Coombe House Residential Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

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

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 79 (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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

Managers completed assessments of people’s needs before they were offered a place in the service. Assessments included details of people’s health, mobility and social needs and identified any risks that people needed support to manage. These assessments included the person and their relatives.

Information was requested from people and their families to gather further details on the person’s life history, communication needs, preferred routines and if anything made the person anxious or upset. The form used was designed by the ‘Alzheimer’s Society’ and the ‘Royal College of Nursing’. This meant that the home ensured all aspects of a person’s health and wellbeing was recorded and used to form the care plan. One person’s relative told us “They are brilliant, [person] been there for about a month. Really informative. Settled in well. [deputy manager] was really helpful and wanted to know everything about [person] so they could help them settle. Staff are all great”.

People’s care needs were assessed regularly by the management team and senior staff. They involved people, where possible, and their next of kin. People told us they were informed of any changes and, when necessary, professionals such as district nurses or doctors were due to visit “so we are able to come as well”.

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

The registered manager demonstrated an exceptional commitment to supporting people living with dementia.

Care and treatment were provided using the latest guidance and research findings to promote good practice and outcomes for people. For example, the registered manager had considered how a study by the ‘UEA Norwich Medical School’ had recommended ways in which care homes could reduce the risk of dehydration and malnutrition for people. Changes had been made based on this research. Staff enjoyed sharing lunch with people whilst ensuring relaxing music was played in the background. Three members of staff had completed additional training, called 'love to move', combining physical movement and psychological exercises, in which people participated and as a result their appetite increased. The provider explained this had involved "considerable learning and supervisions from a suitably qualified trainer".

The home and staff worked to the principles of the ‘Butterfly Approach’ which included staff ‘being with’ people, rather than a task led role and people being able to participate in cooking, gardening and household chores to maintain a sense of purpose.

A leading expert in dementia care told us the registered manager had imbedded best practice dementia care and created a “new culture of dementia care”, which had developed over time”.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The management and staff teams worked jointly with other services and professionals to ensure people received effective and timely care. There were good relationships between the service and external professionals, such as district nurses.

Professionals told us the service worked with them well and commented, “When we attend the home it is always clean and tidy, the staff are friendly. it’s the nicest home we go to” and “My medical students are taken to see what a good care home should be like…I am grateful it’s in my patch; they have looked after tricky patients in a person-centred way".

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Care records showed a range of health care professionals were involved in people’s care and treatment, and staff made appropriate and timely referrals to support people to stay healthy. Staff followed the recommendations of professionals, who confirmed staff worked closely with them to ensure people’s health and medical needs were met.

Lunch was served in the dining room and was observed to be a very social occasion. Staff sat with people and enjoyed having lunch together. A variety of dishes were served including jacket potatoes, salad, grated cheese and tuna in which everyone could help themselves and offer the serving bowl to other people. This meant people could choose what they wanted and how much. Mealtimes were calm, unrushed and soft music was playing in the background.

The manager had considered recent research which identified physical activity had the benefit of increasing appetite. The manager told us 2 staff members had attended additional training. The 'British Gymnastic Training love to Move' was nationally and internationally accredited, and focused on providing an exercise class especially designed for people living with dementia. The activity sessions included physical exercises and had psychological benefits as it was designed to be fun and interactive.

The service was designed to maximise people’s independence and facilitate engagement with tasks and activities within the house and its gardens. A range of interesting activities designed for people living with dementia was available to maximise people’s wellbeing.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The provider consistently monitored outcomes and used feedback to improve care and quality of life. Regular reviews and audits were completed, and feedback from people and relatives informed changes and improvements.

Relatives told us they thought the dedication and commitment of staff and oversight of the registered manager, meant people had positive outcomes. They spoke of how the registered manager and staff were in regular contact and kept them up to date. Records of care confirmed staff monitored peoples care and took prompt action when any changes were noted.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

During the assessment people made their own choices and decisions about what they did, what they ate and how they filled their time. Our observations confirmed staff respected people’s choices and decisions.

All care was provided in the least restrictive way. People could access all areas of the home, including the gardens as they wished.