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Swiss Cottage Care Home Good

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Good

Updated 26 January 2018

Swiss Cottage provides accommodation and nursing care for up to 82 people with a wide range of care needs. At the time of our inspection there were 49 people living at the service, many of whom were living with dementia and other conditions.

Following our previous comprehensive inspection in February 2017, we gave this location an overall rating of ‘Inadequate’ and was therefore placed into ‘special measures’. We carried out a focused inspection in May 2017 to check they had met legal requirements. We found a number of breaches continued.

At that inspection we found that people’s risk assessments were in place for each person. We found that some work had been completed but was yet to be audited and signed off by the manager. The risk assessments we reviewed as part of this inspection showed some improvements in the details contained within the documents but work was still required in this area to ensure every person had current, detailed assessments in place to reduce the risk of them coming to harm. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We found that medicines were not managed safely. On the residential unit, we found stock carried over from one month to the next was not always recorded. This made it difficult to maintain an accurate record of overall stock of individual medicines for each person. While boxed and liquid medicines were dated to show the date they were opened, this was not the case for inhalers. The records for one person who was prescribed a specific medicine did not include any details of the correct procedure to ensure this medicine was administered safely and as prescribed. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People had not been involved in the development of their care plans. They did not accurately reflect people’s current needs and lacked personalisation. This was a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Activities provision was poor and did not support people to maintain their interests and hobbies. People cared for in their bedrooms were isolated, with little to do other than watching television. This was a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014.

The service did not provide appropriate food to people with specific dietary needs and support offered to people at meal times was poor and not in line with their care plans. This was a breach of Regulation 14 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We identified a significant lack of training and supervision for staff. This was a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Although the ratio of staff to people had increased, the deployment of staff was not meeting the needs of people using the service. This was a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We found that, although improvements had been made in some areas, continuing breaches were identified in relation to medicines management, staffing, the way in which people's food and hydration needs were met and in the provision of a person centred service. We saw that the provider had plans in place to further improve the service and was monitoring this work to ensure it was completed to a good standard and in a timely manner. However, this work was not completed

at the time of the inspection. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014.

You can read the report from this comprehensive inspection by selecting the 'all reports' link for Swiss Cottage on our website at www.cqc.org.uk.

We carried out this unannounced comprehensive inspection on 30 and 31 October 2017, to see if the provider ha

Inspection areas

Safe

Good

Updated 26 January 2018

The service was safe.

Staff were knowledgeable about protecting people from harm and abuse.

People had up to date risk assessments in place.

There were enough trained staff to support people with their needs.

Staff had been recruited using a robust recruitment process.

Systems were in place for the safe management of medicines.

Effective

Good

Updated 26 January 2018

The service was effective.

Staff had attended a variety of training to keep their skills up to date and were supported with regular supervision and appraisals.

People could make choices about their food and drink and were provided with support when required.

People had access to health care professionals to ensure they received effective care or treatment.

Caring

Good

Updated 26 January 2018

The service was caring.

People were able to make decisions about their daily activities.

Staff treated people with kindness and compassion.

People were treated with dignity and respect, and had the privacy they required.

Responsive

Good

Updated 26 January 2018

The service was responsive.

Care and support plans were personalised and reflected people�s individual requirements.

People and their relatives were involved in decisions regarding their care and support needs.

There was a complaints system in place and people were aware of this.

Well-led

Requires improvement

Updated 26 January 2018

The service was not always well led.

People knew who the registered manager was.

People and their relatives were asked for, and gave, feedback which was acted on.

Quality monitoring systems were in place and were effective.

We could not improve the rating for well led because to do so requires consistent good practice over time. We will check this during our next planned comprehensive inspection.