Cromwell House

Updated 18 January 2024

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures 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 service was inspected by 2 inspectors and 1 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 House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Cromwell House is a care home without nursing care. Care Quality Commission (CQC ) regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 12 people who used the service and 6 family members about their experience of the care provided. We spoke with 9 members of staff including the registered manager, deputy manager, 2 senior care assistants, 2 care assistants, 1 activities assistant, 1 chef and 1 kitchen assistant.

We reviewed a range of records. This included 6 people's care records and 3 medication records. We looked at 3 staff files in relation to recruitment and staff supervision. We looked at a variety of records relating to the management of the service, including policies, procedures, and audits. We looked at documents relating to the health and safety of the service, including equipment maintenance records, health and safety checks and fire safety documentation.

Updated 18 January 2024

About the service

Cromwell House is a residential care home providing accommodation and personal care to up to 38 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 37 people using the service.

The care home has 2 floors. There were shared spaces such as a lounge, a dining room, bathrooms, toilets and 2 kitchenette areas for people to use. People’s bedrooms had ensuite facilities and some had showers. There was a garden for people to access.

People’s experience of using this service and what we found

Risks associated with peoples care needs had not always been assessed thoroughly. Care records and risk assessments did not always accurately reflect the care people needed.

Medicines were not always managed safely, and people did not always receive their medicines as prescribed.

Quality assurance systems and service oversight was not always effective. The provider took action when prompted by our findings.

The service had enough staff but they were not always safely recruited.

People were treated with dignity and respect. People told us they enjoyed the activities within the service. We observed, and people told us, that mealtimes were a sociable and pleasant experience.

Staff knew people’s life histories well. People were encouraged to stay independent and continue their hobbies and interests at the service.

People spoke positively about the atmosphere within the service. People using the service and their relatives found the registered manager to be approachable and caring. The service sought the views of staff and people using the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service 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

The last rating for this service was good (published 10 July 2018). At this inspection we found the provider was in breach of regulations. The service is now rated requires improvement.

Why we inspected

We inspected this service due to the length of time since the last inspection. As a result, we undertook a comprehensive inspection of the service.

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.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive, effective and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cromwell House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.