16 March 2022
During an inspection looking at part of the service
Cosham Court Nursing Home provides care and accommodation for up to 47 people. The home specialises in providing care to older people, who have nursing needs. At the time of our inspection there were 32 people living at the home.
People’s experience of using this service and what we found
We could not be fully assured the provider had effective management of infection control risks to keep people safe.
Some areas of the home were poorly maintained, so could not be effectively cleaned and staff failed to wear personal protective equipment, such as masks appropriately.
The provider’s quality assurance systems had not always been used effectively to either identify areas for improvement and/or to bring about effective improvement.
Care records including care plans and risk assessments did not provide clear and consistent information in relation to people’s needs and abilities and some information was conflicting. This placed people at risk of receiving inappropriate and ineffective care and treatment which could result in harm.
On day one of the inspection we could not be assured people’s prescribed topical medicines were consistently applied as required. When this was discussed with the staff this was immediately addressed. All other medicines were managed safely.
Appropriate recruitment procedures were in place and there were enough staff to support people's needs. Staff had received training and support to enable them to carry out their role safely.
There were appropriate policies and systems in place to protect people from the risk of abuse. 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 policies and systems in the service supported this practice.
Relatives had mixed views about communication with the staff at the home and the opportunity to speak to their loved ones. However, people and relatives were also complimentary about many aspects of the service and described staff as kind and responsive.
CQC were notified of all significant events that occurred in the service and the previous performance rating was prominently displayed on the premises as per requirements.
The service worked in collaboration with all relevant agencies, including health and social care professionals. This helped to ensure there was joined-up care provision.
The provider was responsive to our feedback and discussed how they planned to make changes to improve the service.
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 10 April 2019).
Why we inspected
The inspection was prompted in part due to concerns received about; staffing levels, the management of people’s nursing and personal care needs and good governance. As a result, we undertook a focused inspection to review the key questions of safe and well-led only to examine those risks.
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. This included checking the provider was meeting COVID-19 vaccination requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cosham Court Nursing Home on our website at www.cqc.org.uk.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to the infection control, risk management and the governance of the service.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will continue to monitor information we receive about the service, which will help inform when we next inspect.