CQC report explained · a nursing home
What the CQC found at Colonia Court Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that people were protected from avoidable harm. Risks were assessed, staff knew how to safeguard people, medicines were managed safely and there were enough staff with the right skills.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its rating was carried over from the last inspection when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its rating was carried over from the last inspection when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its rating was carried over from the last inspection when calculating the overall rating.
- Well-led?
- Good
- Inspectors found clear leadership, effective audits and action plans, and staff who understood their roles. Relatives knew who to speak to if they had concerns.
What inspectors found, March 2023
Rated Good; inspectors found safe, caring and well-managed care, with some cleaning issues needing attention.
This was an unannounced focused inspection on 20 and 23 February 2023. Inspectors spoke with people, relatives and staff, observed care, and checked care and management records. They also checked infection prevention and control.
The home was rated Good for Safe and Well-led. Inspectors found enough suitably skilled staff, safe medicines systems, appropriate risk assessments and good safeguarding arrangements. They also found that the manager investigated incidents and complaints and used them to improve care.
People and relatives spoke positively about the home. Staff were described as kind, respectful and committed. The home was working to improve its buildings, but some toilet brushes and holders were soiled and stained, and some bathrooms were unhygienic. The manager acted on these issues during or after the inspection.
The previous overall rating was Requires Improvement, with breaches of regulations. Inspectors found that improvements had been made and that the home was no longer in breach. Because this was a focused inspection, the overall Good rating also used previous ratings for the other areas not inspected.
Kind and respectful staff
People and relatives spoke very positively about staff. Inspectors saw warm, considerate interactions and staff who understood people's needs and preferences.
“Staff were highly thought of and were said to be 'the best thing' about this service.” from the report
Safe staffing
Inspectors found enough staff with the right skills and competencies to meet people's needs. Recruitment checks were completed before new staff started.
“At the time of our visits staff were suitably deployed and there were enough staff with the right competencies and skills to meet people's needs and spend time with them.” from the report
Good risk management
Care risks such as falls, moving and handling, nutrition and skin damage were assessed. Staff had guidance on how to reduce these risks.
“People were protected from risks associated with their care needs.” from the report
Safe medicines
People received medicines as prescribed. Staff were trained, their competence was checked, and medicines were given calmly and with explanations.
“Staff administered medicines in a safe, calm and person-centred manner giving clear explanation to the person about what they were for, and time to take their medicine.” from the report
Improved leadership
The home had effective audits, action plans and systems for learning from incidents. Inspectors found that previous management weaknesses had been addressed.
“Governance arrangements were embedded and effective.” from the report
Soiled toilet equipment
needs fixingOn some units, toilet brushes and holders were soiled and stained, creating a risk of cross infection. The manager bought replacements after inspectors raised this.
“We found on some units toilet brushes and holders were soiled and stained and a source of cross infection.” from the report
Unhygienic bathrooms awaiting refurbishment
needs fixingBathrooms and toilets on Amber unit were unhygienic and difficult to keep clean, although they were not being used at the time. The home said refurbishment would address them by the end of March 2023.
“The bathrooms and toilets on this unit, although not in use at the time, were unhygienic and difficult to keep clean in their current state.” from the report
Manager not known to all relatives
minorSome relatives did not know who the registered manager was. However, they had positive views of the unit managers and knew who to contact with concerns.
“Some relatives did not know who the registered manager was, but the feeling for those seen to be in management positions (for each unit) was very positive.” from the report
- 01Have the bathrooms and toilets on Amber unit now been refurbished, and how are they being kept clean?
- 02What checks are now in place to make sure toilet brushes and holders do not become soiled or stained again?
- 03Who is the registered manager, and who should relatives contact if they have a concern?
- 04What were the ratings for Effective, Caring and Responsive at the previous comprehensive inspection?
- 05How will you tell families about any incidents, complaints or changes to their relative's care?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other key question ratings were carried over from the last inspection. This explanation was written from the published report of 16 March 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, June 2022
Colonia Court Care Home was rated Requires Improvement; inspectors found gaps in risk management, staffing oversight and quality checks.
This was an unannounced focused inspection on 5 April 2022. Inspectors looked only at Safe and Well-led. They spoke with people, relatives, staff and visiting healthcare professionals, observed care and checked care, medicines, staffing and management records.
The home was not always managing safety well. Some risk assessments were out of date, incidents were not always recorded clearly, and staffing was not always arranged so people could receive personal care while staff remained available to support others. Inspectors found no evidence that people had been harmed.
There were also positive findings. Staff generally knew people well, relatives spoke positively about the care, medicines were given as prescribed, infection control was satisfactory and people were protected from abuse. However, the overall rating fell from Good to Requires Improvement because the inspection found breaches relating to safe care and treatment and good governance.
Medicines
People received their medicines as prescribed. Staff were trained and assessed as competent before administering medicines.
“People received their medicines as prescribed. Staff had completed medicines training and the provider had assessed their competency to ensure they understood how to support people safely.” from the report
Protection from abuse
Safeguarding processes were in place. Staff knew how to raise concerns, and relatives said people felt safe living in the home.
“People's relatives told us they felt people were safe living in the service.” from the report
Positive relationships
Relatives described the management as approachable and said they were involved and kept informed. Staff said they felt supported and encouraged to develop.
“Relatives told us they felt involved in the service and able to raise any concerns.” from the report
Working with healthcare professionals
The home worked with other healthcare organisations and held meetings with professionals involved in people's care.
“The provider worked positively alongside a range of different healthcare professionals in order to support people's needs.” from the report
Out-of-date risk information
seriousRisk assessments did not always reflect changes in people's needs or advice from healthcare professionals. Important guidance could therefore be missed by staff.
“People's risk assessments had not always been updated to reflect changes to their support needs or recommendations from health care professionals involved in their care.” from the report
Staff availability
seriousThere were not always enough staff in one area to provide personal care while also supporting people who needed supervision when walking.
“We observed only two staff present during the afternoon, dropping down to one member of staff at one point.” from the report
Incident recording
seriousRecords did not always show clearly what had happened or what action had been taken to reduce the chance of the problem happening again.
“It was not always clear from the records viewed whether all incidents were accurately documented and this meant we could not be assured the manager had analysed or reviewed these to minimise the risk of a reoccurrence.” from the report
Weak quality checks
seriousThe provider's monitoring systems did not identify the problems inspectors found with risks, incidents and staffing.
“The provider did not have robust processes in place to monitor the safety and quality of the service.” from the report
- 01How have you updated residents' risk assessments when their needs or healthcare advice changes?
- 02How do you now make sure enough staff are available in each area, especially when people need two staff for personal care?
- 03How are incidents recorded, reviewed and followed up to reduce the chance of them happening again?
- 04What changes have you made to the checks used by managers to monitor safety, staffing and care quality?
- 05What progress has been made with the planned refurbishment and environmental adaptations?
This was an unannounced focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 1 June 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Colonia Court Care Home
4 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2022Requires improvementSafe: Requires improvementWell-led: Requires improvement
- September 2020Inspected but not ratedSafe: Inspected but not rated
- January 2018Goodup from Requires improvementSafe: Requires improvementWell-led: Good
- December 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 16 November 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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