Archived: Cunningham House

Updated 22 December 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.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was undertaken by one inspector.

Service and service type

Cunningham House 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. Cunningham House 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

This inspection was unannounced.

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 the information the provider sent us in the provider information return (PIR). 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. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people who used the service and received feedback from 5 people’s relatives about their experience of the care and support provided. We spoke with the registered manager, 2 heads of care, 2 care team leaders and we received feedback from 6 members of care staff.

We reviewed a range of records. This included 3 people’s care plans and 2 staff personnel files to review the provider’s recruitment practices, including induction arrangements. We undertook a physical count of a random selection of medicines and reviewed 5 people’s medicine records. We also looked at the provider’s staff training records and supervision arrangements. A variety of records relating to the management of the service, quality assurance information and policies and procedures were viewed.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 22 December 2023

About the service

Cunningham House is a residential care home providing personal care for older people. Younger adults and people living with dementia. The service can support up to 54 people, at this inspection 20 people were living at Cunningham House

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

People did not always receive personalised care and support. People were not always supported to have maximum choice and control of their lives and staff did not always support them in their preferred way and in their best interests. People’s personal preferences were not always respected and their independence was not always promoted.

The provider had arrangements in place to assess and monitor the quality of the service provided. However, these processes had not been effective in addressing shortfalls in relation to personalised care and promoting people’s independence.

The provider had made suitable arrangements to help keep people safe. Staff had received training about safeguarding people and understood how to report any concerns. Risks to people were identified and managed to help prevent them from receiving unsafe care and support. The provider’s arrangements for medicine administration helped to ensure people received their medication in accordance with the prescriber’s instructions and staff’s practice was safe.

Staffing levels were appropriate to meet people’s care and support needs. Robust recruitment procedures were followed to help ensure the right staff were employed to care for people. People were protected by the provider’s arrangements for the prevention and control of infection.

Feedback about the management was overall positive. Staff felt there was more support available to them now after a period of instability in the home’s leadership, which had negatively impacted on morale and culture in the home.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 05 November 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found the provider remained in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 21 September 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the safe care and treatment, staffing, personalised care and overall management oversight.

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.

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 remains Requires Improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cunningham House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified continued breaches in relation to personalised care and management oversight. Please see the action we have told the provider to take at the end of this report.

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.