Cockington House

Updated 6 September 2023

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 inspection was carried out by 2 inspectors.

Service and service type

Cockington 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. Cockington House is a care home without nursing care. 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 not a registered manager in post. The provider had appointed a new manager. They had not started yet but we were told they will be putting an application in to be registered with the CQC. From 17 July 2023 an interim manager and area manager were appointed and were managing the home. For the purpose of this report, where interim manager and area manager have shared responsibility for areas of work, they are referred to as the management team.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals 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 observed people and their interactions with staff and each other throughout the inspection visit. We spoke with 3 people, 3 relatives/representatives and 2 health and social care professionals to gain their views. We also spoke with 7 members of staff including the interim manager, area manager and 5 care staff. We reviewed a range of records, this included 3 care plans, 4 medicine records and 4 staff files in relation to recruitment. We reviewed a range of records relating to the management and oversight of the service, staffing, risk assessments, health and safety records. After the inspection we continued to receive and review health and safety records, information relating to training, and a range of policies and procedures.

Updated 6 September 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Cockington House is a residential care home providing personal care to up to 6 people living with a learning disability. Accommodation is provided over 2 floors. A communal lounge with a dining room, and kitchen are based on the ground floor. At the time of our inspection there were 4 people using the service.

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

People were not supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

Care was not always person-centred. Staffing levels were not always adequate to ensure people received the right care. Staff ensured they respected people’s dignity, privacy and human rights. People were supported by caring staff.

Right Culture:

Governance systems were not effective, and the provider lacked an oversight of the service. Concerns had been raised but were not always investigated and action had not been taken to improve the service. People, staff and relatives had not been asked to provide feedback about their views. There was a new management team in place, who promoted a positive culture and led by example.

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 30 November 2017).

Why we inspected

We received concerns in relation to a closed culture and restrictive practice being used. Concerns were shared about restraint being used by untrained staff, People’s health care needs not being appropriately met and staffing levels which were not safe. Also, we heard about concerns of the management of incidents and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

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

Enforcement

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

Please see the action we have told the provider to take at the end of this report.

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.