We carried out a review of the data available to us about Cooksditch House Nursing & Residential Home 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 Cooksditch House Nursing & Residential Home, you can give feedback on this service.
Cooksditch House Residential and Nursing Home is a residential care home providing personal and nursing care for up to 55 people. At the time of our inspection 46 older people were living at the service, some of whom were living with dementia
People’s experience of using this service and what we found
People told us they felt safe from abuse. Comments included; “There is no abusive behaviour”, “The manager keeps everyone safe” and, “I’m kept safe by my carers”.
Staff were trained to recognise and respond to concerns about safety or abuse and the provider had policies and procedures in place to respond to concerns. People and staff also told us that the registered manager was approachable and had an ‘open door’ to hear their concerns or suggestions.
The service was preventing and controlling infection. Additional COVID-19 training and procedures were used to minimise the risk of infection spread to and from people living, visiting and working at the home.
People told us the registered manager was responsive to complaints. One person said, “In case of any problems I’d go to the manager. She is not out of reach and always has time to chat”.
We found that complaints were handled in a timely and appropriate manner and that people and staff were confident and knew how to raise a complaint and who to escalate it to if need be.
Staff told us the service was well led in providing continuous learning and improving care. Comments included; “Yes the managers door is always open, we have staff meetings and the team communicate regularly,”. Another told us, “I have just completed my level 5 diploma, supported by the home”.
Staff had received regular training, were regularly supervised and involved in team meetings and service reviews.
Rating at last inspection
The last rating for this service was Good (published 25 November 2019).
Why we inspected
The Care Quality Commission have introduced targeted inspections to follow up on a Warning Notice or other specific concerns. They do not look at an entire key question, only the part of the key question we are
specifically concerned about. Targeted inspections do not change the rating from the previous
inspection. This is because they do not assess all areas of a key question.
We undertook a targeted inspection to check complaints, safeguarding procedures and the monitoring of quality and safety. The overall rating for the service has not changed following this targeted inspection and remains Good.
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.
Cooksditch House Residential and Nursing Home is a residential care home providing personal and nursing care to 48 older people, some of whom were living with dementia. The service can support up to 55 people.
People’s experience of using this service
People received their medicines as prescribed by the doctor, due to improvements in the way that medicines were managed at the service.
Systems to assess and monitor the quality of the service had been strengthened, so they were effective in identifying and addressing shortfalls in service provision. When accidents, incidents or a complaint had been made, lessons learned meetings were held to reflect and consider if anything could have been done differently.
People did not have to wait long to receive staff support as staffing levels had been adjusted to meet their needs.
A new full-time activity coordinator had been employed who had developed a programme of activities based on what people enjoyed doing. People went on trips and their art work was displayed around the service. Links had been developed with the local community. Preschool children had visited, and people had made cakes to raise money for charity.
A programme of redecoration and refurbishment continued to benefit people. Signage was displayed to help people living with dementia find their way around their home.
People and their relative said staff knew them well and helped them to feel safe. Checks on staff helped to ensure only staff who understood the values and aims of the service were employed.
Staff received ongoing training and support to ensure they had the necessary skills and knowledge to meet people’s individual needs. A nursing assistant role had been developed to make sure there enough trained staff to support people. Nursing assistants shadowed qualified nurses and received additional training.
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 had access to health care services in a timely manner and there was strong partnerships working with a range of health care professionals. Positive feedback had been received from health care professionals about how their support was requested and acted on. The provider worked in partnership with other organisations and sought their advice to improve outcomes for people.
Staff knew people well and caring relationships had been developed. A dignity champion had been appointed to ensure staff understood how to treat people in a respectful manner.
People’s nutritional needs had been assessed and guidance available in people’s care plans. Mealtimes were social occasions where people sat together, and assistance could be given when needed.
Staff understood how to support people to have a pain free and comfortable end of life, with people around who were important to them.
Everyone said the service was well-led and that the registered manager and provider were approachable. The views of people and their relatives were regularly sought and acted on.
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 requires improvement (published 28 November 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection 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 was a planned inspection based on the rating at the last inspection.
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.
The service has 50 single rooms. It is registered to provide accommodation and personal care support for up to 55 people, if some people choose to share a room. At the time of the inspection there were 48 people living at the service: 31 people were accommodated in the nursing unit and 17 people receiving residential care. The service accommodated older people with a wide range of needs including chronic or long-term health needs, physical disability, mental health and dementia.
The inspection was unannounced and took place on 3 and 4 October 2018. This was the first inspection to the service since it registered with CQC on 25 October 2017. Prior to this, the service was owned and managed by a different provider.
The service was run by a registered manager and they were present on both days of the inspection visit. 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.
Although systems to assess and monitor the quality of the service were being strengthened, they were not always effective in identifying and addressing shortfalls in service provision.
Safe systems were not in place for the management of medicines. Some people did not receive their medicines as prescribed.
There was not a systematic approach in place to determine the number of staff required to meet the needs of people. Staffing levels had been adjusted to meet the needs of people in the nursing unit. People in the residential unit told us that they had to wait a long time to receive staff support. The provider made some adjustments to staffing levels in the residential unit as a direct result of our inspection visit.
There was inconsistency in people’s care and treatment records with regards to fluids, repositioning and personal care so it could not be assured that their needs were being met.
The activity coordinator was absent from the service and this had impacted on the opportunities available for people to take part in. The provider arranged for a member of the care staff team to work an additional three afternoons a week to provide activities as a direct result of our inspection visit. Links with the local community had been developed through open days and with a local school.
Staff understood how to support people to have a pain free and comfortable end of life, with people around who were important to them. However, not everyone who had life limiting conditions had been asked about their wishes at the end of their lives.
People and their relatives told us they felt safe and comfortable with the staff who supported them. Staff had received training in how to safeguard people and knew how to report and act on any concerns to help keep people safe. New staff were checked to make sure they were suitable to work with people.
Assessments of risks to people’s safety and welfare had been carried out and action taken to minimise their occurrence. Health and safety checks were effective in ensuring that the environment was safe and that equipment was in good working order. Accidents and incidents were monitored and appropriate action taken in a timely manner to evidence that lessons had been learned.
People benefitted from a clean environment and staff knew what to do to minimise the spread of any infection.
People were supported to access health care services when needed. The provider worked in partnership with a range of healthcare professionals to ensure people received appropriate care and treatment. People had sufficient food and drink and were provided with choices and at mealtimes.
Staff received the training they needed to enable them to support people with a range of needs. Staff were suitably trained, received regular supervisions and felt well supported. The provider made sure the registered nurses had access to the training required to ensure their continuous professional development.
People were supported to have maximum choice and control of their lives in line with the principles of the Mental Capacity Act 2005. The provider had taken the necessary steps to ensure that people only received lawful care that was the least restrictive possible.
The provider had invested in the service for the benefit of people and staff. They had undertaken maintenance and repairs, installed new flooring and commenced a programme of redecoration. This had improved the standard of décor and people’s satisfaction with the environment.
Staff were kind and caring and treated people with dignity and respect. Staff had developed positive relationships with people. Visitors such as family and friends were welcome at all times.
A new care planning system was being rolled out to help improve the consistency of guidance available to staff.
Consideration had been given to presenting information to people in a way that they could understand. This included the use of whiteboards to write messages for people who were hard of hearing.
The provider had a complaints procedure in place and people who used the service and their relative were aware of how to make a complaint.
Staff felt well supported by the management team. People and their relatives said the service was well run and the registered manager was approachable. Feedback from people and their relatives was regularly sought and acted on so that the service improved for their benefit.
The service worked in partnership with other organisations and sought their advice to improve outcomes for people.
Further information is in the detailed findings below.