The Cottage Nursing Home

Updated 8 January 2020

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.

Inspection team

The inspection was carried out by one inspector 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

The Cottage Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 the Care Quality Commission. 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 inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection, which included information from local authority commissioners. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection-

We spoke with seven people who used the service and six relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager, deputy manager, nurses, and care workers. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision and a variety of records relating to the management 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 training data and an incident record.

Updated 8 January 2020

About the service

The Cottage Nursing Home is a residential care home providing personal and nursing care for up to 33 people aged 65 and over. The accommodation is provided in a single building, arranged over two floors, with communal facilities including a lounge and dining room, activities room and secure garden. At the time of our inspection, 32 people were using the service, some of whom were living with dementia.

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

The provider and registered manager monitored the quality and safety of the service. However, some quality audits were not sufficiently robust, and improvements were needed to ensure they were consistently effective in identifying and rectifying any shortfalls. We have made a recommendation to improve the audits of medicines and care plans.

Staff knew how to protect people from the risk of abuse. Risks associated with people's care were identified and managed safely. People received their medicines as prescribed. People were supported to access other professionals to maintain good health.

There were sufficient, safely recruited staff to keep people safe and promote their wellbeing. Staff received training and ongoing support to meet people’s individual needs. People were supported to enjoy their meals and maintain a healthy diet.

Staff were kind and caring, treated people with respect and promoted their privacy and dignity at all times. People's diversity was recognised and promoted by the staff and systems were in place to meet people's communication needs. People were supported to have maximum choice and control of their lives, in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People’s care and support plans reflected their needs and preferences and were kept under review. People had opportunities to take part in activities and social events and were supported to follow their hobbies and spiritual beliefs. Staff were proactive and ensured people received timely and dignified care at the end of their life.

People benefitted from a service that had an open and inclusive culture. People and their relatives felt confident any concerns and complaints they raised would be acted on. There were systems in place to capture people’s views on how the service could be improved and these were acted on. Staff enjoyed working at the service and felt supported and valued by the registered manager.

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 23 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.