Archived: Combe House

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This summary is based upon our observations, discussions with people who used the service and the staff who supported them and from looking at the records held in the home. We also observed the interactions between people living there and the staff supporting and caring for them. We used the Short Observational Framework for Inspection (SOFI) during the visit. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

This is a summary of what we found. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People who used this service lived and were cared for in a clean, safe and hygienic environment. Equipment in the home was being maintained under service contracts and was clean.

There were enough staff on duty with appropriate skills and experience to meet the needs of the people who lived at Combe House.

We saw that risk assessments had been carried out to help make sure that people who lived there received safe and appropriate care and treatment. This included in the important areas of nutrition, personal care, skin care and wound management, mobility and moving and handling and the risk of falls.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We looked at the records of applications that had been made. These had been correctly submitted and were in order. The service had appropriate policies and procedures in place in relation to this and also regarding the Mental Capacity Act 2005.

Is the service effective?

People told us that they were happy with the care they received and felt that their needs had been met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs.

We found that staff had been supported in their work by regular supervision, appraisal and through appropriate training.

Visitors we spoke with confirmed that they could visit anytime. They also told us they could see their relatives in private in their rooms as well as communal areas.

We found that mobility equipment was in place and people had been assessed for its use. The equipment and how it was to be used was set out in people's care plans.

Is the service caring?

We saw from our observations and using SOFI that people were supported by kind and supportive staff. We saw that care workers were patient and gave people the time they needed to communicate and move around the home.

There was a calm and friendly atmosphere in the home at the time of our inspection with a lot of good natured chatter and banter between staff and people living there.

People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives.

Is the service responsive?

We found that people had received an assessment of their needs before they came to live there. This helped to make sure that the home could meet people's needs and could help them to settle in if they had any particular problems.

We saw that care records had been reviewed and contained up to date and relevant information about the care and support needs of people who used this service. We saw that where needs had changed, care plans had been reviewed and updated to reflect this.

People had access to activities and had been supported to maintain relationships with their friends and families. People living there were able to join in organised activities if they wanted to and some people went out into the local community. We saw people were able to follow their own faiths and attend religious services if they wanted to.

Is the service well-led?

We saw evidence that quality assurance processes were in place and in use at the home including a system of regular checks or 'audits'. This helped to identify any areas where there were problems or that needed to be changed.

There were policies and procedures in place and subject to regular review to guide staff practices. People who lived at Combe House had been asked for their views on the service they received.

People who lived at Combe House told us they saw the manager on a daily basis and could speak about 'anything'. Staff told us the home was a good place to work, with good teamwork and an 'approachable' manager.

We did not receive any negative comments about the standard of personal care received, the food served, the cleanliness of the home or the staff approaches and support. People were very complimentary about the food and told us the meals were "very good" and there was " always plenty of choice".

From our observations and conversations with people living there we found they had received the support they needed and were given choices about their care and their social activities. We observed that staff encouraged people to maintain their independence and control over their lives. All the people we spoke with gave positive feedback about how their privacy and dignity were promoted and how staff asked them what they wanted. We saw that people were comfortable and confident with the staff supporting them.We found that staff knew the people who lived there well and were familiar with their conditions and needs.

The provider had effective systems for monitoring the quality of the services, including care planning, medication, staff recruitment and training. The standard of record keeping within the home was good. These things helped protect the interests and welfare of people living there.