Old Wall Cottage Care Home

Updated 2 February 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by two inspectors, a nurse specialist advisor 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

Old Wall Cottage is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Old Wall Cottage is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 3 people and 12 family members about their experience of the care provided. We spoke with 12 members of staff including the registered manager, deputy manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We received feedback from 2 healthcare professionals.

We reviewed a range of records. This included 7 people's care and support records and medicine administration records. We looked at five staff files in relation to recruitment and training. We also reviewed a variety of records relating to the management of the home, including policies and procedures, staffing rotas, accident and incident records, safeguarding records and reports.

Updated 2 February 2023

About the service

Old Wall Cottage is a residential care home providing personal and nursing care to up to 36 people aged 65 and over, many of whom live with dementia. At the time of our inspection there were 34 people using the service, living in two units (Topaz and Sapphire).

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

Improvements had been made and the home was well-led. The registered manager had a robust governance and auditing system in place. Audits were up to date and identified any lessons learnt following incidents and accidents so that they could take action to keep people safe. Notifications were submitted to CQC in a timely manner.

The planning and provision of meaningful activities for people had improved. They considered people’s individual needs and preferences, including those cared for in their rooms. The environment was enhanced so that people who lived with dementia were able to locate themselves around the building. Adjustments were made so that people could spend time in quite spaces as they chose.

People told us they were safe at Old Wall Cottage. Staff understood their responsibilities in safeguarding people from abuse and knew how to report any concerns they had. Assessments were carried out to identify any potential risks to people and measures put in place to mitigate these. Medicines were managed safely. The home was clean and hygienic, and staff maintained effective systems of infection prevention and control. The provider exercised safe recruitment practices.

There were enough staff on each shift to keep people safe and meet their needs. People told us they did not have to wait when they needed support and did not feel rushed when staff provided their care. Staff received an induction when they started work and had access to the training they needed for their roles. Staff were expected to meet regularly with their managers for supervision and appraisal.

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. People were supported to maintain good health and to access healthcare services when they needed them. They received person centred care, planned and reviewed to meet their individual needs. People and relatives told us staff knew them well. Staff supported people in a kind and compassionate way, considering their dignity and respect.

People, relatives and staff spoke positively of the culture within the home. Communication amongst the staff team was effective, which helped ensure people received safe and effective care. Staff were well-supported by their managers and colleagues and felt valued for the work they did. Staff and managers had developed effective working relationships with other professionals involved in people's care and implemented any professional guidance effectively.

The home was following up to date government guidance relating to COVID-19 for care homes. Cleaning and infection control procedures followed the relevant COVID-19 guidance to help protect people, visitors and staff from the risk 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 and update

The last rating for this service was requires improvement (published 20 September 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Old Wall Cottage on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.