Cumberland House

We found the following examples of good practice. People living at the home often went out independently for walks and visits. A robust testing regime ensured all people were re-tested on returning to the home to minimise the risk of spreading the virus within the home. Staff spent time reassuring people whose anxiety had increased due to the pandemic, explaining the latest guidance and supporting people by spending time talking to them.

Cumberland House is a residential care home providing personal care and nursing care to older people, male and female who are living with mental health needs. Some people have lived with anxiety and depression for many years and others have specific conditions like Korsakoff’s syndrome. The service can support up to 18 people and at the time of the inspection there were 11 people living at the home.

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

People were safe and were protected from harm and abuse. Staff had received safeguarding training and were able to describe different types of abuse and what they would do in a variety of circumstances. A whistleblowing policy was in place. The home was clean, tidy and free from unpleasant odours. Fire and other safety checks were carried out regularly and accidents and incidents were reported. Staff were recruited safely and there were enough on duty every shift. Staff understood risk and the need to update care plans. People were supported to take their medicines.

Staff received a comprehensive induction which was supported by ongoing training. Training was tailored to address the needs of people living at Cumberland House. People were supported to access health and social care professionals. People were offered a variety of food and drink according to their wishes and dietary needs. Staff sought consent from people and provided people with choice. People were supported in the least restrictive way and best interests’ meetings took place according to needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were treated with kindness and were shown respect and compassion. Staff understood people and what their day to day care and support needs were. People’s privacy, dignity and independence were supported.

People received person centred care and staff knew them well. Most people were independent and could come and go from the home as they wished. At the home there were activities for people to take part in if they wished. A complaints policy was in place and was accessible to everyone. Very few complaints had been made but people and relatives were aware of how to complain and raise issues if needed. People were supported well and with dignity towards the end of their lives.

The registered manager knew people well and provided daily support to people and staff. Auditing processes were in place and Cumberland House had established good working relationships within the community and among professionals such as GP’s, district nurses and pharmacists.

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

Rating at last inspection

Good. (Report published 22 March 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The home is registered for 18 people with mental health needs, but actually provides support for up to 14 people and there were 12 people living at the home during the inspection. Some people were independent and needed minimal assistance while others required some assistance with looking after themselves due to their mental health care needs.

This home is not required to have a registered manager as part of its conditions of registration. The provider is the registered person and they have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the home is run.

At the last inspection on 5 and 7 October 2016 we carried out an unannounced comprehensive inspection and found the provider was not meeting the regulation with regard to recruitment under the ‘safe’ question. The provider wrote to us and said they would meet the legal requirements by November 2016.

We undertook this focused inspection on the 2 March 2017 to check that they had followed their plan and to confirm that they now met legal requirement. This report only covers our findings in relation to that requirement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Cumberland House on our website at www.cqc.org.uk.

We found the recruitment procedure had been reviewed; staff files included relevant checks and the information required to ensure that only suitable staff were employed to work at the home. People said there were enough staff to provide the support they wanted. One person told us, “They are very good, they know how much support we need.” Staff told us there were sufficient staff working in the home to provide the support people needed; they were not rushed and had time to support people to make choices and, “Do what they want to do”, such as go shopping.

People told us Cumberland House was their home; they were happy living there and their rooms had been personalised to suite their individual tastes. Risk assessments had been completed to ensure people were supported safely to be independent. These included environmental risk assessments for the use kettles, fridges and other electrical equipment in their rooms. People said they felt safe and received the support they needed. Staff had attended safeguarding training. They demonstrated a good understanding of their responsibilities with regard to supporting vulnerable people and the action they should take if they had any concerns.

The management of medicines had been reviewed since the last inspection and changes had been agreed with the new pharmacist to ensure the provider followed current guidance with regard to storing and giving out medicines safely. Staff said they had attended relevant training and records supported this.

The home was well maintained; refurbishment was on going and people had chosen the décor.

This comprehensive inspection took place on 5 and 7 October 2016 and was unannounced. There were 14 people living at the home when we visited.

This home is not required to have a registered manager as part of its conditions of registration. The provider is the registered person and they have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the home is run.

People were happy to be living at Cumberland House, which they described as their home, and they had positive, warm and friendly relationships with the staff. Most of the staff had worked at the home for a number of years and several of them talked about it as a family. They enjoyed working at the home and were well supported by the owner/manager and deputy manager.

Staff had undergone training and knew how to recognise and report any incidents of harm. Potential risks to people had been assessed, which meant that people were kept as safe as possible. Medicines were managed well so that people received their prescribed medicines safely.

There were sufficient staff on duty to make sure that each person had the support they needed to do whatever they wanted to do. Staff had undertaken training in a range of topics relevant to their role so that they were equipped to do their job well. Staff had not always been recruited in a way that made sure that only staff suitable to work in a care home were employed.

The CQC monitors the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS), which apply to care services. People’s capacity to make decisions for themselves had been assessed. Staff had a good understanding of the principles of the MCA and DoLS. Appropriate applications had been made to the relevant authorities to ensure that people’s rights were protected if they lacked the mental capacity to make decisions for themselves.

People’s healthcare needs were monitored and staff involved a range of healthcare professionals to make sure that people were supported to maintain good health and well-being. People were given sufficient amounts of food and drink and people’s dietary needs were met.

Staff showed that they cared about the people they were supporting. Staff treated people with kindness, respect and compassion and made sure that people’s privacy and dignity were upheld at all times. People were encouraged and supported to be as independent as possible. People’s personal information was kept securely so that their confidentiality and privacy were maintained.

People had been fully involved in planning their care and support. Care plans gave staff detailed, individualised information about the ways in which each person wanted their care and support delivered and about their hopes, aspirations and goals. People received consistent, personalised care and support from the staff team.

Each person was encouraged to live their life in the way they wanted to and do what they wanted to do each day. Staff were creative in organising activities and outings based on their deep understanding of what each person wanted to do. People chose whether or not to join in. People were sure that their concerns would be listened to and addressed quickly.

The managers were very approachable and supportive. People and staff were given a range of opportunities to share their views about the service delivered by the staff and put forward ideas for improvements. Audits of a number of aspects of the way the home was managed were carried out to make sure that a good quality care and support service was provided. Records were maintained as required.

We found that consent was sought prior to care and that people were included in the development of their care plans. One person told us, 'I like living here the staff are very friendly and will always chat.'

We found that the meals were varied and nutritionally balanced. One person told us, 'The food is very good, always tasty.'

We found that the home was clean and tidy. Although up-to-date infection control training had not been undertaken by most staff. Staff we spoke to were knowledgeable on infection control practice. Staff we spoke to enjoyed working at the home one told us, 'It is a great place to work and I enjoy working with the people who live here.' We found that the staff were knowledgeable about the people they were caring for.

The systems the home had in place to monitor the quality of service that people received had improved since our last inspection in January 2013. There was evidence that people who lived at the home and visitors had been consulted and actions taken on their views.

Everyone we spoke with told us they felt safe living there, and staff were able to tell us about the signs of potential abuse and how to raise concerns. Staff had received recent training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards, however most staff had not had recent training in safeguarding.

Staff received supervision and told us they felt they benefitted from informal support from management. We saw staff were familiar with the individual needs of the people they looked after.

We saw that one audit had been carried out but there was no record of how the result had fed back into improving the service. Staff had not been updated on the audit result. We saw that accidents and incidents had been recorded, however again, we saw no evidence that learning from incidents took place and appropriate changes were implemented.