Cow Lees Care Home

This assessment was completed to follow up on action we told the provider to take at the last inspection. The provider was previously in breach of the legal regulations in relation to consent, safe care and treatment and good governance. Some improvements were found at this assessment and the provider was no longer in breach of the regulations in relation to consent and safe care and treatment. However, the provider remains in breach of the regulation relating to good governance because not enough improvement was made. We also found a breach related to premises which had potential to put people at risk of harm.

The provider had improved their quality assurance systems since the last inspection and there were systems and process however these were not fully embedded in day-to-day practice. Where checks were delegated to others, there was limited or no oversight to ensure those checks were completed or accurate. A lack of effective checks of the environment put people at risk of harm. We found some fire doors may not provide the right amount of protection in the event of a fire because checks did not identify potential problems. Exposed radiators, window restrictors and some windows that could become an entrapment risk put people at risk of harm. Infection control practices required improvement to limit the risk of cross infection. People were supported to use a courtyard, but people were under supervision at all times because of risks within the courtyard. There was a lack of consideration to balance and managing risk with constant supervision and people’s freedoms.

Staff considered decisions in people’s best interests where they did not have capacity, but these were not always recorded clearly to evidence why specific decisions were reached. Staff reviewed assessments taking account of people’s communication, personal and health needs. Staff worked with agencies involved in people’s care to support the best outcomes. Our observations showed staff were on hand to support people when situations quickly escalated. People had opportunities to provide feedback through ‘resident of the day’ and via feedback forms. Staff protected people’s privacy and dignity and offered people choice in their day to day activities.

Staff received training relevant to their roles to keep their skills and practice updated. Managers told us they completed staff supervisions and observations of staff practice. People were protected and kept safe from abuse. Where accidents and incidents took place, managers reviewed and investigated those to learn lessons which staff told us where shared with them to keep people safe. Managers worked well with external teams to ensure people received the right care at the right time. It was evident there were improvements from the previous inspection, but more work was needed. The management team were committed to continue to improve where required to make sure people received care in a safe way.