Cressington Court Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question inadequate. At this assessment the rating has changed to requires improvement. This meant although the service was safe and people were protected from harm, further time was required to evidence sustainability and embed improved practices. We assessed 8 quality statements in the safe key question. The service had made improvements and was no longer in breach of regulations. Processes for assessing risk to people had been reviewed since the last assessment. Risks to people were assessed, mitigated and managed by staff who understood them. People were involved in the management of their risks as much as possible. Processes for managing safeguarding concerns had been reviewed since the last assessment. Incidents were appropriately investigated and reported and were referred to external agencies where appropriate. Safeguarding and whistle-blowing policies were in place which helped protect people from the risk of abuse and harm. Lessons were learn from safety incidents and reflective sessions took place with staff to help improve practice The service provided a safe and hygienic environment for people to live. Cleaning schedules had been introduced since the last assessment to ensure equipment was kept clean and hygienic. Staff were recruited safely. Appropriate staffing levels were in place to help ensure people received safe, good quality care that met their needs. However, we did observe people left in the main lounge for a prolonged period without staff intervention. Additional training had been provided for staff since the last assessment and staff had been trained to ensure they were able to carry out their role. People’s medicines were managed in a safe way. PRN medicine protocols (as and when required medicines) had been reviewed since the last assessment.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People's feedback confirmed there was a culture of safety and learning and that risks to people were managed and not overlooked. People told us they felt safe living at Cressington Court, comments included, “Oh yes I do feel safe here” and “I feel safe here, I want to be here. I have everything that I need in my room.”

Feedback from staff and leaders confirmed safety was a top priority. Staff were encouraged to raise concerns. Lessons were learnt with opportunities to learn from safety events being communicated amongst staff to help support improvement. The manager told us how reflections took place with staff to discuss what they could do better in the future.

Processes were in place to help ensure risks were treated seriously and safety and learning were part of the culture. Learning and reflective practices took place in staff meetings and handovers. Policies were in place to help ensure people’s safety, such as a whistle-blowing and safeguarding policy. Staff had completed training in topics of health and safety, including safeguarding, to help keep people safe. The provider had demonstrated a lesson learnt approach by making the required improvement to address shortfalls found at the last assessment. However, these improvements were recent and further time was required to ensure that all processes were firmly embedded and fully effective.

People's feedback confirmed that safety and continuity of care was treated as a top priority in the home. People’s transition into the home was managed in a safe way. People told us they had access to the equipment they required. One person told us, “I’m in a wheelchair and staff help me with this.”

Staff and leaders understood their responsibilities for ensuring safe systems of care including working with other professionals and services, to help ensure people received continuity of care. The manager told us how this process started before people were admitted to the service, “I personally assess people myself before they come here to make sure we know we can meet their needs before they arrive.”

Feedback from partners confirmed the service had worked well to address the shortfalls found at the last assessment.

Processes were in place to help ensure people received continuity of care and appropriate referrals when needed. Referrals to external professionals were evident in people’s care records with advice or outcomes being recorded appropriately. However, these improvements to processes were recent and further time was required to ensure that all processes were firmly embedded and fully effective.

People’s experience confirmed they were protected from the risk of harm, abuse and neglect. People were supported to understand what being safe meant to them and how to raise concerns. People told us they felt safe living at Cressington Court and knew who to speak to if they did not feel safe. Comments from people included, “I feel safe here. I would tell the girls if I was worried” and “I do feel safe here. I would be able to speak to the girls if I had a problem.” People’s relatives also told us they thought their loved one was kept safe, one relative told us, “I do feel that [Name] is safe here.”

Feedback from staff and leaders confirmed there was a strong understanding of safeguarding and how to take appropriate action. The manager told us, “Any safeguarding concerns are discussed with staff so we can learn from them.” Staff told us they were confident they would recognise the signs of anything of concern and would not hesitate to speak up. One member of staff confirmed, “I would report any concerns [safeguarding] to the manager or person in charge.”

We observed people being cared for in a way which maintained their safety and well-being. For example, we observed staff supporting people to mobilise with equipment in a safe way.

Processes were in place to help people receive care in a safe way and to help keep people free from the risk of abuse and harm. Safeguarding and whistle-blowing policies were in place and easily accessible to staff. However, we observed that CQC had not always been made aware of any ‘notifiable’ incidents in a timely way. We spoke to the manager about this who confirmed this was due to technical issues. Since our last assessment, provider systems to ensure applications to deprive a person of their liberty (DoLS) had not always been followed. We identified a small number of applications had not been applied for in a timely manner. We raised this with the manager who told us this had been a recent area of focus. We noted improvements had been made in recent weeks.

People’s experience confirmed they were informed about any risks and how to keep themselves safe. People were supported to manage their risks and were involved in decisions about their risks.

Feedback from staff and leaders confirmed they understood the risks to people and how to keep them safe. The manager explained how they used a clinical risk tool which was updated and reviewed regularly to ensure people were involved in the management of risks as much as possible. A member of staff told us, “I have access to care plans which provide good information about residents and risks.”

We observed staff support people in a way which minimised risks to their well-being and safety. For example, staff ensured people had access to their mobility aids so they were able to mobilise safely.

Processes had been overhauled since the last assessment to help ensure risks to people were identified, managed and mitigated appropriately. A balanced approach to risk was taken in line with people’s choices and ability. However, these improvements to processes were recent and further time was required to ensure that all processes were firmly embedded and fully effective.

People’s experience confirmed they were cared for in a safe environment, and that the home was clean and safely maintained. One person told us, “It’s very clean!”

Feedback from leaders confirmed staff had completed training in topics of health and safety. The manager showed a good understanding of their responsibilities for ensuring a safe environment and the safe use of equipment. The manager explained how they carried out daily walk arounds of the home. We spoke to the maintenance person who confirmed they carried out regular checks of the environment, such as call bells, window restrictors, beds and fire equipment.

We observed the environment was clean and well maintained. However, we observed some people’s bedrooms did not display their names on doors. We spoke to the manager about this who advised there was a person who continuously removed the signs, the missing signs were replaced after we raised this. We also found some clocks were not displaying the right time. This is particularly important for people living with dementia, to help orientate people. We raised this with the manager, and this was acted upon. Whilst people’s bedrooms were clean, they lacked personal artefacts to help them appear more homely and person centred.

Processes were in place to help ensure the safety of the environment and equipment. Safety checks on the environment and equipment were carried out at the required intervals and prompt action was taken to address any safety concerns. An up-to-date PEEP (Personal emergency and evacuation plan) was completed for each person and regularly reviewed, to help ensure people could be removed from the building safely in an emergency. Since the last assessment, more regular checks of equipment had been introduced to help ensure it was clean and hygienic before use. However, these improvements to processes were recent and further time was required to ensure that all processes were firmly embedded and fully effective.

People told us they thought there was enough staff to help support them to meet their needs. One person told us, “Yes, I think there’s enough staff.”

Generally, staff felt there were enough staff on duty however, one staff member felt additional staff would be beneficial on the first floor of the home due to the needs of people who resided there. We shared this feedback with the management team. Staff confirmed they received an induction when they started and the training they needed for their role.

We observed people being left alone for prolonged periods of time in the main lounge. We spoke to the manager about this who confirmed this was unusual, but they would monitor this in the future.

Processes were in place to ensure staff were recruited safely and supported to perform their role in a safe and competent way. Staff had completed a full induction and all mandatory training.

People’s experience confirmed there were good standards of hygiene in the home. People told us the home and their rooms were clean and well maintained. One person told us, “It’s nice and clean. I like my room with no clutter.”

Feedback from staff and leaders confirmed there were clear roles and responsibilities around infection control. The manager told us domestic staff were employed to help keep the environment clean and hygienic. We spoke to the domestic staff who confirmed they had good supplies of cleaning products and equipment and how they completed cleaning records and schedules daily.

We observed the environment was clean and hygienic. There was a good stock of PPE located around the home and staff used and disposed of it safely. We also observed the kitchen and laundry areas and found them to clean and well organised. Records were maintained to show all required safety checks had been carried out.

Processes were in place to ensure the risk of the spread of infection was minimised. Cleaning schedules were followed for both the environment and new cleaning schedules had been introduced for equipment. Regular IPC audits were completed, and any improvements noted were promptly acted upon. However, these improvements to processes were recent and further time was required to ensure that all processes were firmly embedded and fully effective.

People’s experience confirmed they received their medicines as prescribed and on time. One person told us, “My medication, it’s doing me good!”

Feedback leaders confirmed how procedures around medicines had been improved since the last assessment. The manager explained how they carried out medicines’ competencies for staff, as well as weekly stock checks and monthly medicines audits.

Processes were in place to ensure medicines were given in line with best practice guidance and appropriate arrangements were in place for the safe management, use and oversight of medicines, including the use of controlled drugs. Medicine records were completed appropriately. Where people were prescribed PRN (as and when required medicines) protocols were in place to help ensure staff know when to administer them. An up-to-date medicines policy was in place to provide guidance for staff. The service also adhered to the principles of STOMP (a national programme designed to stop the inappropriate prescribing of psychotropic medicines). Processes were in place to help ensure people were involved in decisions about their medicines, where possible. Medicine audits were completed monthly. Any lessons were learnt where errors had been found. This included supervisions with individual staff members and additional training as necessary.