Archived: Colindale Care Home

Colindale Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Colindale Care Home specialises in providing care to people living with dementia. It accommodates up to 14 people in an adapted house. Individual bedrooms are located on all four floors, and there is a stairlift between the ground and first floors. There were 13 people living there when we inspected.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe and Well Led to at least good. At this inspection, we found that action had been taken to meet the regulations for both of these key questions, although further improvements were required in relation to Safe.

At our last inspection in November 2017 we asked the provider to make improvements to how medicines were stored and managed. This action has now been completed. Medicines were stored securely and managed safely. We have made a recommendation about the recording of variable doses of medicines.

At our last inspection in November 2017 we also asked the provider to make improvements to how they monitored and managed the quality of the service. This action has now been completed. There were arrangements in place to monitor and improve the quality of the service.

The provider acknowledged that refurbishment of paintwork, tiling and carpets was needed in various parts of the home. The provider had already identified and planned to address most of the issues we found.

The premises were kept as clean as they could be, given the maintenance improvements that were necessary, and most areas smelt fresh. Routine infection control measures, such as hand cleansing and staff use of personal protective equipment, were in operation.

Care and support was planned and delivered to promote a good quality of life. People’s needs and choices were assessed holistically and their care was personalised according to their individual needs. Assessments and support plans flagged people’s sensory and communication impairments and how staff should assist them to communicate. A range of activities was provided, and people were supported to access the local community. People had the support they needed to eat and drink enough. Medical attention was sought promptly if people became unwell or to address unplanned weight loss.

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 supported this practice. Risks were assessed and managed with the fewest possible restrictions. Records were up to date, securely stored and readily accessible. Staff understood their responsibilities for safeguarding people from abuse and discrimination. Recruitment procedures protected people from staff who were known to be unsuitable to work in care.

Staff were motivated and proud of their work and there was a strong sense of teamwork. There were sufficient staff to provide the care people needed. Staff had the necessary skills and knowledge. They were supported through training, supervision and appraisal.

People were treated with kindness and compassion. Staff knew and cared about the people they were supporting. They noticed when people looked upset and were quick to support them. They maintained people’s dignity and as far as possible promoted their independence.

People were supported at the end of their lives to have a dignified, comfortable death when the time came.

Lessons were learned, and improvements made when things went wrong. Complaints were taken seriously and used to improve the quality of care.

The service had a friendly, homely feel. The provider and staff had informal, open communication with people and their families and friends. Staff reported they were starting to have more communication with the provider and business manager. We have made a recommendation regarding the ongoing development of communication between the management and staff teams.

The provider had developed working relationships with the local authority safeguarding and contracts teams, and this had supported them to plan for and bring about improvements. Legal requirements were understood and met.

This unannounced comprehensive inspection took place on 15 and 16 November 2017.

There was a registered manager employed at the service. 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.’

People told us they were happy living at the home and felt they were well cared for. Relatives spoke positively about the way care and support was given. One relative said, “We’ve been very happy with the general care and have no complaints, any problems are sorted straight away…it’s been very good.”

At this inspection we found two breaches of the regulations.

People received their medicines as prescribed but we found weaknesses regarding the storage and management of medicines. This was a breach of the regulations.

We identified weaknesses in the provider’s governance systems. The provider’s existing audits and systems had not identified these weaknesses which meant these audits and systems were not fully effective. This was a breach of the regulations.

Staff were aware of what constituted abuse and the actions they should take if they suspected abuse. Relevant checks were undertaken before new staff started working at the service which ensured they were safe to work with vulnerable adults.

Staff had the right skills and training to support people appropriately. Staff spoke knowledgeably about how people liked their care and support to be given. Staff had completed or were in the process of completing The Care Certificate, which is a nationally recognised set of standards for health and social care workers.

Staff told us they felt well supported to carry out their roles and told us everyone worked very well together as a team for the benefit of the people living at Colindale Care Home.

Pre-admission assessments were completed prior to people moving into the home. People’s risks were assessed and plans developed to ensure care was provided safely. Accidents and incidents were monitored to ensure any trends were identified to enable action to be taken to safeguard people.

People were referred to health care professionals as required. If people needed additional equipment to help them mobilise or keep them safe and comfortable this was readily available.

The manager was aware of their responsibilities in regard to the Deprivation of Liberty Safeguards (DoLS). These safeguards aim to protect people living in care homes and hospitals from being inappropriately deprived of their liberty. These safeguards can only be used when there is no other way of supporting a person safely.

Staff ensured people’s privacy and dignity was protected. People received personalised care from staff who were responsive to their needs and knew them well. Staff created a relaxed, friendly atmosphere in the home.

People told us they enjoyed the choice of home cooked food that was available at Colindale Care Home. Food was presented in an appetising way and people were supported sensitively to eat their meals whilst being encouraged to retain as much of their independence as possible.

People had access to a range of activities that they enjoyed taking part in. We observed individual and group activities were available for people throughout our inspection.

People told us they knew how to make a complaint and said staff listened to them and took action if they needed to raise concerns or queries.

People told us they felt the service was well led, with a clear management structure in place. Relatives told us they were made to feel welcome at any time and were always kept informed of any changes to their relative's health and care needs.

There were some systems in place to drive the improvement of the safety and quality of the service. The manager was in the process of implementing further quality assurance systems.

We observed how people were cared for and supported.

People were consulted about the way they were cared for where they could give consent. Where people did not have the mental capacity to be consulted about the way they were cared for, best interest decisions were made on their behalf.

People's care needs had been assessed and care plans developed so that staff knew how to care for people.

There were suitable arrangements in place for safe administration, storing and disposal of medicines.

The provider had taken action to eliminate risks to people that we had identified at inspection visits on 6 February 2013 and 28 May 2013.

There has been a change to management structure of the home, but the provider was able to demonstrate that they had overall responsibility for the day to day running of the home.

There were systems in place to monitor the quality of service provided to people.

People were involved in their care to the extent that their dementia allowed. Relatives were involved where best interest decisions were made on behalf of people living at the home.

People's care needs had been assessed and care plans put in place so that staff knew how to support people.

People were protected from the risks of abuse as staff had been trained in adult abuse and the protection of vulnerable adults.

The temperature of some of the radiators in the home did not protect people from the risks of receiving burns from hot surfaces.

There were robust recruitment procedures in place to make sure that suitable staff were employed to support people.

There were systems in place to monitor the quality of service provided to people living at Colindale Care Home.