Collingwood Court is a large residential care home in North Shields. The service provides accommodation, care and support for up to 63 older people, most of whom have physical and/or mental health related conditions. They do not provide nursing care. At the time of the inspection, 59 people were using the service. 56 people lived at the service permanently and three people were staying on a short term basis for respite.We last inspected the service in December 2016, at which time we found the provider continued to breach one of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, related to safe care and treatment from their previous inspection in March 2016. Subsequently, the provider sent us an action plan setting out the improvements they had made to immediately rectify the issue. This inspection took place on 20 June 2017 and was unannounced.
The service had a registered manager in post. This was the same registered manager who was present at the last inspections. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
At the last inspection in December 2016 we identified that the procedure around the disposal of unwanted medicines which had been removed from its packaging was both unsafe and untraceable. The staff we spoke with confirmed this was their working practice. We spoke to the registered manager about this issue and it was immediately addressed. By the end of that inspection, safe working practices had been implemented. At this inspection, we checked that these had been sustained and found that they were.
At this inspection, people told us they felt safe at Collingwood Court and relatives confirmed this. Staff were able to describe their responsibilities with regards to safeguarding vulnerable people from abuse and they had attended an awareness course.
We found staffing levels to be appropriate and people told us they were responded to promptly. Safe recruitment procedures were followed and pre-employment vetting checks continued to be carried out.
Company policies, procedures and reporting systems were used effectively to enable staff to provide safe and good quality care. Improvements to record keeping, noted at our last inspection, had been sustained. Care plans were thorough, personalised and up to date. Regular reviews and updates took place following changes to people’s needs.
Accidents and incidents were recorded and reviewed without delay to enable the registered manager to monitor people’s well-being and make referrals to external health and social care professionals as required. People had good access to specialists for on-going monitoring of their needs.
Emergency plans were up to date and the safety and maintenance of the premises continued to be monitored. The home was attractively decorated and was clean and tidy. There were elements of a ‘dementia friendly’ environment incorporated into the design of the home.
CQC is required by law to monitor the operations of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. MCA is a law that protects and supports people who do not have the ability to make their own decisions and to ensure decisions are made in their ‘best interests’. It also ensures unlawful restrictions are not placed on people in care homes and hospitals. In England, the local authority authorises applications to deprive people of their liberty. We found the provider was complying with their legal requirements.
People were supported to maintain a healthy and well-balanced diet. Catering and care staff followed best practice guidance and they were knowledgeable about people’s special dietary needs.
A corporate induction process was in place for all new employees and any staff new to the care industry also completed a robust induction process which measured their competency. All staff were regularly supported by senior staff and the registered manager through staff meetings, supervision and appraisal sessions.
Staff displayed kind and compassionate attitudes and treated people with respect. We saw staff gave people choices and their dignity and privacy was protected.
The registered manager had not yet filled a vacancy for a second activities coordinator which meant people may not always have access to activities which met their individual preferences. The current programme of activities included meaningful and stimulating activities which were mostly offered on a group basis, although some one-to-one support was given by the activities coordinator and care staff. The service continued to welcome families, friends and visitors into the home and supported people to maintain links with the community.
The registered manager held meetings with staff, residents and relatives to gather their feedback of the service. People and relatives told us they knew how to complain and would feel confident to do so. Complaints records showed the registered manager followed company procedures to record, investigate and respond to all complaints or concerns as necessary.
The registered manager maintained records which showed the quality and safety of the service was robustly monitored through daily, weekly and monthly audits.