5 January 2023
During a routine inspection
Crowstone House is a residential care home providing personal care to up to 54 people. The service provides support to older people including people living with dementia. At the time of our inspection there were 45 people using the service.
People’s experience of using this service and what we found
The provider did not have robust systems in place to assess and monitor risks to people’s health and safety. Risks within people's living environment were not always identified or adequately managed in order to keep people safe from harm. The provider’s processes for monitoring the quality and safety of the service were not always effective in highlighting and addressing concerns.
The provider had not always ensured all relevant recruitment checks were completed for new staff. We have made a recommendation about the safe recruitment of staff. The provider had recently increased staffing levels in the service. However, we found the deployment of staff did not always fully meet people’s needs.
The provider had processes in place to manage people’s medicines. However, some guidance did not reflect how medicines were being administered.
Staff were aware of how to report safeguarding concerns and the provider had sent notifications and shared information with the relevant authorities when appropriate. People and relatives told us they knew who to speak to if they had any concerns or complaints.
The provider had safe infection prevention and control processes in place and visitors were welcomed into the service. Relatives were encouraged to give feedback and spoke positively about the approachability and availability of the management team. Staff had received an induction and relevant training and told us they felt valued and supported in their roles.
People were encouraged to maintain their independence and the provider worked alongside other healthcare professionals to support people’s health needs. People and relatives told us staff were generally kind and caring and were respectful of people’s privacy. 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
The last rating for this service was outstanding (published January 2018).
Why we inspected
The inspection was prompted in part due to concerns received about the number of people having falls in the service and the number of staff available to support people. The inspection was also prompted in part by notification of an incident following which a person using the service died. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk. This inspection examined those risks.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We have found evidence the provider needs to make improvements. Please see the safe, responsive and well-led sections of this full report. The overall rating for the service has changed from outstanding to requires improvement based on the findings of this inspection.
Enforcement and Recommendations
We have identified breaches in relation to the management of risks to people’s health and safety and the oversight of the service at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.