Collingtree Park

Collingtree Park is a residential care home providing personal care to up to 79 people. The service provides support to older people, some of whom were living with dementia. At the time of our inspection there were 47 people using the service.

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

People felt safe living at the service. There were enough staff working within the service who were trained to ensure their practice and knowledge was up to standard.

Risk assessments were in place to ensure staff worked safely with people. Staff understood people’s needs, and the risks present within their lives.

Medicines were administered safely, and the correct documentation was being used. People were happy with their support in this area.

The service was clean and tidy, and infection control procedures were in place and adhered to.

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.

People were supported to maintain a healthy diet, and to access health care professionals when required. Choices were offered at meal times and dietary preferences and requirements were catered for.

Audits and checks were in place to ensure errors were found and corrected and staff felt supported by management, and felt the service had undergone positive changes. People were able to feedback on the service and had their voices heard

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

The last rating for this service was requires improvement (10 December 2021) and there were breaches of 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

We carried out an unannounced comprehensive inspection of this service on 4 October 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

The inspection was prompted in part due to concerns received about staffing levels and poor care within the service . A decision was made for us to inspect and examine those risks under the key questions of safe, effective and well led.

We also undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, and Well-led.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Collingtree Park is a residential care home providing accommodation and personal care for up to 79 older people, younger people and people living with dementia. At the time of inspection 70 people were being supported at the service.

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

People were at potential risk from abuse due to unexplained injuries not being investigated to identify a cause. Records of injuries were not consistently completed and follow ups to injuries were not always recorded to evidence an injury was healing.

Risk assessments were not always clear regarding what actions staff should complete to reduce the known risks. Records of care tasks were not completed consistently, which put people at risk of not receiving the support they required to keep safe and healthy.

Medicine recording was not consistently completed to evidence the proper administration of medicines.

Staffing levels required improvement. People, relatives and staff all felt the staffing levels were not satisfactory. Observations completed during the inspection evidenced staffing levels were a concern.

Systems and processes to ensure oversight were not always effective. Audits had not been completed on daily recording, audits on accidents and incidents and medicines had not identified the concerns found. We found missing and conflicting information recorded about people’s needs.

People were supported by staff who had received adequate training and where safely recruited. Staff were tested regularly for COVID 19 and followed government guidance of the use of personal protective equipment (PPE).

People, staff and relatives knew how to complain and felt listened to by the registered manager. Feedback was requested annually and during reviews. The provider had an action plan in place to make improvements.

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 14 February 2018)

Why we inspected

We received concerns in relation to staffing levels, infection control, records and care plans. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

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.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to records, risks, medicines and oversight 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 continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Collingtree Park provides accommodation and care for up to 79 older people, including people that need support because of their physical frailty and those who are living with dementia. Respite care and short breaks are also part of the service provided at Collingtree Park. The home is purpose built and adapted throughout to meet the diverse care needs of the people in residence. The home had recently been refurbished and redecorated throughout. There were 76 people in residence when we inspected the service on 6 and 7 December 2017.

At the last inspection on 24 and 25 September 2015 the service was rated ‘Good’. At this unannounced inspection we found the service remained ‘Good’.

People were safe. People were protected by robust recruitment procedures that made sure people did not receive unsafe care from staff that were unsuited to work at the service. People were cared for by sufficient numbers of staff. They received care from staff that had received training and support to carry out their roles.

People's needs had been assessed prior to admission and they each had an agreed care plan that was regularly reviewed to ensure they continued to receive the care and support they needed. Risks to people’s safety were reviewed as their needs and dependencies changed. The premises and equipment used to provide people with the care they needed were appropriately maintained throughout to ensure their safety and that of the staff.

People were supported and safeguarded from avoidable harm and poor practice by staff that understood how to keep people safe. Safeguarding procedures were in place to help protect people from harm and staff understood their responsibilities to do so and to report any concerns. All safeguarding issues were investigated and appropriate action was taken.

People received care and support from staff that knew what was expected of them. Staff were friendly, kind and compassionate. They were attentive to people's needs and respected people's individuality and rights to make choices. Staff had insight into people’s capabilities and aspirations. People were encouraged and enabled to do things for themselves. Their individual preferences for the way they liked to receive their care and support were respected. Staff responded to people in a timely way whenever they needed assistance. Care plans were personalised, reflected each person’s individual needs and provided staff with the information and guidance they needed to support people. Care planning involved people and supported their diverse needs. Staff had a good understanding of people’s preferences and supported people to participate in activities they enjoyed.

People’s capacity to make informed choices had been assessed and regularly reviewed. The provider and staff were mindful of the Mental Capacity Act 2005 and the importance of seeking people’s consent when receiving care and support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s healthcare needs were monitored. They had access to community based healthcare professionals, such as GP’s and nurses, and had regular check-ups. They received timely medical attention when needed. Medicines were safely managed. They were securely stored and suitable arrangements were in place for their timely administration by staff that had received training.

People had enough to eat and drink. They said the meals were enjoyable and catered for their tastes and appetites. Individuals who needed encouragement and support with eating a healthy diet received the help they required. People were supported to have a balanced diet and to have their nutritional needs met.

Systems were in place to ensure the premises was kept clean and hygienic so that people were protected by the prevention and control of infection. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

The provider and manager led staff by example and enabled the staff team to deliver individualised care that consistently achieved good outcomes for all people using the service. People and their relatives were encouraged to be involved in making improvements to the home and their feedback was acted upon.

The rating from our previous inspection was prominently displayed in the foyer of the home. The provider also ensured that this rating was clearly displayed on their website. Comprehensive information about the service offered at Collingtree Park was readily accessible on the provider’s website. The provider’s website for the home had been designed to take make finding information about the service straightforward.

Staff respected people's wishes and obtained their consent before providing care. We saw that staff approached people who used the service in a calm and friendly manner and were attentive to their individual needs.

Records showed that assessments of people's physical, social and emotional needs were carried out. People's care plans were based on the assessments and informed staff about the care to be delivered. We spoke with four staff and the manager, who were all knowledgeable about the needs of people who used the service, and their responsibilities in relation to the provision of care.

Medication was safely managed and recruitment checks were sufficiently robust to guard against employing unsuitable staff.

We found that Collingtree Park was generally well managed with good systems were in place to assess and monitor the quality of care.