Coldwells House 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. Coldwells House accommodates up to 41 older people with dementia in one adapted building. The service also provides specialist care for people living with dementia, mental health needs and physical disabilities and older people. There were 39 people living in the home when we inspected.
At the last inspection in January 2016 the service was rated as Good overall, and outstanding in Caring. At this inspection we found the service had improved to Outstanding overall.
Why the service is rated Outstanding.
People consistently received very supportive and compassionate care which they said made it a pleasure to live at the home. People showed us they had developed exceptionally strong bonds with the staff who supported them.
Staff were passionate about providing warm and considerate care. To facilitate this, staff had developed an in-depth knowledge of people’s unique histories, interests and communication preferences. Staff skilfully and imaginatively used this knowledge when caring for people; people were empowered to make their own decisions and to enjoy the best well-being possible. Staff were proactive in promoting people’s dignity, privacy and independence.
People enjoyed a very wide range of interesting things to do. Staff very thoughtfully devised tailored opportunities for people to creatively express themselves. These were based on people’s individual histories and preferences, and built on people’s links with the local community. This ensured people were connected with their past, their relationships with people who mattered to them were promoted, and their achievements were celebrated.
Systems supported people to make any complaints they wished to. People and their relatives advised us they would be confident to make any complaints, but had not needed to because the quality of care provided was very good.
We found relatives had been very positive about the compassionate action taken by staff at the end of their family member’s lives.
People’s care needs were comprehensively and sensitively assessed by staff, who focused on finding solutions to people’s complex support needs. Staff were exceptionally skilled at supporting people so they enjoyed an enhanced quality of life.
People highlighted how much they enjoyed their meals, which were pleasurable, social occasions with relatives and staff. People enjoyed improved health because their nutritional and hydration needs were fully met.
There were very good systems for working across staff teams and with external specialists, with clear evidence of people achieving greatly improved physical and mental health. A healthcare professional who regularly visited the home commended staff for their commitment to improving people’s health and well-being.
The needs and wishes of people were central to how the home was used. People and their relatives enjoyed using the onsite café and benefited from meeting up in quieter or more lively areas of the home and gardens.
Staff had used discreet symbols to let people know they would be valued for themselves, and their lifestyles would be respected. Staff were proactive in promoting people’s freedoms and respected their rights. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People told us they loved living at the home and staff felt very supported. The culture in the home was open, and all staff teams consistently focused on improving and further developing people’s care. The management team had developed ways of working across organisations to support staff to provide excellent care, so people’s care expectations were exceeded. This reflected the best practice standards used within the home. The registered manager and provider also shared their knowledge with external health and social care providers, so all people in Herefordshire would benefit from initiatives developed in the home to enhance people’s health and well-being.
People and their relatives found the management team to be very approachable, and this encouraged people to contribute their suggestions for continually developing the home. These suggestions were listened to so people had an exceptional quality of life. Regular checks were undertaken on the quality of care provided, so the registered manager and provider could be assured people had an excellent level of care.
Staff were available to meet people’s needs; people and their relatives highlighted people were always supported by staff who knew them and their safety needs well. People benefited from living in a home where staff understood risk to their safety and knew how to protect people from abuse. Systems had been put in place to promote the safe administration of medicines. Staff told us about the checks undertaken by the management team prior to them coming to work at Coldwell’s House. These helped to ensure recruited staff were suitable to work with people living at the home.
Further information is in the detailed findings below.