This was an unannounced inspection, which took place on the 19 January 2015. Collingwood Grange Care Centre is a care home with nursing provided by BUPA. Collingwood Grange Care Centre provides care for up 90 people on a short- and long-term basis. The care provided includes nursing, care for people living with dementia and care for people with Huntington disease.
At the time of inspection there was a registered manager. 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 and associated Regulations about how the service is run.
People and their relatives said they felt they were safe with the staff. One person said “I feel safe and happy here; I would tell the manager if I had safety concerns but there's been no need”. Another said “You can be vulnerable somewhere like this but I feel safe”. Not all staff had received updated safeguarding adults training but had knowledge of the safeguarding procedures and what to do if they suspected abuse.
There were not always enough staff to safely meet people’s needs. This meant that sometimes people did not receive care in a timely way. Staff felt that care was rushed as a result of there not being enough staff. One person said ”The staff look after you well but sometimes I have to wait a bit when I press the buzzer, they're probably too busy to come right away.”
Risk assessments for people were undertaken and measures put in place to reduce the risk of them coming to harm. Staff were aware of people’s risks and what to do to minimise them.
Medicine was administered safely and disposed of in a safe way. People’s medicine charts were completed correctly and a nurse signed to say that people’s medicines had been given. There was guidance for staff on when to give people their PRN (as needed) medicines.
Pre-employment checks for staff were completed. For example in relation to their full employment history and reasons why they had left previous employment. This meant that only suitable staff were employed.
One relative told us “We’re happy with the nurses and carers here. They seem efficient. If my husband is unwell and I'm not here, the staff always notify me including letting me know if the doctor's been to see him. I don't have to wait long”. Health care professionals said that staff had the support and skills to deal with some people’s complex conditions.
Staff were not up to date with the service mandatory training and others had not had any training in some areas. This included first aid, fire training and infection control. This meant that staff would not have the most up to date guidance. Not at all staff had received a one to one supervision or appraisal with their manager.
People said staff asked them for consent before they gave care. One said “The staff look after me well and ask for my consent to care.” Staff knew about the Mental Capacity Act 2005 and mental capacity assessments had taken place for most people. However where people’s freedom was restricted by keypad doors and the provider had not completed the appropriate forms to the Local Authority.
People thought the food was good and felt that their nutritional needs were catered for. People were encouraged to make their own decisions about the food they wanted. There was a wide variety of fresh food and drinks available for people. However those people who needed additional support to eat were not always given that.
People had access to a range of health care professionals, such as chiropodist, community matron and a GP. GPs visited regularly and people were referred when there were concerns with their health.
People thought that the staff were caring and that they were treated with dignity and respect. People also felt that if they needed privacy then this would be given. We saw instances where staff were not always caring. These related to people who needed additional support and were living with dementia.
Some people felt there was enough to do. One told us “I can do what I want - go out in the summertime, phone my family, watch television and I decide when to go to bed.”
There were not enough activities provided for people specific to their needs. This was more specific to the needs of people living with dementia. Some people said that they didn’t like group activities but preferred to sit with one person to do something meaningful to them. They felt that this was not always offered to them.
People and relatives said they understood how to make a complaint and felt comfortable to do so. There was a copy of the complaints procedure for everyone to see in the reception area. All of the complaints were logged and there was evidence that the provider learned from these complaints.
People, relatives and staff were asked for their opinion and feedback on what they thought of the service. The Manager was unable to show us the analysis of the 2013 Survey and was waiting for the analysis of the 2014 Survey. Regular residents and relatives meeting had taken place and suggestions and issues were used to improve the service.
People and staff felt that the service was well managed. However not all of the audits that took place were effective and improvements had not always been made as a result of the audits. For example in relation to cleanliness and staff being caring.
We found nine breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.
You can see what action we told the provider to take at the back of the full version of the report.