An adult social care inspector carried out this inspection. At the time of this inspection Cotleigh was providing care and support to 60 people, some of whom had a diagnosis of dementia. We spoke with twelve people living at the home, seven relatives and two visiting professionals to obtain their views of the support provided. In addition, we spoke with the registered manager, the deputy manager, two team leaders, four care staff, the activities worker, a senior cook and a domestic about their roles and responsibilities.We gathered evidence against the outcomes we inspected to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?
Below is a summary of what we found. The summary is based on speaking with people using the service, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read our full report.
Is the service safe?
People supported by the service, or their representatives told us they felt safe.
People told us that they felt their rights and dignity were respected.
Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.
We found that risk assessments had been undertaken to identify any potential risk and the actions required to manage the risk. This meant that people were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.
The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant that people would be safeguarded as required.
The service was safe, clean and hygienic.
Is the service effective?
People's health and care needs were assessed with them and their representatives, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required.
Staff were provided with training to ensure they had the skills to meet people's needs. Managers' were accessible to staff for advice and support. Staff were provided with formal individual supervision and appraisals at an appropriate frequency to ensure they were adequately supported and their performance was appraised.
Visitors confirmed that they were able to see people in private and that visiting times were flexible.
Is the service caring?
We asked people using the service and relatives for their opinions about the support provided. Feedback from people was positive, for example; 'it is very good here, the staff are very caring', 'they (staff) give me the help I need' and 'they (staff) are lovely. Just ask and you get'.
When speaking with staff it was clear that they genuinely cared for the people they supported and had a good knowledge of the person's interests, personality and support needs.
People using the service and their relatives completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
Is the service responsive?
People regularly engaged in a range of activities in and outside the service. The home had access to a shared adapted minibus, which helped to keep people involved with their local community.
Some people required specialised diets for health or personal reasons. We found the service provided food and drinks specifically requested by people. People told us, 'The food is good home cooking, they (staff) always ask us what we want to eat' and 'we always have drinks. I can't complain about the food at all'.
People spoken with said they knew how to make a complaint if they were unhappy. We found that appropriate procedures were in place to respond to and record any complaints received. People could be assured that systems were in place to investigate complaints and take action as necessary.
Is the service well-led?
The service worked well with other agencies and services to make sure people received their care in a joined up way. However, we found some information had not been shared with agencies that managers have a responsibility to report to. This meant that full and safe procedures had not been adhered to so that people's safety and well-being was promoted.
The service had a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. However, we found that some audits had not been undertaken at the identified frequency. This posed a risk as full monitoring had not taken place to identify and act on any issues.
Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and the quality assurance processes in place. This helped to ensure that people received a good quality service at all times. Whilst staff were provided with a range of training, we found the procedures for the provision of refresher training had not always been adhered to so staff skills were maintained.
We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to quality assurance, and the improvements they will make to ensure information is shared with appropriate agencies and that audits and refresher training is completed at the required frequency.