Cosin Lodge

Updated 9 June 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.

Inspection team

This inspection was carried out by 1 inspector.

Service and service type

Cosin Lodge 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. Cosin Lodge is a care home without 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

We gave the service 24 hours’ notice of the inspection. This was because we did not want to cause anyone who used the service any distress by attending unannounced.

Inspection activity started on 12 April 2023 and ended on 28 April 2023. We visited the service on 12 April 2023 and 13 April 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We met with 3 people who used the service and observed their interactions with staff. We spoke with 2 relatives about their experience of the care provided. We spoke with 5 members of staff including the registered manager, the deputy manager and 3 support workers. We spoke with 1 professional who worked closely with the service.

We reviewed a range of records. This included 2 people’s care records, 2 staff recruitment files and medicine records for 2 people. A variety of documents relating to the management of the service, including policies, audits and training records, were reviewed.

Updated 9 June 2023

About the service

Cosin Lodge is a residential care home providing accommodation and personal care to up to 4 people. The service provides support to people with learning disabilities and autistic people. At the time of our inspection there were 4 people using the service.

Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection, 3 people using the service received personal care.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: Systems and processes were not always robust enough to ensure people were safeguarded from the risk of improper treatment. People were generally supported to have maximum choice and control of their lives, but documentation was not in place to assure us that staff always supported people in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. We found the use of 1 restrictive practice where documentation and procedures around its use were not robust. The registered manager took steps to address this immediately.

The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. People had a choice about their living environment and were able to personalise their rooms. Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

Right Care: The service had enough appropriately skilled staff to meet people’s needs and keep them safe. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. People were supported to attend medical appointments.

Right Culture: Quality assurance systems and processes were in place. However, they were not robust enough around the use of a restrictive practice and this had not been identified.

There was a culture of learning within the service. Lessons learnt were shared with staff in meetings, supervisions and appraisals. There was a positive culture within the service. Staff felt supported and valued. Feedback was sought from staff, people, relatives and professionals. Actions were implemented in response to the feedback received.

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 2 October 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

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. 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 Cosin Lodge on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified a breach in relation to having appropriate systems, processes and documentation in place to ensure people are receiving appropriate treatment and safeguarded from potential improper treatment.

Please see the action we have told the provider to take at the end of this report.

We have made a recommendation about the effectiveness of oversight of restrictive practices.

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 work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.