Background to this inspection
Updated
24 January 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
One inspector, an assistant inspector and an Expert by Experience carried out this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Coton Hill House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We asked the local authority and Healthwatch for any information they had which would aid our inspection. Local authorities together with other agencies may have responsibility for funding people who used the service and monitoring its quality. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.
During the inspection
We spoke with four people who used the service and two relatives. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We spoke with nine members of staff including, the registered manager, senior carer, laundry assistant, four care assistants, the maintenance person and the operations director.
We reviewed a range of records. These included three people’s care record and daily reports. We also looked at the records of medicines administration. We had sight of two staff members file’s in relation to recruitment and supervision. In addition, we looked at a variety of records relating to the management of the service, including any quality monitoring checks and incident and accident records.
Updated
24 January 2020
About the service
Coton Hill House provides accommodation and nursing or personal care for up to 45 people. There were 40 people living at the home on the day of our inspection, some of whom were living with dementia. People were cared for in five units over two floors. Cherry and Berwick units were on the ground floor. River View, West View and Castle View units were on the first floor which were accessible by stairs and lifts.
People’s experience of using this service and what we found
People did not always receive safe support with their medicines.
Environmental checks did not always follow best practice designed to keep people safe.
The provider's quality assurance and monitoring systems were not always effective in assuring a good and consistent service.
People were protected from the risks of abuse and ill-treatment as the staff team were trained to recognise potential signs of abuse and understood what to do to if they suspected wrongdoing.
The provider had assessed the risks to people associated with their care and support. Staff members were knowledgeable about these risks and knew what to do to minimise the potential for harm to people. When changes to risks occurred, the provider had systems in place to review how they supported people.
Staff members followed effective infection prevention and control procedures when supporting people. Staff members had access to, and used, appropriate personal protection equipment.
The provider supported staff in providing effective care for people through person-centred care planning, training and one-to-one supervision.
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 at Coton Hill House supported this practice.
People had access to additional healthcare services when required. Staff members knew people’s individual health outcomes and supported them appropriately. People were supported to maintain a healthy diet by a staff team which knew their individual preferences.
People received help and support from a kind and compassionate staff team with whom they had developed positive relationships. People were supported by staff members who were aware of their individual protected characteristics like age, gender and disability.
People were provided with information in a way they could understand. The provider had systems in place to encourage and respond to any complaints or compliments from people or those close to them.
The provider, and management team, had good links with the local communities within which people lived.
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 13 June 2017).
Enforcement
We have identified one breach or regulations in relation to people not being safely supported.
Please see the action we have told the provider to take at the end of this report.
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.