including to people living with dementia.
Those people with whom we spoke confirmed that they felt respected and involved by staff. They also confirmed that they were satisfied with the care and attention provided by staff. Two people said that they enjoyed being able to walk around the gardens and appreciated the fresh air. Three people said the food was 'Nice'.
Visitors with whom we spoke confirmed that they were consulted with about the care that their relative were receiving and felt able to talk to senior staff if they had any concerns. One visitor reported that they considered that individual's choices and rights are respected and promoted by staff in this home.
Visitors confirmed that they were pleased with the care and support that they had observed and that they if they had any concerns were able to approach staff and were confident that these would be addressed appropriately.