We carried out a review of the data available to us about Cooksons Court on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Cooksons Court, you can give feedback on this service.
At the last inspection of the service in February 2017 we found that improvements were needed.
We found people were at risk of receiving unsafe and ineffective care and treatment because care records relating to the management of risk were incomplete and not reflective of people’s needs.
We also found that systems in place to monitor and improve the service people received were not always effective in addressing shortfalls or sustaining improvements.
Following the last inspection, we asked the provider to complete an action plan to show what they would do, and by when, to improve the key questions safe, effective and well led to at least good. At this inspection we found improvements had been made in all areas identified as requiring improvement.
Cooksons Court 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.
Accommodation for people was provided in three separate units. Bramley provides care and accommodation to people who have basic nursing care needs. Russet accommodates people who have more complex nursing needs. Pippin is a specialist unit, run in partnership with the local NHS trust, to provide people with re-enablement support to facilitate hospital discharge and enable people to regain independence to return home.
Cooksons Court accommodates up to 65 in a purpose built home. At the time of the inspection there were 57 people living at the home. This included 18 people staying for re-enablement following discharge from hospital before returning to their own homes.
There is a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The management team and the provider had worked hard to ensure shortfalls in the service were identified and addressed through their quality monitoring systems. Action plans were put in place which were monitored to make sure changes made led to sustained improvements in the care people received.
People we spoke with praised the standard of care they received and said they would recommend the home. One person said, “Very nice. Couldn’t wish for better. Excellent in fact.” Another person commented, “I feel very lucky to be here and I’m very fussy.”
People felt safe at the home and comfortable with the staff who supported them. One person said they felt, “Safe and content.” Staff we spoke with were confident that any concerns raised would be dealt with promptly to make sure people were protected from the risks of abuse.
People were supported by staff who were kind and friendly. Staff received appropriate training to make sure they were able to care for people with varying needs and abilities. There were sufficient numbers of staff to effectively support people and ensure their safety.
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. Staff worked in accordance with up to date guidance to make sure people’s legal rights were protected.
Assessments of people’s care needs took account of their individual beliefs, culture and lifestyle choices. People were able to make decisions about their day to day care and their views were sought regarding the running of the home.
People’s healthcare needs were monitored by trained nurses and they had access to more specialist healthcare support to meet their specific needs. The staff worked in partnership with other professionals to promote people’s well-being and help them to achieve their goals.
People’s nutritional needs were assessed and met. People received meals in accordance with their dietary needs and preferences. People were positive about the food served at the home and told us there was always a choice of meals.
People were treated with respect and dignity. When people needed support with personal care this was provided in private and respectfully. One person told us, “They help me to get washed and dressed. They are very gentle and extremely respectful.”
There were opportunities for people to take part in a range of activities according to their interests and hobbies. One person told us how much they enjoyed the activities. They said, “There have been visits from llamas, donkeys and children. There’s lots of entertainment… Elvis is coming.”
This was the first inspection of the service since it was registered with the Care Quality Commission in September 2015.
Cooksons Court is a purpose built home which can accommodate a maximum of 65 people. Accommodation is arranged over three floors and divided into three units. Bramley unit is situated on the ground floor and provides nursing care for up to 23 people with basic nursing needs. Russet unit is situated on the first floor and provides nursing care to up to 24 people who have more complex needs. The Pippen unit on the second floor has 18 beds and provides a reablement service for people who are moving from hospital back to their own homes. Bedrooms are for single occupancy and all have the provision of en-suite toilet and shower facilities. There are pleasant accessible gardens and parking.
At the time of this inspection there was no registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
In the absence of a registered manager the service was being managed by one of the provider’s experienced peripatetic nurse managers. They had over 20 years experience as a registered nurse, and prior to joining the peripatetic team at Cooksons Court had been the Registered Manager of one of the provider’s other nursing homes for over 10 years. This person had a handover from the previous registered manager and took over immediately they left.. They were supported by a deputy manager and clinical manager. One of the provider’s operations managers regularly visited and monitored the quality of the service provided. A new manager had been appointed and is due to start at the home. They will make an application to the Care Quality Commission to be registered manager.
People who had been assessed as being at high risk of malnutrition and of developing pressure sores and those who were being treated for a pressure sore were not fully protected from receiving unsafe or inappropriate care. This was because care records did not demonstrate people received the care and treatment as detailed in their plan of care.
There were systems in place to monitor and improve the quality of the service provided. However these were not always effective in identifying and improving shortfalls.
People felt safe at the home and praised the staff who supported them. One person said “I am very content with everything. The staff and the other residents all seem very nice.” Another person told us “Couldn’t feel safer.”
People were satisfied with the choice and quality of food provided and people received meals in accordance with their needs and preferences. However the mealtime experience and arrangements for serving soft diets for people who lived on the Russet unit needed some improvements.
People had access to appropriate healthcare professionals to make sure they received effective treatment when required. One person who lived at the home told us “The staff notice if you are a little off colour and they will always call the doctor if needed.” People received their medicines when they needed them and medicines were stored securely. A person who lived at the home said “They [the staff] make sure I get my tablets when I need them. They regularly ask me if I need any painkillers. They want to make sure you are comfortable.”
People were supported to be as independent as they could be. One person on the reablement unit (Pippin) said “They [the staff] have helped me get my life back. I can do things that I never thought I’d be able to do when I left hospital. They’ve got me back to normal and I will be going back home soon.” Another person told us “The staff are absolutely wonderful. Their hard work means I am now back on my feet and able to do more and more for myself.”
Risks of abuse to people were minimised because there were effective recruitment processes for all new staff. Staff had been trained and had a good understanding of how to recognise and report any signs of abuse.
People were cared for by staff who were well trained and competent in their role. There were effective systems in place to monitor the skills of staff. One member of staff said “I feel I have had all the training I need. If ever you don’t feel confident about something, they will arrange more training.”
Care plans were in place to ensure people’s wishes and preferences during their final days and following death were respected.
Staff had received training about the principles of the Mental Capacity Act 2005 and they knew how to make sure people’s legal and human rights were protected. People were asked for their consent before staff assisted them with a task. One person said “I do what I please. They [the staff] would never make any of us do something we didn’t want to do. They are treasures.”
People were provided with opportunities for social stimulation and they were supported to maintain contact with their friends and family. People told us they could see their visitors whenever they wished and that they were always made to feel welcome.
People and their visitors knew how to make a complaint. Everyone we spoke with said they felt confident any concerns would be addressed.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.