About the service Colne House is a residential care home providing personal care and accommodation for up to 38 older people, some of whom may have mental health needs and or may be living with dementia. At the time of our inspection 25 people were living in the service.
Colne House is an adapted building, consisting of three floors with a separate annex.
People’s experience of using this service and what we found
Systems and processes in place were not effective enough to review and assess the quality of service provision. This meant the previously demonstrated good standard in well-led had not been maintained. In safe, shortfalls identified in risk management and infection control, meant it remained as requires improvement.
Risks to people had not been fully assessed and action. Improvements were needed to minimise the risk of people experiencing anxiety due to other people living with dementia entering their bedrooms by mistake. Staff monitored people’s temperature and oxygen levels as early indicators of infection and deterioration in health. However, staff had not been given effective training and guidance in the use of pulse oximeters and when to seek medical advice.
We found improvements were needed in the provider’s oversight and monitoring of the service to ensure staff feel valued through good communication.
Staff wore personal protective equipment (PPE) to keep people safe and reduce the risks of cross infection. However, we found shortfalls where staff were not always following safe practice, including hand hygiene, enhanced cleaning and management of risks.
The service continues to follow safe recruitment procedures to ensure only suitable staff were employed to work at the service. A relative described staff as being, “So loving and caring.”
Relatives provided examples of the good relationships they had built up with staff, who kept them updated on any incidents or health issues and systems. They praised the dedication of the new registered manager and staff during the pandemic, sending thank you notes to the service, one referring to staff as the ‘Kingsley Heroes.’
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 20 June 2019). At this inspection we found the rating had changed to requires improvement.
Why we inspected
We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about staffing, monitoring people’s oxygen levels, supporting people living with dementia and infection control. A decision was made for us to inspect and examine those risks.
We inspected and found there was a concern with oversight of the service to check the systems they had in place were effective to support people in a clean and safe environment. So, we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement.
This is based on the findings at this inspection. 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 Colne House on our website at www.cqc.org.uk.
Enforcement
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 have identified breaches of regulation in relation to infection control, risk management and good governance at this inspection.