CQC report explained · a residential care home
What the CQC found at The Cottage Residential Care Home
Rated Inadequate: inspectors found the home performing badly and the CQC has taken enforcement action.
What inspectors found, December 2018
Rated Good and out of special measures; inspectors found major improvements, with a few remaining safety and record-keeping issues.
This was an unannounced comprehensive inspection. Inspectors visited the home on several dates, spoke with people, relatives and staff, observed care, and checked care, recruitment, training and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found safer medicines systems, enough staff, better training, detailed care plans, kind care and improved management oversight.
The home had previously been rated Inadequate and placed in special measures after eight breaches were found at the previous comprehensive inspection. Inspectors found significant progress, so the home was no longer in special measures.
Some issues still needed attention. These included a missing bed rail risk assessment, worn feet on a walking frame, cleaning and maintenance problems, some records that needed updating, and incomplete recording of vacant staff hours.
Safer medicines
Medicines were stored, given and recorded safely. Staff had training and competency checks, including for emergency seizure medicine.
“Medicines were now managed safely and people received their medicines as prescribed.” from the report
Kind and respectful care
Staff knew people well, supported their choices and promoted privacy, dignity and independence.
“Staff had developed positive relationships with people and there was a friendly, relaxed atmosphere within the service.” from the report
Personalised support
Care plans included people's views and wishes. Activities and trips into the community had improved.
“People had detailed support plans in place which covered a range of subjects and included their views and wishes.” from the report
Improved oversight
The management team had introduced audits, clearer responsibilities and action plans to monitor quality and safety.
“Audits were completed in areas including the environment and care plans.” from the report
Bed rail risk
seriousOne person's use of bed rails had not been risk assessed and there was a possible entrapment risk. The manager acted immediately after the inspection, completing an assessment and addressing the risk.
“However, there was no risk assessment for one person with bed rails and there were gaps between the bedrail and the mattress.” from the report
Walking frame safety
seriousThe rubber feet on one walking frame were worn and could have caused slipping. The deputy manager said this would be addressed and future checks would be carried out.
“However, where one person used a walking frame to support them with their mobility, the rubber feet [ferrules] on the frame were worn which placed the person at risk of slipping as the ferrules had no grip.” from the report
Cleaning and maintenance
needs fixingOne bedroom smelled of urine, two carpets needed cleaning and bathroom sealant needed repair. The home later confirmed that new carpets had been ordered and the maintenance work completed.
“However, one bedroom smelt of urine and two carpets required cleaning and the toilet and bathroom required some maintenance where the sealant had come away from the bath.” from the report
End of life records
needs fixingPeople's basic end of life preferences were recorded, but their wishes were not yet fully explored, recorded and understood.
“People's care records detailed their basic preferences and choices for their end of life care, however these could be further developed to ensure that people's end of life wishes were fully explored, recorded and understood.” from the report
- 01Have the bed rail risk assessment and the action to prevent entrapment been completed and reviewed?
- 02Has the worn walking frame been repaired or replaced, and how often are mobility aids checked?
- 03Have the carpets and bathroom maintenance work been completed, and how is cleanliness now monitored?
- 04How will you record and review each person's end of life wishes?
- 05How do you ensure the rota accurately records how all vacant staff hours are covered?
This was an unannounced comprehensive inspection covering all five key questions and checking whether improvements had been made since the previous inspection. This explanation was written from the published report of 11 December 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, March 2018
Rated Inadequate and placed in special measures; inspectors found serious risks in safety, medicines, hygiene and leadership.
Inspectors visited over four days in December 2017 and January 2018. They spoke with people living in the home, staff and professionals, observed care, and checked care, medicines, staffing and management records.
They found people were at potential risk because risk assessments, medicines systems, infection control and fire safety were not reliable. Records were incomplete or not securely stored. Staff training and guidance were not always up to date.
Staff were generally kind and knew people well. However, the home did not consistently protect privacy, dignity, independence, choice, nutrition or access to activities. Care plans did not show clearly how people's individual needs were being met.
The overall rating was Inadequate. Safe and Well-led were Inadequate, while Effective, Caring and Responsive Requires Improvement. The home was placed in special measures because inspectors found that earlier problems had not been properly addressed.
Staff knew people well
The home had a stable staff group, including some staff who had worked there for many years. This helped staff understand the people they supported.
“There was consistency in staffing, some of whom had also worked at the service for many years.” from the report
Kind and respectful care
Feedback from professionals and people living in the home was positive about staff's kindness and respect.
“Feedback from social care professionals showed that staff were treating people with kindness and respect.” from the report
Compassionate end of life support
Although the written end of life plans were not adequate, inspectors observed caring support and involvement from a hospice team.
“Although there was a lack of plan and guidance for end of life care, we observed staff were caring and compassionate.” from the report
Unsafe medicines systems
seriousInspectors found problems with ordering, storage, administration and recording. Staff were not always trained or checked as competent to give medicines.
“The service did not have safe systems in place for the management of medication.” from the report
Risk of harm
seriousRisk assessments and guidance were missing or incomplete for issues including epilepsy, swallowing, mobility and emergencies in the bathroom.
“Insufficient guidance for staff meant that opportunities to limit risk were not understood or recognised.” from the report
Poor hygiene and cleanliness
seriousInspectors found unsafe infection control practices and an environment that was not consistently clean and hygienic.
“The system in place to protect people from infection and promote good hygiene practice was not safe or effective.” from the report
Fire and environmental safety
seriousFire doors were being wedged open, fire exit signs were missing and some environmental risks had not been dealt with.
“In the event of a fire these doors would not provide any effective barrier against smoke / fire because the wedge prevented the automatic closure if the alarm went off.” from the report
Privacy and dignity
needs fixingShared toilets had no privacy locks. Inspectors also found shared personal items and records that could reveal private information about residents.
“This did not protect their dignity or privacy.” from the report
Weak leadership and monitoring
seriousThe provider had not acted effectively on the previous inspection's recommendations. Systems did not identify or correct important risks.
“Systems in place for identifying, capturing and managing organisational risks were ineffective.” from the report
- 01What has been done to make medicines ordering, storage, administration and recording safe?
- 02How are risks such as epilepsy, swallowing, mobility and emergencies in the bathroom now assessed and managed?
- 03What changes have been made to fire safety, including fire doors, exit signs and window restrictors?
- 04How do you check that staff have current training and are competent to support people's specific health and communication needs?
- 05How are care plans now showing people's choices, privacy, independence, activities, community contact and end of life wishes?
This was a comprehensive inspection covering all five key questions, with visits to the home, observations, discussions and checks of care, medicines, staffing and management records. This explanation was written from the published report of 22 March 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.
Every inspection of The Cottage Residential Care Home
3 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- December 2018Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at The Cottage Residential Care Home →
- March 2018Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
Read what inspectors found at The Cottage Residential Care Home →
- April 2016Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 14 January 2011.
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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