Archived: East Cosham House

Updated 16 April 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 conducted by two inspectors on the first day and one inspector on the second and third day.

Service and service type

East Cosham House 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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with seven people who used the service and five relatives about their experience of the care provided. We spoke with eleven members of staff including the nominated individual, registered manager, deputy manager, care workers, the housekeeper, the activities coordinator and the cook. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at six staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and policies and procedures.

Updated 16 April 2020

East Cosham House is a residential care home providing personal care to 23 people aged 65 and over at the time of the inspection. The care home can accommodate 24 people in one adapted building.

People’s experience of using this service and what we found

The provider lacked effective governance systems to identify concerns in the service and drive the necessary improvement. At times there was a lack of clear and accurate records regarding people’s medicines, support and any potential risks to them. Accidents and incidents were not analysed sufficiently to ensure risks were reduced for people. Insufficient mental and physical stimulation was provided due to a lack of activities staff.

We found concerns in relation to cleanliness of the home and a failure to report safeguarding incidents to the local authority and CQC, We also observed that there were some health and safety concerns in relation to an uncovered floor level radiator and windows that needed to be propped open.

The provider had not followed legislation that required them to act in an open and transparent way when people came to harm.

Best practice guidance was not utilised in providing an environment that promoted the well-being of people who lived with dementia. Some parts of the home were not well maintained and were a risk to people.

People were happy living at East Cosham House and people told us they felt safe. People were supported by staff who were kind, caring and who mostly understood their likes, dislikes and preferences. People’s religious needs were met. People were cared for by staff who were well supported and received regular supervision to meet people's needs effectively.

People and their relatives knew the management team and felt able to speak to them if they had any concerns. The registered manager and provider demonstrated a willingness to make improvements.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 17 January 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections. At the last inspection there was one breach of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection enough improvement, had not been made and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to safe care and treatment of people, safeguarding people from improper treatment, maintaining suitable premises, failure to notify CQC of reportable incidents and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We identified five breaches of regulation and because this is the second consecutive time the service has been rated as requires improvement we will request a clear action plan from the provider to understand what they will do to improve the standards of quality and safety. We will also meet with the provider following receipt of this plan. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.