Collingswood House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People were protected from the risk of harm and abuse. Care plans were clear and provided guidance for staff to keep people safe. However, people told us and their visits were not always on time and that sometimes staff did not stay for the full allotted time of their care visit. In the majority of cases the service carried out robust investigations when things went wrong in the service. However we noted the service could strengthen its practices in relation to the recording of risk assessments and investigations and referrals to the barring service.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Some people told us they had made complaints and these had been resolved. Other people said when they made complaints they had not received a response or actions had not been taken.

The registered manager and provider were able to describe their duty’s in relation to The Duty of Candour, the actions they would take, their understanding of and how (where appropriate) they would include relatives and or advocates.

Although some people told us complaints were not sometimes not dealt with. Records showed complaints that had been raised through the providers formal complaints procedure had been dealt with in line with the provider's complaints policy. The provider explained how accidents and incidents were recorded. Senior leaders confirmed the process.

People told us if they were unwell, staff would act on it and contact health professionals as needed.

Observations, discussions with leaders and records confirmed the service worked with healthcare professionals such as, G.Ps and physiotherapists to ensure that people received effective and responsive care.

The provider worked closely with the Local Authority Commissioning Team and Safeguarding Team, who confirmed this.

Where healthcare professionals provided advice about people's care this was incorporated into people's care plans and risk assessments.

People told us they felt safe.

The providers knowledge of The Mental Capacity Act 2005 (MCA)was not in line with MCA code of practice 2005. This meant people could be placed at risk of unnecessary delays in appropriate consent to care being sought. We raised the with the registered manager who acknowledged our concerns and arranged for additional training to be put in place for staff and the senior leadership team. Staff knew how to report safeguarding concerns within the organisation and externally. Staff told us when they raised safeguarding concerns these had been dealt with appropriately.

Safeguarding systems and processes were in place to identify report and investigate, allegations of abuse. The provider had logs and records that showed appropriate action had been taken. Systems were aligned to the providers policies and procedures. Senior leaders were committed to ensuring people were safeguarded from avoidable harm. However, the service could strengthen its practices in relation to the recording of risk assessments and investigations. The service was signposted to seek out national guidance on barring referrals to consider this against their internal processes.

People told us the service carried out an assessment to discuss risks before they started to receive care.

The leadership team were able to articulate how safety and well-being were being managed through a risk management process.

People's care plans contained risk assessments which included risks associated with moving and handling, falls, epilepsy and pressure damage. Where risks were identified plans were in place to identify how risks would be managed. All care plans and subsequently the risk management plans demonstrated people’s involvement in managing their individual risks.

Most people told us they felt safe when staff used equipment to support them. Where a couple of people had experienced an issue with staff not using equipment safely, they reported this to the office.

The leadership team fully understood their responsibilities to keep people safe in their own homes.

Individual risk assessments on people’s environmental needs were carried out. The provider also had systems to ensure people were protected from untoward incidents. Senior leaders carried out quality assurance calls which included questions surrounding safety.

People complimented their regular staff and told us they knew how to meet their needs. Comments included “I look forward to the carers calling we have a good laugh, there is usually a team of 6 to 8 carers and I know them all” and “Staff are competent and trained makes all the difference having good carers”. Some people told us they have lots of different staff and staff who visited did not always know how to meet their needs. Comments included “they come in and they don’t know what they’re doing. They haven’t read the care plan…I’m the sort of person who doesn’t like telling people so it makes me a bit uncomfortable” and “We have a lot of different carers, people he doesn’t know and often 2 together who we don’t know at all”. Some people told us their visits were on time but others said their times varied and that staff didn’t stay the full allotted time.

Leaders told us and records confirmed that staff had access to further training and development opportunities. For example, staff had access to national qualifications in care. However Competency checks relating to medicines were not carried out in line with national guidance. Staff told us they received regular training so they knew how to meet people’s needs. One staff member commented “Training at Collingswood is in-depth training better than I've previously had, they tell you everything you need to know and if you think you’re not confident in any areas you can come back and do the training again”. Some staff told us they had regular supervision and spot checks, whilst others said they didn’t. Over half the staff who gave us feedback said they didn’t have enough travel time between visits. For example, a visit could end at 08:30am and the next one starts at 08:30am which doesn’t allow for traffic, distance or parking. One staff member said “you have to leave the appointment early in order to get to the next call on time”.

Records showed that staff completed training which included safeguarding, MCA, infection control, medication, moving and handling, and pressure care. Records showed newly appointed care staff went through an induction period. This included training for their role, shadowing an experienced member of staff and having their competencies assessed prior to working independently with people.

Most people told us staff wore appropriate PPE including gloves, aprons, and masks when needed. A few people said staff arrived at their home wearing PPE.

The registered manager was able to describe and demonstrate that staff had easy access to PPE.

People had Individual Infection Prevention Control risk assessments in place. We have observed staff accessing stock on their own accord. The provider's infection prevention and control policy was up to date. Staff received training and spot checks carried out by the leadership team ensured compliance and competency.

People told us they received their medicines as prescribed. One person told us "No problems with getting my medication”. Another person said “They do my tablets, it’s all fine”.

The registered manager and senior leadership team described how medicines incidents or errors were reported and investigated. They described how staff were trained in safe medicines handling. Following our concerns regarding the absence of a formal system for recording staff competencies to make sure they gave medicines safely. The provider introduced a new system during our assessment. This new system was aligned to national best practice.

Staff created electronic medicine charts to record when they supported people with their medicines. This information was also available as an App for staff to identify which medicines were due at each visit. Medicines and doses due were listed individually. However robust checking systems were not in place to ensure that these were accurate. When people’s medicines were changed there was not always an audit trail or checks to ensure these were accurately recorded. A new system was introduced during the assessment to ensure suitable checks were carried out in future. Medicines incidents or errors were reported and investigated. Staff were trained in safe medicines handling, but there was no formal system for recording that their competencies were checked to make sure they gave medicines safely. A new system for this was introduced during the assessment to be used going forward.