Background to this inspection
Updated
31 October 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team
This inspection was carried out by one inspector.
Service and service type
The Coombe House 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before 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 all of this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During inspection
We spoke with two people who used the service and three relatives. We spoke with the chef, three carers, the administrator, the deputy manager, the registered manager and a visiting healthcare professional. We spent time in the communal areas of the home to understand how people spent their day and how staff supported people. We looked at aspects of two people’s care records and other records relating to people’s care such as medication records, audits and other records about the management of the service.
After inspection
In addition we spoke with a further relative and an external healthcare professional. We received written feedback from a further healthcare professional.
Updated
31 October 2019
About the service
Coombe House is a residential care home providing personal and nursing care to 12 people who have a learning disability. Coombe House accommodates 12 people in one adapted building which is set over two floors.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 12 people, 12 people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home.
People’s experience of using this service
People told us they felt safe and well supported. Relatives confirmed they felt their family member was safe. Staff had a good understanding in how they protected people from harm and recognised different types of abuse and how to report it. Potential risks to people had been identified and staff had consistent knowledge in how to reduce the risk of harm. There were enough staff on duty to keep people safe and meet their needs. People’s medicines were managed and stored in a safe way. Safe practice was carried out to reduce the risk of infection.
People’s care continued to be assessed and reviewed with the person and their relative or advocates involved throughout. People were supported to have a healthy balanced diet and were given food they enjoyed. Where people required a specialised diet, this was in line with external healthcare professional’s advice and in line with best practice. Staff worked with external healthcare professionals and followed their guidance and advice about how to support people following best practice. 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.
Staff cared for people in a kind and considerate manner. People were treated with respect and their dignity and privacy was maintained. Staff helped people to make choices about their care and the views and decisions they had made about their care were listened and acted upon.
People’s care was delivered in a timely way, with any changes in care being communicated clearly to the staff team. People were supported and encouraged to maintain their hobbies and interests. People and relatives had access to information about how to raise a complaint.
People and their relatives were happy with the way the service was run. The registered manager was visible in the home, listened and responded to those who lived in the home and the staff who worked there. The culture of the service was an open and transparent. People and relatives were listened to and had the opportunity to raise their suggestions and ideas about how the service was run. Staff worked well as a team and were supported by the provider to carry out their roles and responsibilities effectively, through training and regular contact with the registered manager. The checks the registered manager and provider made ensured the service was meeting people’s needs and focused upon people’s views and experiences.
Rating at last inspection
The last rating for this service was Good. The last report was published 24 May 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.