This inspection was carried out over three days between 12 and 14 February 2018. Our initial visit on 12 February was unannounced.
We last inspected Cawood House in December 2016. At that inspection we rated the service as good in all domains.
Cawood House is one of 11 care homes in Stockport owned by Borough Care Limited. Cawood House is situated in the Brinnington area of Stockport and provides accommodation for up to 42 older people who require accommodation and personal care. All rooms provide single accommodation and nine rooms have en-suite facilities. Bedrooms are located over two floors and can be accessed by stairs or passenger lift. Communal bathrooms and toilet facilities are available throughout the home. The home is divided into two floors; each floor consists of a lounge and dining area. There is a quiet room on the first floor and a garden room on the ground floor. The laundry and large kitchen are located on the ground floor. There is a large enclosed paved patio and lawned areas to the rear of the building that are accessible to people who live at Cawood House.
At the time of our inspection there were 39 people living at Cawood House.
The service had a registered manager in place. 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.
This inspection was carried out in response to information contained in a regulation 28 report from the Coroner’s office. This is a report that is written after an inquest into someone’s death and the Coroner believes there is a risk of other deaths occurring in similar circumstances. Cawood House was not the subject of the regulation 28 report, but was involved in the care of the person who was the subject of the inquest and concerns relating to Cawood House were raised by the Coroner. .
We identified breaches of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches related to Safe Care and Treatment, in particular infection control, accident management, individual risk assessments, care plans and Good Governance. You can see what action we told the provider to take at the back of this report.
We made three recommendations. One recommendation relates to the provider taking action to ensure people always receive their specifically prescribed fortified diet when required. The second recommendation relates to ensuring handover and meeting notes are completed. The third recommendation relates to ensuring only current policies and procedures are in place.
People, their relatives, visitors and staff spoke highly of the service; one person told us, “I can’t fault the home…There’s nothing they could do to look after [name] any better.”
During this inspection we found that there were enough staff available to meet people’s needs and they were being cared for by people who knew them well.
People were supported by staff who were kind and caring and ensured people’s dignity was respected when providing care and support.
The staff files we looked at showed us that safe and appropriate recruitment and selection practices had been completed by management to satisfy themselves that suitable staff were employed to care for vulnerable people.
Staff we spoke with were aware of how to safeguard people and were able to demonstrate their knowledge around safeguarding procedures and how to inform the relevant authorities if they suspected anyone was at risk from harm.
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 support this practice.
Relatives and staff gave us mixed feedback regarding the menu and food choices provided at the home. One relative told us, “The food is lovely.” One staff member told us, “The food could be better…The people on a soft diet seem to get the same.”
Care records at the home showed us that people received input from health care professionals, such as nurses, opticians and podiatrists. For example, we saw the district nursing team visiting the home to provide diabetes care and check people’s skin integrity.
Medicines were safely managed at the home.
Some care files we looked at did not always accurately reflect people’s current care needs as they had not always been kept up to date and relevant risk assessments were not always in place.
During our initial tour of Cawood House on the first morning of our inspection, we saw that the home was clean. However, we were aware of a malodour due to problems with drainage under the building and the home was having difficulties with the boiler system. The registered manager told us they were aware of the problem and they were in the process of rectifying the issues. The malodour had resolved by the end of our inspection; however, contractors were still remedying the boiler.
A full-time activities co-ordinator was employed and a full range of activities offered at the home.
There was a complaints policy in place and we saw that complaints were acted upon. The home had also received a large number of compliments.
People we spoke with were complimentary regarding the registered manager and felt they had made a positive impact on the home since their arrival in September 2017.