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Archived: The Cottage Care Home Requires improvement

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Inspection report

Date of Inspection: 6 August 2014
Date of Publication: 29 August 2014
Inspection Report published 29 August 2014 PDF

Overview

Inspection carried out on 6 August 2014

During a routine inspection

At the time of our inspection the provider had a new manager in post. The manager was applying for registration with the Care Quality Commission. In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.

Four people lived at the home but we were unable to speak to them as they had complex needs and had difficulty communicating. We gathered evidence of people's experiences by reviewing records, observing care practices and talking with staff.

A single adult social care inspector carried out the inspection. The focus of the inspection was to answer five questions: Is the service safe, effective, caring, responsive and well-led?

We found the service was safe.

Overall we found the service was safe but we found the management of medicines to be unsafe. We found inappropriate arrangements for the recording, handling, dispensing and disposal of medicines.

Staff told us they had received training about safeguarding vulnerable people. They told us they would report concerns immediately to a senior staff member. Policies, procedures and local guidelines were available for staff to follow. The provider might find it useful to note that the policies read were dated 2010 and we found no evidence of policies being reviewed.

We saw that staff had a good rapport and interacted well with the people living in the home. We saw that people freely approached members of staff when they wanted support.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS), which applies to care homes. The provider had policies and procedures in relation to the Mental Capacity Act (MCA) and people had DoLS authorisations in place. This was in line with the provider's policies and procedures, and the CQC had been notified as required by law. This meant that people would be safeguarded as required. We saw systems in place to ensure that managers and staff learnt from accidents and incidents as well as comments received from professionals and relatives of people who use the service.

Is the service effective?

People's health and care needs were assessed comprehensively and found they had been supported to be involved with their health action plans and care plans. We saw involvement from external health professionals such as the community learning disability team (CDLT).

We spoke with staff who told us the had received regular supervision and an annual appraisal.

We found the service was caring.

We spoke with staff, and observed the interactions they had with people. We found, without exception, that staff spoke kindly and demonstrated a good understanding of people's needs. Staff said they enjoyed working at the home as each day was different. During our visit we observed there was a relaxed atmosphere with people choosing where they wished to spend their time. We observed staff treating people with kindness and patience. Staff demonstrated they knew people's needs and ensured people were treated with privacy and dignity.

We found the service was responsive.

People had their needs assessed on a regular basis. They met with their key workers regularly to review their plans and to discuss what was important to them. Staff told us that people understood what they said and were able to respond through the use of symbols, signs and gestures. We saw care plans which showed us that that the care, treatment and support was reviewed in line with people's changing needs. Records confirmed people's likes and dislikes and preferred routines.

We found the service was well-led.

The service had a good quality monitoring system which ensured that the manager was aware of any changes in the service and was able to respond proactively.

Other agencies had written positive comments about the way the service provided good information and worked in a way that improved people's health and well-being.

We observed good relationship between staff and management on the day of our visit. Staff were clear about their roles and responsibilities and told us that they were supported by their manager.