The Cotswold

Updated 20 September 2019

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 one inspector, an assistant inspector and one Expert by Experience. 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

The Cotswold 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 registered manager. The 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 unannounced and took place on 13 August 2019.

What we did before the 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 also looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law.

During the inspection

We spoke with six people who used the service and four relatives about their experience of the care provided. We spoke with eight members of staff including the registered manager, a nurse, care staff, the receptionist, a member of housekeeping staff and the kitchen staff. We reviewed a range of records. This included three people’s electronic care records and samples of medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including accidents log, complaints and quality audits were viewed.

After the inspection

We contacted nine external health and social care professionals, including commissioners to gather their views about the service.

Updated 20 September 2019

About the service

The Cotswold is a care home providing personal and nursing care for people predominantly aged 65 and over, either on permanent or short stay basis. The service is a purpose-built two storey building providing private rooms and a choice of communal spaces, such as a library as well as beautiful gardens. The Cotswold can accommodate up to 51 people and there were 49 people living at the service at the time of our inspection.

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

The entire team put people at the heart of the service delivery. Meeting people’s individual expectations, including any smallest and unique expectations as explored by gathering people’s life histories was the driving force for the staff. Staff fully appreciated the importance of ensuring people kept their own individuality and had the support that met their wishes and expectations, this included using innovative ideas.

The provider’s aim was to provide “Exceptional care delivered around the clock” and there was evidence the entire team shared this aim and delivered it successfully. The staff excelled at ensuring people experienced the benefits and the values of person-centred care. People described staff as “Marvellous”. Staff demonstrated they knew people’s needs in detail and formed a meaningful rapport with people and their relatives. People’s visitors were welcomed without restriction and encouraged to be actively involved in the life of the service.

Staff excelled in providing compassionate and dignified end of life care, with people’s lives celebrated and valued. We received exemplary feedback from people’s relatives around support they had with planning for the end of life care and the delivery of palliative care.

The registered manager promoted a positive approach to complaints management and they were able to demonstrate where improvements had been made as result of learning from concerns.

The service was run exceptionally well which ensured an excellent track record of their compliance with the regulations. The team was led by example by the extremely passionate registered manager who was fully committed to continuous improvement, she told us, “I always think we can do better”.

The registered manager proactively sourced any opportunities that ensured the staff were, in their words, “Ahead of the game” in relation to following the good practice guidance. They participated in local and national projects to ensure the quality of care delivered was constantly being enhanced.

The team worked closely with other agencies and promoted an open and transparent culture with a strong emphasis on staff development. We had exemplary feedback from the staff. One staff member reflecting on their personal development journey at the service commented, “It’s the role I want to do, the person I want to be”. There was a very high staff morale and the team demonstrated a real sense of pride working at the service. External professionals were very complimentary of the service and told us, “It is always a pleasure to visit the home”.

There was a very high level of confidence in the leadership of the service expressed by people, relatives, external health professionals and staff. There was a strong emphasis on involvement of people. This was not only in decisions relating to day to day running of the service but also in contributing to developing policies, recruitment of staff and decision at the provider’s level, such as marketing campaign. The registered manager ensured their systems to monitor the quality and safety of the service provided remained effective. There were additional checks at the provider’s level that ensured the team at The Cotswold was well supported.

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 were supported to meet their nutritional needs and access health care services.

People remained safe and supported by sufficient numbers of skilled and motivated staff who provided caring and compassionate support. People’s dignity, privacy and confidentiality were respected.

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

Rating at last inspection

Good (report published 10 March 2017).

Why we inspected

This was a scheduled 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.