CQC report explained · a nursing home
What the CQC found at Cooksditch House Nursing & Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People said they felt safe, and staff understood how to recognise and report abuse. Inspectors were assured that infection prevention and control measures were in place.
- Effective?
- Good
- Does the care work? Training, consent, food and drink, working with GPs and nurses.
- Caring?
- Good
- Are people treated with kindness and dignity?
- Responsive?
- Good
- The home had a complaints procedure. Four complaints recorded that year had been dealt with appropriately and in a timely way, with lessons used to improve care.
- Well-led?
- Good
- Inspectors found regular training, supervision, team meetings, surveys, audits and quality checks. The management culture was described as positive and open to learning.
What inspectors found, December 2020
Targeted inspection, not a new rating; the previous Good rating remained, with safeguarding and complaints handled well.
This was an unannounced, targeted inspection on 9 December 2020. Inspectors checked safeguarding, complaints and quality monitoring. They also looked at infection prevention and control.
People and relatives said they felt safe and knew how to raise concerns. Inspectors found safeguarding procedures, complaint handling and records were in place. Complaints had been investigated and used to make improvements.
Inspectors were assured that the home was managing COVID-19 infection risks, including visiting, testing, PPE, cleaning and social distancing. They also found regular staff training, supervision, meetings and quality checks.
This visit did not give new ratings for the questions checked. The previous overall rating was Good, published on 25 November 2019, and the report says it remained Good.
Safeguarding
Staff had safeguarding training and knew how to report concerns. People and relatives said they felt safe.
“Processes and procedures were in place to protect people from abuse, neglect, discrimination and harassment.” from the report
Infection control
Inspectors were assured that the home was using infection control measures, including PPE, testing, social distancing and a screened visiting room.
“We were assured that the provider was using PPE effectively and safely.” from the report
Complaints handled well
Complaints were investigated, recorded and answered in a timely way. The home used complaints to make changes.
“There had been four complaints recorded this year which had all been dealt with appropriately and in a timely manner.” from the report
Learning and improvement
Staff received training and supervision. Audits and team meetings were used to identify shortfalls and improve care.
“Quality checks and audits continued to be effective in identifying shortfalls and making improvements to the quality of the service.” from the report
Further infection control development
minorInspectors signposted the provider to resources to develop its infection prevention and control approach. The report does not say exactly what needed improving.
“We have also signposted the provider to resources to develop their approach.” from the report
Some feedback identified room for improvement
minorMost survey respondents said the manager was honest when things went wrong, but a small proportion saw this as an area for improvement.
“9% responded this was an area for improvement.” from the report
- 01What infection control resources did the CQC signpost you to, and what changes have you made since the inspection?
- 02How do you make sure lessons from complaints are shared with staff and followed up?
- 03How can residents and relatives raise a safeguarding concern if they do not feel able to speak to the manager?
- 04What did the survey feedback about honesty when things went wrong lead you to change?
- 05What parts of care were not reviewed during this targeted inspection?
This was a targeted inspection of safeguarding, complaints, quality assurance and infection control; it did not review the full key questions, so the previous Good ratings carried over. This explanation was written from the published report of 30 December 2020 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, November 2019
Cooksditch House Nursing & Residential Home was rated Good; inspectors found kind, safe care and clear improvements since the previous inspection.
This was an unannounced, planned inspection. Inspectors spoke with people using the home, relatives, staff and health professionals. They observed care and lunch, and checked care, medicines, staff and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found improvements in medicines management, staffing, activities, care records and quality checks.
The previous inspection rated the home Requires Improvement and found several breaches of regulation. At this inspection, inspectors said enough improvement had been made and the home was no longer in breach of those regulations.
Safer medicines
Checks and audits had led to significant improvements in medicines management. Staff were trained and their competence was assessed.
“An increase in the frequency of checks and audits had resulted in significant improvements in the way medicines were managed.” from the report
Staff available
Staffing levels had been increased and reviewed against people's needs. People said they did not wait long for help.
“People did not have to wait long to receive staff support as staffing levels had been adjusted to meet their needs.” from the report
Kind relationships
Staff knew people well and treated them with kindness, dignity and respect. They also encouraged people to remain as independent as possible.
“Staff took time to get to know people and had developed positive relationships.” from the report
Activities and personal interests
A new activity programme was based on what people enjoyed. People took part in trips, creative activities and links with the local community.
“Since the last inspection, the provider had implemented a creative activity programme which met people's social needs and interests.” from the report
Stronger oversight
Management checks and audits were more effective at finding and addressing shortfalls. Care records and daily communication had also improved.
“Quality checks and audits had been strengthened and were effective in identifying areas where improvements would benefit people.” from the report
One bedroom needed cleaning
minorThe service was clean apart from one bedroom during the inspection. A deep clean had started and the provider said it was completed the following day.
“During the inspection the service was clean and odourless with the exception of one bedroom.” from the report
Feedback was not fully collated
minorPeople's and relatives' survey responses were positive, but the responses had not yet all been brought together when inspectors visited.
“People's responses were positive but had not yet been fully collated.” from the report
- 01How are medicines checked now, and how do you make sure staff complete all medication records?
- 02How do you decide whether staffing levels are enough for people's changing needs?
- 03What activities are currently available for people who cannot take part in group activities?
- 04How do you check that care records remain accurate and reflect people's current needs?
- 05What action was taken after the survey feedback was fully collated?
This was an unannounced, planned inspection covering the overall service and all five key questions, including care, premises, records and management systems. This explanation was written from the published report of 26 November 2019 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 Cooksditch House Nursing & Residential Home
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- December 2020Inspected but not ratedcurrent ratingSafe: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
Read what inspectors found at Cooksditch House Nursing & Residential Home →
- November 2019Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Cooksditch House Nursing & Residential Home →
- November 2018Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2017
Registered with the Care Quality Commission on 11 October 2017.
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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