CQC report explained · a nursing home
What the CQC found at Cooksons Court
Rated Outstanding: inspectors found the home performing exceptionally well.
What inspectors found, July 2018
Cooksons Court was rated Good; inspectors found safe, kind and well-managed care, with some gaps in following care plans and providing activities.
This was an unannounced inspection on 19 and 20 June 2018. Inspectors spoke with 32 people living there, visitors and staff. They also observed care, meals and the premises, and checked care plans, medicines, complaints and management records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People generally said they felt safe, respected and well cared for. Staff were described as kind, trained and available when help was needed.
The inspection found clear improvements since February 2017. Earlier concerns included incomplete risk records, disorganised mealtimes and weak checks on service quality. The home had addressed these areas, although inspectors still found some care plans were not always followed and some people did not know about activities available to them.
Improved safety records
Records for repositioning and wound care were clearer and matched the care people needed. This addressed a major concern from the previous inspection.
“At this inspection we found the necessary improvements had been made.” from the report
Kind and respectful staff
People described staff as kind, friendly and respectful. Inspectors also saw people being supported with personal care privately and respectfully.
“They help me to get washed and dressed. They are very gentle and extremely respectful.” from the report
Good partnership working
Nurses and care staff worked with healthcare professionals to meet people's needs. The re-enablement service worked with NHS professionals to help people regain independence.
“Staff had built good relationships and worked in partnership with other professionals to ensure people received effective care and support to meet their needs.” from the report
Strong improvement systems
The provider used action plans, audits and feedback to identify problems and check that improvements lasted. This was a clear improvement since the previous inspection.
“This had ensured that action plans were put in place and monitored to show improvements were being made and sustained.” from the report
Some care plans were not followed
needs fixingInspectors found examples where staff did not provide support recorded in a person's plan, including clean glasses and a snack box. Staff corrected one issue during the inspection.
“Although care plans were detailed staff were not always following the plans of care.” from the report
Snacks were not always offered
needs fixingSnack boxes were available in communal areas, but inspectors did not see snacks being offered to people who were in bed or unable to help themselves.
“During the inspection we did not see snacks being offered to people who were unable to help themselves.” from the report
Uneven access to activities
minorMost people were positive about activities, but some people on the re-enablement unit did not know what was available and felt they had little to do.
“Another person said they were not aware of activities, they said, "I sit around too much with nothing to do".” from the report
Care plan involvement was unclear
needs fixingSome care records did not show how people receiving nursing care had been involved or what their views were.
“It was therefore difficult to see how much involvement people had had.” from the report
- 01How do you check that staff follow each person's care plan, including instructions about glasses, snacks and eating support?
- 02How are snacks offered to people who are cared for in bed or cannot help themselves?
- 03What activities are currently available for people in the re-enablement unit, and how are they told about them?
- 04How do you record the views and involvement of people receiving nursing care when their care plans are reviewed?
- 05What checks are now used to make sure the improvements made since the previous inspection continue?
This was an unannounced inspection of the overall service and all five CQC questions, including care, accommodation, records and management systems. This explanation was written from the published report of 7 July 2018 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, April 2017
Rated Requires Improvement; inspectors found kind, responsive care but unsafe record-keeping and weak quality checks.
This was an unannounced inspection on 7 and 8 February 2017. Inspectors spoke with 19 people and staff, and checked care records, medicines, recruitment, health and safety, and quality checks. This was the first inspection since the home registered in September 2015.
People generally said they felt safe and praised the staff. Inspectors found kind and respectful care, good support for independence, activities, visitors and complaints. Medicines were given safely, staff were trained, and people could access healthcare professionals.
However, records did not always show that people at risk of malnutrition or pressure sores received the care set out in their plans. Some people waited too long for help with meals, and quality checks did not always identify or fix these problems. The home was rated Requires Improvement overall, with Requires Improvement for Safe, Effective and Well-led, and Good for Caring and Responsive.
Kind and respectful staff
Inspectors saw staff treating people with warmth, patience and dignity. People were supported to make choices and staff respected their privacy.
“We observed all staff to be exceptionally kind and caring towards the people who lived at the home.” from the report
Support with independence
The reablement unit helped people regain skills after hospital and work towards returning home. Staff were expected to support people to do what they could for themselves.
“The focus is on getting you back on your feet and doing the things you used to do at home.” from the report
Safe medicines and safeguarding
Medicines were stored securely and given by staff whose competence had been checked. Staff understood how to recognise and report abuse.
“People's medicines were administered by registered nurses or senior care staff whose competency had been assessed on a regular basis” from the report
Activities and family contact
People could take part in group and one-to-one activities, or choose not to. Visitors were welcomed and people had different places to spend time with them.
“This showed a variety of activities and social events which included a coffee club, pat dog, bingo, crafts, music and films.” from the report
Incomplete records for higher-risk care
seriousRecords did not show that some people at high risk of malnutrition or pressure sores received planned food, fluids, wound care and repositioning. This could put people's safety at risk.
“People were at risk of receiving unsafe and ineffective care and treatment because care records relating to risks associated with the management of people assessed at high risk of malnutrition” from the report
Delays and poor presentation at some mealtimes
needs fixingOn the Russet unit, the lunch service was disorganised. One person waited 45 minutes for help, and a soft meal developed a skin while being kept hot.
“Some people had to wait long periods before they were assisted with their meal. One person waited forty five minutes before staff assisted them.” from the report
Quality checks did not prevent repeat problems
seriousAudits and monitoring were in place, but they did not always identify shortfalls or make sure improvements lasted. This included care records and mealtime arrangements.
“However these systems were not always effective in addressing identified shortfalls or sustaining any improvements made.” from the report
No registered manager at inspection
needs fixingThere was no registered manager in post during the inspection. An experienced nurse manager was running the home, and a new manager had been appointed.
“The home does not currently have a registered manager in post however the home was being managed by one of the provider's experienced peripatetic nurse managers.” from the report
- 01What changes have been made to record food, drink, wound care and repositioning for people at higher risk?
- 02How do you check that the care recorded is the care actually given, especially on the Russet unit?
- 03What has changed about mealtime staffing, waiting times and the serving of soft diets?
- 04Has the new manager started and applied to become the registered manager?
- 05How will you show that quality checks now identify problems and make sure improvements last?
This was an unannounced comprehensive inspection covering all five areas of the service, and it was the first inspection since registration in September 2015. This explanation was written from the published report of 20 April 2017 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 Cooksons Court
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- July 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2015
Registered with the Care Quality Commission on 28 September 2015.
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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