Coniston House Care Home

Updated 26 March 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of COVID-19, we are conducting reviews to ensure that the IPC practice is safe and that services are compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 17 February 2022 and was unannounced.

Updated 26 March 2022

We inspected Coniston house on the 6 and 7 March 2018. We returned to the home on 8 March 2018 to provide feedback to the available staff and management at the home. As the home had significantly improved we invited staff at the service to hear the feedback and found a number of them showed interest in the findings from the inspection. The first day of the inspection was unannounced which means the home did not know we were coming to the home to inspect on that day.

The home has been in special measures since early 2016. Since that time there has been a new registered manager, new area manager and a number of new staff to the home. At the last inspection in July 2017 we found six breaches to the regulations. We were particularly concerned around how the home supported people who were falling and found appropriate timely action was not always taken to support these people. We issued a notice to ensure no further people were admitted to the home until the falls management at the home had improved.

Following the last inspection, we met with the provider to confirm an action plan to show what they would do and by when, to improve provision and meet the requirements of the regulations. The action plan showed us how the home intended to improve the ratings to the key questions of safe, effective, responsive and well led to at least good.

At this inspection we found the home had addressed the action plan. Enough improvement work had been completed by the home’s management team and staff, to show they had met all the previous identified breaches and were now safely managing falls. We found the home was now supporting people effectively to reduce the risks of further falls. This gave us confidence to allow the home to admit further people to the home in line with a developed readmissions plan.

Coniston house is a purpose built care home over two floors. Each floor has its own lounge and dining area. The lower floor houses the main kitchen and laundry facilities and the upper floor now has its own newly built satellite kitchen. This has greatly improved facilities to the top floor including access to drinks and snacks.

The home supports up to 43 people and at the time of the inspection there were 30 people living in the home. The low number was primarily due to the previous restriction on admissions. The home provides residential care and specifically focuses on providing residential support to people living with dementia.

Coniston house is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Coniston house does not provide nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Coniston house is required to have a registered manager. 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.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

At the last inspection in July 2017 we found the home was in breach of Regulation 12 in relation to how the home managed and supported people with falls. We also found them in breach of regulation 18 in that there were not enough suitably trained staff to meet people’s needs. We found these two breaches to have a high impact on the safety of people in the home and issued a notice to ensure no further people were admitted to the home. At this inspection we found the home had worked to greatly improve falls management and staff had increased to ensure people’s needs were suitably met. We have lifted the restriction on admissions and the home can now safely assess and support further people as deemed appropriate by the home.

At the last inspection we found the home in breach of Regulation 9. We found people’s assessments did not include all the required information to sufficiently meet people’s needs. At this inspection it was noted that all assessments were person centred and up to date. People’s needs were now being met.

At the last inspection we found the home in breach of Regulation 11. We found that consent was not always acquired from people about the care and support they received. We also found people had sometimes given consent on behalf of people when they did not have the authority to do so. At this inspection we found the home had made big improvements in this area. We found everyone had an up to date capacity assessment and consent was acquired from appropriate people, where people were found to lack capacity to give consent themselves.

At the last inspection we also found the home in breach of regulation 13 safeguarding and Regulation 17 good governance. Again we found the home had worked to improve the management of safeguarding situations and that monitoring and improvement planning had much improved.

We found the home was no longer in breach of any of the Health and social Care Act (Regulated Activities) Regulations at this inspection.

We have issued two recommendations following this inspection. One ensuring end of life care was more detailed and the other ensuring staff updating the care plans used all the available information.

At this inspection we found there was a staff team who well trained and motivated to meet people’s needs. Staff had taken on dedicated roles in the improvements at the home and there were staff champions for key support areas. This included champions in areas of care and support in nutrition, dignity, medicines, infection control and safeguarding. This had led to improvements in all of these areas. We also noted most staff was working towards an NVQ with three staff working towards level 5.

People living in the home and visitors all told us how much the home had improved. The environment continued to be developed with focus on supporting and orientating those people living with dementia. We found staff were friendly and clearly knew and respected the people they were supporting. The home’s domestic, catering and maintenance staff all took pride in what they offer to the role and the people in the home. We found activities in the home had improved greatly with focused activities taking place for groups of people and individually for those people who preferred this.

The home received two complaints in the eight months between inspections, they were managed appropriately and information on improvements was shared. We saw from resident and relatives meeting minutes and questionnaires that they were involved with the improvements at the home.

The home completed appropriate monitoring and audits of the service provided and took appropriate action when concerns were identified. The home was taking part in a number of local initiatives to improve outcomes for people in the home including triaged referral services and direct links to telecare and the falls team. We saw this all improved the quality of the service people received living in the home.

The overall rating for this service is Good and the provider has been taken out of special measures.