The Cottage Residential Care Home

Updated 11 December 2018

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 unannounced inspection took place between the 31 October and the 16 November 2018. The first day was a visit to the service and was undertaken by one inspector and one assistant inspector. Following this we made telephone calls to staff and relatives.

Before our inspection a Provider Information Return (PIR) was submitted by the registered manager. This is a form that asks the provider to give some key information about the service: what the service does well and improvements they plan to make.

We reviewed information we had received about the service such as notifications. This is information about important events which the provider is required to send us by law. We also looked at information sent to us from other stakeholders, for example the local authority.

During our inspection, we looked at the care records of four people, recruitment records of three staff members and records relating to staff training and the management of the service and quality monitoring. We spoke with one person living at the service and three people’s relatives. Where people were unable to speak with us directly, we observed how staff interacted with people and used informal observations to evaluate their experiences and help us assess how their needs were being met. We spoke with six staff including the registered manager and the deputy manager.

Updated 11 December 2018

We carried out an unannounced inspection of this service in March 2016 and found that the service required improvement and we made a recommendation that the service sought advice and guidance from a reputable source on up to date best practice regarding supporting people with autism and learning difficulties. We carried out a comprehensive inspection in December 2017 and January 2018 to check that the service had made the required improvements and found there were eight breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service was rated ‘Inadequate’ and placed into special measures.

The management team were working closely with the Clinical Commissioning Group, and the local commissioner’s safeguarding and quality improvement teams which mitigated the risk to people living at the service.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Cottage Residential Home on our website at www.cqc.org.uk

Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe.

We undertook this comprehensive inspection to check that the registered provider had made the required improvements and to confirm they now met legal requirements. The management team had made significant progress to address the previous concerns and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

The Cottage Residential Care Home is a ‘care home’. People in care homes receive accommodation and 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 care home accommodates up to 10 people who have a learning disability or autistic spectrum disorder. People who use the service may also have mental health needs, a physical disability or dementia.

The Cottage is situated in a residential area, close to the seafront and the town centre. The premises are on two floors with each person having their own individual bedroom and communal areas are available throughout. At the time of our inspection, eight people were using the service.

There was a registered manager in post. 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.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy

Safe processes were in place for the administration of medicines and there were procedures in place to ensure the safety of the people who used the service. There were systems in place to safeguard people from abuse. There were adequate numbers of staff who had been recruited safely and were trained and supported to meet people’s needs. Staff were aware of their responsibilities and knew how to report any concerns.

Staff demonstrated an understanding of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS.) 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 support this practice. People were supported to eat and drink enough and to ensure they maintained a balanced diet and referrals to other health professionals were made when required. The environment was well maintained and suitable for the needs of those living at the service.

People and their relatives were involved in the planning and review of their care. People were supported to follow their interests and participate in social activities. A complaints policy was in place.

Risk assessments and care plans provided detailed and relevant guidance for staff in the home. People were supported effectively with their nutritional needs and received personalised care from a staff team who were kind and caring, respected their privacy and dignity and promoted their independence.

Systems and quality assurance processes had been improved. The management team were more pro-active and committed to continuous development which had led to improvement in the managerial oversight of the service.