College Hill Residential Home

We found the following examples of good practice.

The service followed current government visiting guidance. There were safe visiting arrangements in place. Visitors were required to have a confirmed negative lateral flow test at home or when they arrived at the care home. There was a designated room for visitors to complete lateral flow tests when they arrived at the care home. Visitors were required to wear appropriate personal protective equipment (PPE) and hand washing before and after visiting.

There were arrangements to manage infection risks. There was an up to date infection control policy in place and there were standard operating procedures that were regularly updated in line with changes in government policy. Staff and people receiving care had received all doses of the vaccine. Regular testing was also carried out for people, visitors and visiting professionals in order to identify any positive cases as early as possible so that people could self-isolate to reduce the spread of infection.

All staff had received training about COVID-19, hand washing and in the proper use and on donning and doffing of PPE. The service carried out monitoring checks of staff infection prevention control (IPC) practice and further training was provided when needed. This helped to assure the provider that people were protected and safe.

The service had ensured there were sufficient supplies of PPE. During the COVID-19 pandemic, the service was able to reliably get hold of enough of the right PPE to meet people’s needs.

Any staff or person who had tested positive, were isolated in line with government guidance. This minimised the risk of spreading infection in the care home.

During the pandemic the provider promptly communicated with staff, people and relatives. This and regular communication with the host local authority, public health teams, community healthcare professionals and managers from other care homes helped to ensure the home carried out good IPC practice that kept people safe.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

People were protected from the risk of abuse because staff had a clear understanding of the safeguarding process. There were risk assessments in place to reduce risks to people’s safety. These were reviewed regularly to ensure appropriate action was taken to mitigate the risk. We saw that people’s medicines were handled safely. There were suitable arrangements for the recording, storage, administration and disposal of medicines. There were enough staff deployed to meet peoples care needs and we saw evidence that new employees were checked before they could commence work to ensure they did not pose a risk to people who used the service.

Staff had access to a variety of training. Regular supervisions and appraisals were also provided to staff. People had choice of a nutritious and well-balanced diet. The service ensured that people’s health was monitored and if required external health care support was sought to ensure people’s health and wellbeing was maintained. People's capacity to make choices had been considered in line with the Mental Capacity Act 2005 (MCA). However, we found that the service could do more so that the environment was more supportive and enabling for people with dementia.

People told us staff were caring and compassionate. We observed that staff treated people with respect and dignity. People's individual preferences were respected. Staff demonstrated a good understanding of protecting and respecting people's human rights. They treated people's beliefs and cultures with respect. The service was mindful of the information they received about people. It recognised people’s rights to privacy and confidentiality. The service had updated its confidentiality policies to comply with the new General Data Protection Regulation (GDPR) law, which came into effect on 25 May 2018.

People received care that reflected their likes, dislikes and preferences. This was evident in all areas of care. People had been consulted when their care plans were written. The care plans were being regularly reviewed and updated to ensure they reflected people's changing needs and wishes. People confirmed that they could complain if needed. There was a complaints procedure which they were aware of. There was a programme of activities organised by the home, which people participated in.

There were structures, processes and systems to support good governance. The registered manager had established policies, procedures and activities to ensure safety. The service had effective systems in place to continually monitor the quality of care and people were asked for their opinions and action plans were developed to address shortfalls.

College Hill Residential Home provides accommodation and care for a maximum of 11 older people some of who may have dementia. There were 11 people using the service on the day of the inspection.

The home had 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 2008 and associated Regulations about how the service is run.

We observed people receiving care to be comfortable and relaxed in their home environment and in the presence of staff. They told us they felt safe and content and were generally complimentary about the standard of care provided.

People receiving care told us the service was meeting their needs. We found their needs had been assessed and planned for so that staff understood how to provide care and to keep them safe from harm.

We received consistent feedback from people regarding the competence of staff. They told us staff were excellent and compassionate. The provider had a programme of staff induction that was tailored to current care standards. Additional support structures for staff were in place in the form of supervisions, appraisals and ream meetings.

Staff knew what to do if people could not make decisions about their care needs. Where possible, people were involved in decisions about their care and how their needs would be met. Otherwise, arrangements were put in place for relatives or other representatives who could represent their best interests.

People were supported to eat and drink. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs.

The interactions between staff and people were positive and responsive. People’s choices were respected. We observed staff engaged with people in a compassionate manner.

There were systems to monitor important aspects of the service. This ensured the services continued to receive internal and external audit, which were used to monitor quality and to make improvements.

We used a number of different methods to help us understand the experiences of people using the service, because people using the service had complex needs which meant they were not able to tell us their experiences. We observed the care provided and the interaction between staff and people who used the service. We also spoke with six care staff. We also read comments from relatives and spoke with a health care professional.

Below is a summary of what we found. The summary describes what people using the service and staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

We observed that staff were constantly supervising people to ensure that they were safe. Care records contained risk assessments which provided guidance to staff on action to take to keep people safe. CQC monitors the operation of the Deprivation of Liberty Safeguards (DOLs) which applies to care homes. While no applications have been submitted, appropriate policies and procedures were in place. When speaking with staff we found most had an understanding of the Mental Capacity Act (MCA) 2005 and the DOLs and how it applied to the people they were providing care and support to on a daily basis.

Is the service effective?

Comments from relatives and a health care professional indicated that the service was effective and responsive to the needs of people. People's health and care needs were assessed with them, and they were involved in writing their plans of care. People's likes and dislikes were documented and staff we spoke with were aware of these. There was evidence that people's needs had been attended to by healthcare professionals such as psychiatrist, dentists and their GP.

Is the service caring?

We observed that people who used the service were well cared for. We saw staff attending to people and offering them drinks. Staff were gentle and pleasant towards people. We noted that people were able to approach staff freely and came to them when they needed help. Comments from a health care professional and relatives indicated staff were caring towards people. People's preferences, interests, aspirations and their diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

We observed that staff were attentive towards people and when people needed help or attention, staff responded immediately. During the inspection, a few people changed their choice of meals and this was accommodated by staff. People's bedrooms had been refurbished and decorated to suit people's needs.

Is the service well-led?

The home did not have registered manager. An area manager who was knowledgeable about the role and responsibilities was overseeing the day to day management of the home. There were arrangements for monitoring the quality of care provided. Regular audits on all aspects of care, health and safety were carried out. As a result the quality of the service was continuingly improving.