11 May 2023
During a routine inspection
Cressington Court Care Home is a residential care home providing personal care to 43 people, including people living with dementia and physical disabilities. The service can support up to 53 people. The service is a domestic style property and accommodation is over two floors.
People's experience of using this service and what we found
At this inspection we identified concerns with the management of risk, care planning, the management of medicines and governance.
Risk was not always effectively mitigated. Care plans reviewed were not updated following reviews by professionals and changes to peoples care needs. Advice and guidance from professionals had not always been acted upon or implemented and care plan reviews were inconsistent.
Medicines were not always managed safely. There was a high volume of medication errors being reported and a number of actions identified following quality audits. Covert medications were not being administered safely for a person and the covert care plan was not being followed.
The governance arrangements in place were not robust and records were not always adequately maintained. There were gaps in auditing, and some audits were not effective. The audits for the medicines and the environment had failed to identify the issues found during the inspection.
There were systems in place to determine safe staffing levels. People and their relatives told us staff were kind, caring and respectful. The majority of people we spoke with felt there were enough staff on duty to support people's needs. Mixed feedback was received regarding agency staff, the provider was open and transparent regarding the barriers they were facing with regards to
recruitment of staff.
People received support from a range of health and social care professionals including dieticians; social workers, community nurses, community mental health teams, speech and language therapy and their local GP.
The culture of the service was open and transparent. The acting manager and CEO engaged with the inspection positively and were committed to making any necessary improvements.
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 and update.
The last rating for this service was Requires improvement (published 10 October 2022).
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.
Why we inspected
This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the domains of 'safe’, effective, ‘caring’, 'responsive' and' well-led’.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cressington Care Home on our website at www.cqc.org.uk.
Enforcement and Recommendations
At this inspection we found breaches of regulations 12 and 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The breaches related to the failure to ensure people received safe care and treatment and a failure to ensure the service was always governed and managed adequately.
You can see what action we have asked the provider to take at the end of this full 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.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
The overall rating for the service has remained at requires improvement based on the findings of this inspection.