CQC report explained · a nursing home
What the CQC found at Cote House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Inspectors only looked at infection prevention and control, not the whole Safe question. They found protective equipment, weekly testing, cleaning arrangements and enough familiar staff 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
- Is care built around the person? Care plans, activities, complaints.
- Well-led?
- Good
- Is the home run well? The manager, the culture, how problems get found and fixed.
What inspectors found, November 2020
Overall rating remains Good; this targeted inspection was not rated and focused on infection control during a COVID-19 outbreak.
Inspectors visited the home without notice on 20, 22 and 23 October 2020. One inspector and one public health specialist looked at infection prevention and control, including the use of protective equipment, cleaning, testing and records.
The home had enough protective equipment and staff had been trained to use it. People and staff were tested weekly for COVID-19. The home was clean, high-contact areas were cleaned more often, and there were enough staff without using agency workers.
The home was closed to visitors during the outbreak. People were supported to keep in touch with relatives by telephone or electronic applications. This was a targeted inspection, so it did not reassess the whole service. The overall rating remained Good, while Safe was recorded as Inspected but not rated.
Protective equipment
The home had good supplies of protective equipment, with regular checks on stock and staff training on how to use it safely.
“The provider had made sure there were stocks of good quality PPE at the service.” from the report
Enough familiar staff
Inspectors found enough staff to support people, and no agency workers were being used.
“There was no agency staff being used, which meant people were supported by staff that knew them.” from the report
Clean environment
The home was clean, with cleaning schedules in place and extra cleaning of high-contact areas.
“People were living in an environment that was clean with no malodours noted.” from the report
Keeping families connected
Although visits were stopped during the outbreak, staff supported people to keep in touch with family and friends by telephone or electronic applications.
“People's wellbeing was being supported by contact with families and friends using electronic applications or telephone.” from the report
Inspectors raised no specific concerns in this report.
- 01What is the current visiting policy, and how would visits be managed if there were another infection outbreak?
- 02What infection prevention training do staff receive, and how is their use of protective equipment checked?
- 03How often are people and staff tested for infections, and what happens after a positive result?
- 04The previous Safe rating was Requires Improvement. What were the earlier concerns, and what action has been taken since then?
- 05How will people keep in contact with relatives if in-person visits are restricted?
This was a targeted inspection of infection prevention and control under Safe during a COVID-19 outbreak; it did not assess the whole Safe question or the other key questions, whose ratings were not changed. This explanation was written from the published report of 18 November 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, March 2019
Cote House rated Good overall, but Safe Requires Improvement because medicines checks and some safety records were not always reliable.
Inspectors visited without warning on 7 and 8 February 2019. They spoke with people living there, a relative, staff and healthcare professionals. They reviewed care plans, medicines records, accident records, audits and other documents.
People generally received kind, personalised care. Staff were trained, people were supported to make choices, and there were enough staff to spend time with people and support activities. The home was clean and people said they felt safe.
The main concerns were medicines stock records, medicines competency checks and conflicting information in some safety checks. The overall rating was Good, but Safe was rated Requires Improvement. The other four areas were rated Good.
Kind and respectful care
People said staff were kind and helpful. Inspectors observed caring and respectful interactions.
“People were happy with their care and told us they had good relationships with the staff.” from the report
Personalised support
Care plans contained detailed guidance about people's needs. People could choose their routines, activities and how they spent their time.
“People had their own care plans which were personalised and contained good detail on how to support them.” from the report
Improved staffing and training
Staffing had increased since the previous inspection. Staff had received appropriate training and said they felt supported.
“At this inspection we saw this improvement had been made. Staff had received appropriate training and had the skills required to meet people's needs.” from the report
Medicine stock and competency checks
seriousMedicine stock was not always counted and recorded. Not all nursing staff had been assessed by the provider as competent to administer medicines.
“Not all medicines had been counted and signed into the service.” from the report
Safety records were not always dependable
seriousSome checks did not show what action had been taken. Bed rail records contained conflicting information, and water temperature results had not always led to action.
“We saw that the checks did not always record what action had been taken when there was concern.” from the report
Basic daily notes
needs fixingSome daily records gave little detail about the care provided or people's emotional wellbeing. The manager had identified this and planned improvements.
“These at times were basic, containing basic information about the care delivered with no detail on emotional well-being.” from the report
Two safety incidents
seriousInspectors had concerns about two incidents where a person's safety was put at risk. The home said it had introduced further safety measures after discussion with inspectors.
“We had concerns about two incidents where a person's safety was put at risk.” from the report
- 01How are all staff who administer medicines assessed as competent, including staff who joined since the inspection?
- 02How do you count and record each person's medicine stock, and how quickly do you investigate any mismatch?
- 03What changes have been made to bed rail, water temperature and other safety checks since the inspection?
- 04What further safety measures were put in place after the two incidents mentioned in the report?
- 05How are daily notes now recording people's emotional wellbeing as well as the care provided?
This was an unannounced planned comprehensive inspection covering all five key questions, following the previous Requires Improvement rating. This explanation was written from the published report of 16 March 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 Cote House
3 rated inspections over 3 years: the service has held its Good rating throughout.
- November 2020Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- March 2019Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 20 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.
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