Archived: Keychange Charity Cressingham House Care Home

We found the following examples of good practice.

There was a programme of regular COVID-19 testing for both people living in the home, staff, essential carers and visitors to the home. Screening procedures included temperature checks, healthcare questionnaires and a negative lateral flow test.

The registered manager reported no impact on people's care because of sector workforce challenges.

People living in the home and their relatives were supported to maintain contact. There was visiting room that could be accessed via the rear of the building so relatives could see their loved ones regularly reducing the risk of infection to visitors and people living at the home.

Staff used personal protective equipment (PPE) and followed guidance and practices. There was abundant PPE available to staff.

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

Quality assurance processes were carried out by the registered manager. However, issues regarding the management of records, such as, social support, health and safety, supervisions and appraisals and deployment of staffing levels needed further review to improve monitoring and record keeping.

We have made a recommendation for the provider to review all aspect of record keeping within the service.

People living at Cressingham House were positive about the staff being caring and kind, they were happy with the facilities and standards of care and support provided. People received good support from a committed staff team. People told us there were enough staff around to help them receive care and support.

People received person-centred care. Staff were familiar with the people they supported, and positive relationships had developed. Care plans were in place and generally contained the correct level of information in relation to the support people needed. Some areas of recording needed updating.

Recruitment checks were organised and showed appropriate records to ensure staff were suitable to work at the service. The staff team were well trained and skilled in effective communication to ensure people felt supported.

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 service was clean and staff used appropriate techniques to prevent the spread of infection.

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 August 2017.) At this inspection we found the service to remain the same and rated the service as 'good.'

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

The service is registered to provide accommodation and personal care for up to 16 people and 13 people were living there when we visited. The people accommodated were older people who required 24 hour support from staff. The home is part of the range of services provided by the London based Christian organisation Keychange Charity and had a manager who was registered with the Care Quality Commission.

All of the people we spoke with said they felt safe at all times. They felt there were always enough staff on duty and that call bells were answered very promptly. New staff had been recruited safely and the staff team had completed training courses covering a wide range of subjects to enable them to meet people’s needs.

We looked all around the home and found that people had a comfortable, well maintained, clean and warm environment with a choice of lounges, dining room and a pleasant outside area to sit in. Records we looked at showed that regular health and safety checks were carried out and up to date certificates were in place for the maintenance of equipment and services.

People’s medicines were managed safely.

At the time of this inspection none of the people living at the home had a DoLS and the senior care worker told us that although some people had early dementia they were still able to make their own decisions. 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.

Everyone we spoke with was happy with the meals provided. The meals were presented well and people received the support they required with their meal. People we spoke with said how kind, considerate and polite all members of staff were.

The manager told us that the home was part of an initiative called ‘The Centre for Creativity and Innovation in Care’. The staff were encouraged to be spontaneous and creative in the ways that they provided care and support for people.

People's care and support needs were assessed and plans put in place for how their needs should be met. These were individualised and covered all aspects of a person's needs including physical, mental health and social needs.

The home’s complaints procedure was displayed in the entrance area and provided details about how, and to whom, complaints should be addressed. All of the people we spoke with said they had never had reason to complain but they would tell the staff if they did have a complaint.

People told us that the manager was approachable and all felt she would act if they made a complaint. They said that the home was “friendly, welcoming and so homely.” We saw that people had completed satisfaction surveys but they were not recent. Survey forms were available in the entrance hall and people could chose to fill them in anonymously. The quality monitoring systems used in the home were proportionate to the size and nature of the service.

All five service users we spoke to said staff were 'very nice' and it was very 'homely'. Two out of the four staff we spoke to said it was 'like one big family'. We saw the activities co-ordinator engaging in activities with the service users. The activities co-ordinator showed a four week plan of activities which ranged from one-on-one time to shopping days out to cake decorating. We saw each service user had a diary of what they had done each day of the week which reflected their preferences.

We saw evidence of staff monitoring weights on a regular basis and were told they informed the GP of any weight loss.

We saw the provider had policies and procedures in place for safeguarding and emergency events. All staff were aware of where to locate them if need be. Staff were able to give us confident and correct examples of what they would do in an event of an emergency.

All the service users we spoke to said they had no concerns over the welfare of any of the other people living there. One told us she felt 'safe' there.

We looked at records held by the provider; we looked at all policy and procedures for the home which had recently been updated. We looked at various maintenance records which were kept up to date. All records were kept confidentially in a locked office. All staff records were kept locked and the key held with the person in charge.

People who used the service said:

'It's excellent here', 'I can't fault anything', 'They treat me very well', 'The care is very good', 'They really do look after us well', 'They are very kind' and 'I wouldn't want to live anywhere else".

People told us they were aware of care plans and were involved in how they were cared for. They said they could make choices in daily living activities such as the time they got up or went to bed, clothes they wore, going out to the local shops and where and what to eat at mealtimes. One person told us she preferred to eat her meals in her room and this was enabled. We found care records reflected individual needs, these were assessed and care plans implemented appropriately.

People told us there was always plenty to eat and drink, staff responded well when they used the call bell and staff listened to the person and did their best to act upon their wishes. People told us there were plenty of activities to do if you wished to join in.