Background to this inspection
Updated
30 September 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
The inspection was carried out by two inspectors and a third inspector who spoke to relatives and staff away from the care service by telephone.
Service and service type
The Cottage Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 did not have a manager registered with the Care Quality Commission, a manager had been employed and had applied to be registered with CQC. A registered manager 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 announced. We gave a short period notice of the inspection because we needed to be sure that the manager would be present to support the inspection, particularly in light of Covid-19.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, the local Clinical Commissioning Group (CCG) and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
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 used all this information to plan our inspection.
During the inspection
We spoke with four people who used the service, five people’s relatives, one nurse and three members of care staff. We also received feedback from a healthcare professional involved with the service and spoke with the service manager.
We reviewed a range of records. This included four people’s care records and medication records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, staff rota’s, policies and quality assurance records.
Updated
30 September 2020
The Cottage Nursing Home Limited is a nursing home which provides nursing and personal care for up to 53 older people. Thirty-one people were living at the service at the time of our visit.
People’s experience of using this service and what we found
Although the arrangements for assessing risk, safety monitoring and management within the service had improved since the last inspection, a number of fire safety risks had been identified in the environment and some works were required to be carried out.
Infection control measures had been increased since Covid-19 and the CQC had signposted the manager towards updated guidance for Personal Protective Equipment (PPE) in Care Homes for their staff.
Risk assessments were in place to support people to receive safe care.
People who used the service told us they felt safe. They told us staff treated them well and they knew who the manager was.
Safeguarding investigations were completed as required and appropriate action was taken when staff had not met expectations.
Relatives felt that communication could have been better during Covid-19. Professional agencies confirmed the management team had worked alongside them during Covid-19 and kept them informed.
The provider had quality monitoring systems in place which reviewed incidents and looked for patterns of behaviour. This was helpful to identify trends, or key times when people may need additional support.
The management team were striving to improve the culture within the service and took an open and transparent approach when incidents occurred. The management team were eager to learn and share good practice and this helped people remain safe. Systems were in place to audit the care provided and to seek feedback from people involved with the service.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 9 September 2019).
At this inspection we found improvements had been made and the provider was no longer in breach of regulation, however the overall rating remains the same.
Why we inspected
We carried out an announced comprehensive inspection of this service on 1 August 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance.
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.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has not changed.
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 The Cottage Nursing Home on our website at www.cqc.org.uk.
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.