Coombe House Residential Home

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question outstanding. At this assessment the rating has remained outstanding.

This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

This service scored 100 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity.

Staff demonstrated an extremely compassionate approach with people. Staff consistently showed warmth and respect in every interaction, ensuring people felt valued and listened to.

People and relatives repeatedly told us staff were exceptionally kind and caring. Comments from relative’s included, “[Person’s name] is happy, cared for and loved here” and “The way they are with everyone is lovely, they give people a hug, it has taken so much pressure off the family it is amazing”.

This exceptional level of kindness had a tangible and powerful impact on people’s quality of life. People were emotionally secure, relaxed, and felt genuinely at home, which enabled them to build trusting relationships, express preferences confidently, and engage more fully in daily life. Relatives told us this compassionate culture reassured them that their loved ones were not only well cared for but genuinely cherished. The emotionally supportive approach to care contributed to people experiencing increased wellbeing, reduced anxiety, and a strong sense of belonging within the home.

The service had a welcoming, positive environment, and we heard lots of laughter and meaningful interactions during our visit. People were encouraged to retain and fully express their individuality and share their sense of humour with others. We observed staff engaged in relaxed, friendly conversations, using humour appropriately and always maintaining privacy.

Healthcare professionals told us the atmosphere and staff behaviour seen on the day of our inspection was “not for show” and reported staff were consistently kind and caring.

The provider treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The provider took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Care plans were highly personalised, reflecting cultural, social and religious needs alongside communication preferences.

People were respected and celebrated as individuals, with diverse and unique skills and stories to share. We observed staff practice being exceptionally patient, person centred and very responsive to individual needs. For example, one person who was taking part in group activity decided that they no longer wanted to participate and wanted to go into the lounge. Staff supported the person immediately in a kind manner that did not disturb the group.

People gave positive feedback about the care, empathy and understanding shown by the staff team. One person explained their relative’s dementia had deteriorated prior to living at the home “But since being here she is less anxious”.

The service fully demonstrated that treating people as individuals was embedded in its culture and practice. This included staff having a clear and detailed knowledge about each person’s life, preferences, and values. During the assessment staff shared people's interests prior to us meeting them. For example, one person had appeared in a fashion magazine, this article was framed in their bedroom and allowed visitors and staff to be able to chat to the person about their experience which the person appeared to enjoy.

People were fully respected as individuals and were supported to achieve their goals. For example, each person had highly personalised care provision, which was directed by them, as a partner in their support planning. This was evident in the interactions between staff and people, the activities planned with people, and ensuring people were fully engaged in decision-making where possible.

The service supported people to regain and maintain their independence, make choices, and feel a sense of control over their lives. For example, 1 person had been living at the home and had an authorised Deprivation of Liberty Safeguard (DoLS) in place, which meant the person would continue to reside at the home. The person wanted to return to their house and a legal challenge resulted in the DoLS being lifted. The service supported the person during this process and ensured they were able to return if they changed their mind.

The provider was exceptional at promoting people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

People living at the home and their relatives were involved in all aspects of their care and support. The manager was dedicated to ensuring choice was consistently provided to promote outstanding care provision. The manager said, “We are determined to prove that in the last years of life with dementia there is still Joy”.

During the assessment we observed a range of activities taking place which reflected people’s previous hobbies and interests, these included pottery, gardening, art and cooking. Feedback from relatives included “[name of person] Mum used to be a ceramicist and they do that with [them], they have chickens and an art room, they have got everything [name of person] would want” and “they do such a lot, [person’s name] loves the music, they ensure [person’s name] is involved. Loads of activities, always something going on”.

Staff respected and valued people’s contribution to the running of the home. People were encouraged and supported to take responsibilities for tasks and chores around the service. Staff ensured people were able to engage with tasks whenever they wished. For example, we observed a member of staff in the kitchen hand washing dishes. Aperson entered the room, the staff member immediately ran cold water into the sink, to lower water temperatures and once safe, stepped back to allow the person to take over this task if they wished. This subtle and enabling action demonstrated the service’s commitment to supporting people to be as independent as possible. This person later told inspectors in response to a question about the quality of food in the service, “It really is good, I am one of the cooks”.

The service had extensive grounds that were accessible to everyone as doors were not locked. Seating areas and covered spaces were provided for people to enjoy being outside. There was a ‘potting’ shed in which people helped the gardeners. People told us they enjoyed being outside and relatives said this ability and ‘freedom’ had a positive impact.

The manager was focused on providing the environment and support necessary to enable people living with dementia to live their best lives. They told us, “Anyone who lives here lives with dementia and need have no boundaries to their everyday life…daily recording shows the richness of life here”. We reviewed the care notes which demonstrated how staff had provided support and encouragement to enable people to achieve their goals. People were able to get up and go to bed when then wished and breakfast was served throughout the morning when people choose to get up.

The provider was exceptional in how they listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Staff responded in a calm and caring manner when a person required assistance or urgent medical help. Any changes in a person’s condition were identified immediately because staff knew people well. This meant specialist support could be requested promptly. For example, 1 person had recently started coughing occasionally during meals. The staff ensured that a referral to the ‘Speech and Language Therapist’ (SALT) team was made to ensure the person was safe and did not experience any distress.

The staff team acted to ensure people recovering from illness were supported to achieve optimum levels of health and wellbeing and reduce symptoms. Following a recent illness one relative contacted the home and stated, “I know [name of person] is always in good, safe hands with you, but the way everyone helped [name of person] to recover from this illness was exceptional. The love and kindness, the attention to little things all made a difference- like bringing [them] chopped fresh fruit, encouraging [them] to stand tall, making [them] laugh. Suggesting the giant game of scabble which [they] really enjoyed, enjoying cuddles with Sion the dog, and getting [them] involved in pottery again. All these things and more so clearly helped build [their] strength and happiness”.

The manager described how care and support extended to people’s relatives and loved ones to reduce anxiety and ensure personal relationships were maintained. One relative stated, “[Name of person] only moved in on Monday. [The manager] and the girls have been amazing. They have made a very difficult thing quite pleasurable. They have made [name of person] feel safe and comfortable and [name of person] has all of [their] special things around [them]. They are outstanding”

The provider always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care.

The manager demonstrated exceptional care of each staff member and told us, “We want the staff to feel as looked after as much as the people that live here”.

Staff told us they loved working at the home and valued the opportunity to support people’s independence. Staff comments included, “It’s really good, really friendly, big happy family. Everyone is working towards same goal. Everyone treated the same way, respected and supported to do what they can” and “The best bit is some of the quirky conversation you can have with people. You just feel you are making a small impact in that moment. Making people not feel different, I think it is special".

Staff wellbeing when incidents occurred was considered, and discussions were held to give staff the opportunity to discuss how they felt in difficult situations and what could have been better. This practice supported both staff wellbeing and practice development as any learning was shared promptly with other staff to help minimise the risk of similar events reoccurring.

The home employed staff to fulfil several roles. The manager told us the rotas were completed with an understanding of individual staff needs, such as childcare arrangements. Staff also told us shift patterns were changed to ensure a good work life balance.

Supervisions were carried out and any concerns could be raised and addressed.

When staff resign, they were encouraged to complete an ‘exit interview’ in order for the manager to understand their reasons for leaving, what that staff member had enjoyed and what had been a challenge whilst working in the home. The manager told us this was a way of continuously improving the experiences of staff. We reviewed these records and noted that staff had resigned due to issues unrelated to their work. One staff member had commented, “I am very grateful for the kindness that was shown to me after announcing my resignation”.

The home worked in partnership with a local college and encouraged volunteers to come and assist in the home to develop their skills and experiences. We observed one volunteer who was laying the dining room tables for lunch. They were supported by a member of staff from the college. The volunteer was very conscientious and spoke with people whilst carrying out their task. The manager had ensured appropriate checks and risk assessments had been completed with the college to ensure the volunteer and people who live in the service were safe. By offering these volunteering opportunities the service supported development of individuals and enabled their practices to be shared with other local care providers.