CQC report explained · a nursing home
What the CQC found at Cosham Court Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found inconsistent infection control, poorly maintained areas, unclear risk information and problems with topical medicines on the first day. Staffing, recruitment, safeguarding and most medicines processes were satisfactory.
- Effective?
- Good
- This question was not inspected during this focused visit. The rating was carried over from the previous inspection.
- Caring?
- Good
- This question was not inspected during this focused visit. The report records that people and relatives described staff as kind and responsive, but no current rating was given.
- Responsive?
- Good
- This question was not inspected during this focused visit. The report records mixed views about communication and mental stimulation, with activities restarting after COVID-19 restrictions eased.
- Well-led?
- Requires improvement
- Quality monitoring systems did not consistently identify or fix problems in care records, infection control, the environment and topical medicines. Staff understood their roles and the provider said it would make changes.
What inspectors found, April 2022
Requires Improvement; inspectors found risks in infection control, care records and quality checks, although staffing and most medicines management were safe.
This was an unannounced focused inspection on 16 and 29 March 2022. Inspectors looked mainly at Safe and Well-led because concerns had been raised about staffing, nursing and personal care, and management. They visited the home, spoke with people, relatives, staff and professionals, and checked the building, medicines, records and infection control.
The home was not always safe. Some areas were poorly maintained and infection control guidance was not followed consistently. Care plans and risk assessments contained unclear or conflicting information, including about mobility and repositioning. On the first day, inspectors could not be sure topical creams were being applied correctly, but this was addressed by the second day.
The home was not always well-led. Audits had failed to identify several problems with care records, infection control and the environment. Inspectors found breaches of Regulations 12 and 17. The overall rating changed from Good in 2019 to Requires Improvement.
Enough staff
Inspectors found enough suitably skilled staff to meet people's needs. People said staff responded when they needed help.
“There were sufficient numbers of skilled staff deployed to keep people safe.” from the report
Safe recruitment and training
Recruitment checks were in place, including checks of references and employment gaps. Staff had training and medicines competence checks.
“There were safe and effective recruitment procedures in place to help ensure only suitable staff were employed.” from the report
Safeguarding
Staff knew how to recognise and report abuse. Safeguarding concerns were reported appropriately.
“Staff understood their safeguarding responsibilities and knew how to report any concerns.” from the report
Kind and responsive staff
People and relatives gave positive feedback about staff's kindness, care and responsiveness. People said they could make choices about their daily routines.
“People and relatives were also complimentary about many aspects of the service and describe staff as kind and responsive.” from the report
Working with professionals
The home worked with health and social care professionals to support joined-up care.
“The service worked in collaboration with all relevant agencies, including health and social care professionals.” from the report
Infection control
seriousSome areas could not be cleaned effectively. Waste disposal was not always suitable and some staff wore masks incorrectly, creating an infection risk.
“The failure to ensure infection and prevention control measures were effectively managed was a breach of Regulation 12 (Safe care and treatment) (Regulated Activities) Regulations 2014.” from the report
Unclear care and risk records
seriousSome records gave conflicting information about mobility and repositioning. This meant staff might support people in the wrong way or fail to manage risks such as skin damage.
“This conflicting information placed the person at risk of harm of injury from being supported to mobilise incorrectly.” from the report
Weak quality checks
seriousAudits did not reliably find problems that inspectors identified. The provider's systems were not robust enough to ensure people received safe care.
“We found no evidence that people had been harmed however, quality monitoring systems were either not in place or robust enough to ensure people received a safe service.” from the report
Topical medicines
needs fixingOn the first inspection day, instructions for creams and other topical medicines were unclear, and some containers were not dated. The home removed the affected creams and introduced new systems by the second day.
“On day one of the inspection we could not be assured people's prescribed topical medicines, such as creams, lotions or ointments were consistently applied as required.” from the report
Communication and activities
minorRelatives had mixed views about communication and opportunities to speak with their loved ones. Some people and a professional also raised concerns about boredom and mental stimulation.
“Two people told us, they were bored at Cosham Court Nursing Home and a relative said, "The physical care is amazing, but mental stimulation is not so good.” from the report
- 01What has been changed to make sure staff follow mask-wearing, waste disposal and cleaning procedures every time?
- 02How are care plans and risk assessments now checked for conflicting information about mobility and repositioning?
- 03How will you show that people are being repositioned as often as their care plan says?
- 04How are topical creams labelled, recorded and checked since the inspection?
- 05What has improved in communication with relatives and in activities for people who may become bored?
This was a 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 29 April 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.
What inspectors found, April 2019
Cosham Court Nursing Home was rated Good; inspectors found safe, kind and personalised care with effective management.
This was an unannounced inspection on 14 March 2019. Inspectors spoke with people living in the home, visitors and staff. They observed care and checked care records, medicines records, staff files, complaints, accidents and quality checks.
The home received a Good rating in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they were happy with their care. Inspectors saw kind interactions and found that staff understood people's needs.
Inspectors found safe staffing, suitable recruitment checks, safe medicines systems and clean surroundings. Care plans were personalised and reviewed at least monthly. People had choices about their care, meals and activities, and could access healthcare when needed.
The home had also been rated Good at the previous inspection, published in September 2016. CQC said it would continue to monitor information about the home until its next inspection.
Kind and respectful care
People described staff positively, and inspectors observed compassionate interactions. Staff offered choices and protected people's privacy and dignity.
“People were treated with care and compassion by staff who knew them well.” from the report
Safe staffing and support
Inspectors found enough staff to meet people's needs. Call bells were answered promptly and recruitment checks were in place.
“Call bells were answered without delay and people told us they did not have to wait for assistance.” from the report
Personalised care
Care plans recorded people's preferences, interests and histories. People were involved in reviews and care plans reflected their current needs.
“People had person centred care plans which reflected their needs, preferences, likes and dislikes.” from the report
Good management and oversight
The home had visible leadership, good teamwork and regular checks covering areas such as medicines, care plans and safety.
“Quality monitoring systems and processes were in place and up to date.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you meet my relative's specific nursing and dementia care needs?
- 02How often would my relative's care plan be reviewed, and how would the family be involved?
- 03How do you make sure medicines are given and recorded correctly?
- 04What activities and one-to-one support would be available for someone who prefers to stay in their room?
- 05Has the planned move to electronic medicines records happened, and what improvement has it made?
This was an unannounced inspection covering all five CQC areas and both the care provided and the care home premises. This explanation was written from the published report of 10 April 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 Cosham Court Nursing Home
3 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- April 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2019Goodstayed GoodSafe: GoodWell-led: Good
- September 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 30 December 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
47 live-in carers within about an hour of Portsmouth
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,240 a week. 38 can care for a couple. 10 years' experience on average.
“I cannot recommend Prisca highly enough, she is one in a million.”
“He stayed with her throughout the pandemic, refusing to visit his own family, who lived nearby, to reduce the risk of infection.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.