Archived: Cottisbraine House

Updated 8 March 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 10 February 2016 and was unannounced. One inspector undertook this inspection.

Prior to this inspection we reviewed the information we held about the service including statutory notifications. These notifications informed us about key events that occurred at the service.

During the inspection we spoke with the two staff on duty, who were the registered manager and the proprietor. We spoke briefly with one person and undertook general observations throughout the day. We reviewed three people’s care records and four staff records. We looked at records relating to the management of the service and reviewed medicines management processes.

After the inspection we spoke with two people’s relatives and three staff.

Updated 8 March 2016

We undertook an unannounced inspection on 10 February 2016. At our previous inspection on 10 June 2014 the service met the regulations inspected.

Cottisbraine House is registered as a partnership and provides accommodation, care and support to up to nine older people with learning disabilities, some of whom also have dementia and other mental health needs. At the time of the inspection six people were using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff were aware of people’s needs and the level of support they required with their personal care and activities of daily living. However, we found that accurate and detailed care records were not maintained about people’s needs, and the support they required in regards to individual health needs. There was a risk that people would not receive the support they required if supported by staff that were unfamiliar with their needs.

The registered manager did not adhere to all the requirements of the Mental Capacity Act 2005. People required one to one support from staff in the community and due to this did not have many opportunities to access the community. The registered manager was aware that this may amount to depriving a person of their liberty but had not made applications for authorisation to do this. There was a risk that people may be unlawfully deprived of their liberty.

Staff received training to ensure they had the knowledge and skills to support people. However, sufficient processes were not in place to ensure staff were adequately supported to undertake their role, and to review their competency and performance. Staff did not receive regular supervision or appraisals.

The registered manager undertook checks on the quality of the service. However, we saw that these checks were not robust enough and did not sufficiently address areas that might require improvement. We also identified that accurate records were not kept in regards to incidents that occurred at the service so these could be analysed to identify trends and patterns to prevent similar incidents from reoccurring. There was a risk that people were not adequately supported after an incident to ensure their safety and welfare.

Staff had built relationships with people and were aware of people’s individual personalities. They were aware of people preferences as to how they wished to be supported, and were aware of people’s interests and hobbies. Staff had arranged for professionals to visit the service to provide activities for people, including a music session and a ‘keep fit’ session. However, there were limited opportunities for people to access the community. We recommended that the registered manager reviews national guidance to support social inclusion for people, in the community.

Staff supported people to have their health needs met. Staff liaised with healthcare professionals if they had concerns about a person’s health and supported people to attend healthcare appointments. People received their medicines as prescribed. Staff were aware of people’s dietary requirements and supported them to have regular meals and fluids to protect them from the risk of malnutrition or dehydration.

Staff respected people’s privacy and supported people to maintain their dignity. There were sufficient staff to provide people with timely and responsive care.

The registered manager had assessed risks to people’s safety upon their admission to the service, and plans were in place to support people to minimise and manage those risks. Staff were aware of their responsibilities to safeguard people from harm and reported any concerns a person was potentially being harmed to the registered manager so appropriate action could be taken to protect the person.

There was open communication amongst the staff team and good information sharing to ensure staff were aware of any changes in people’s support needs. Staff felt listened to by the registered manager and felt able to express their views and opinions.

We identified three breaches of legal requirements in relation to safeguarding people who use services, staffing and good governance. You can see what action we have asked the provider to take at the back of the main body of the report.