Background to this inspection
Updated
12 January 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection, we looked at the infection prevention and control measures that were in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by one inspector, one specialist advisor and an ‘Expert by Experience’. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Cromwell Court is a 'care home'. People in care homes receive accommodation, nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This was an unannounced inspection.
What we did before inspection
We reviewed information we had received about the service and sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with three people receiving support and ten relatives about their experiences of care being provided. We also spoke with the registered manager, five members of staff and one external healthcare professional.
We reviewed a range of records including four people’s care records, medication administration records and four staff files in relation to recruitment. We also reviewed a variety of records relating to the management and governance of the service, including policies and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at audit and governance data, as well as infection prevention and control policies and procedures.
Updated
12 January 2022
About the service
Cromwell Court is a care home providing accommodation, nursing and personal care for up to 67 younger and older adults and people who are living with dementia. At the time of the inspection 64 people were living at the home.
People’s experience of using this service and what we found
Overall governance and quality assurance measures were in place, although further improvements were required. The quality and safety of care was monitored and assessed although records and documentation were not always completed as required. We continue to make a recommendation around quality assurance measures.
People received care and treatment that was centred around their support needs, areas of risk were routinely managed, and people told us they felt safe living at Cromwell Court. One relative told us, “Most definitely [person] is kept safe because of the care [they] receive, you have a feel for a place, they [staff] are all amazing.”
An electronic care planning system meant that people’s care reviews were completed in a timely manner and staff responded when further risks were identified. An external healthcare professional told us that staff knew people well, people were well looked after and there were no concerns around the provision of care people received.
Safeguarding and whistleblowing procedures were in place. Staff were supported with the necessary training and knew how to raise their concerns. One relative told us, “I do think [person] is safe, can’t stress to you how much we feel that [person] is safe, clean and happy.”
Safe medication arrangements were in place. People received support with their medicines from staff who were fully trained and complied with the provider’s medication administration policy. Medicines were routinely ordered, safely stored and administered in accordance with administration instructions.
Staffing levels were routinely monitored, and safe recruitment procedures were in place. Staff told us they felt thoroughly supported and were able to complete training to enhance and develop their skills, qualities and experience.
We were generally assured that safe and effective infection prevention and control procedures (IPC) were in place. We observed staff wearing the appropriate PPE, they were engaged in a routine testing regime and were aware of the different IPC measures that needed to be complied with. We did offer some signposting in relation to enhanced cleaning schedule documentation that needed to be in place.
People were supported to have maximum choice and control of their own lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
A new provider for this service was registered with CQC on 10 March 2020. The last rating for the service (under the previous provider) was 'requires improvement', published on 4 September 2019.
A focused inspection took place and the service was ‘inspected but not rated’ (published 26 October 2020). We only inspected against the safe and well-led key questions and we identified a breach of ‘safe care and treatment’ regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
Although a focused inspection was conducted, we needed to inspect against all key questions, including effective, caring and responsive. This was a planned comprehensive inspection following the new providers registration with CQC.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service until we return to our inspection programme. If we receive any concerning information we may inspect sooner.