We carried out a review of the data available to us about Cambridge Nursing Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Cambridge Nursing Home, you can give feedback on this service.
We found the following examples of good practice.
The provider had policies and procedures regarding the prevention and control of infection. Staff ensured the environment was clean and safe for people. They were aware of their roles and responsibilities for the management of infection.
Staff were provided with personal protective equipment (PPE) such as aprons, masks, and gloves. They also undertook COVID-19 testing on a regular basis. The provider followed the government guidance in relation to isolation criteria.
Visiting professionals needed to provide evidence of their vaccination status to the management team before entering the service.
There were arrangements in place for relatives to visit their loved one in accordance with current guidance. People were encouraged to maintain contact with their relatives.
The provider had assessed and mitigated risks related to COVID-19 to people, staff and visitors. This included the need for a negative COVID-19 test prior to entry in the service.
The management team carried out regular infection, prevention and control audits and followed national guidance to ensure people, staff and visitors were safe.
Staff received training in infection prevention and control. They wore appropriate PPE. There were sufficient numbers of staff to keep people safe.
We found the following examples of good practice.
Visits to the service by friends and relatives were carried out in line with current guidance. There was a designated visiting area which visitors reached directly from the garden. Where relatives had been unable to visit, they were encouraged to maintain contact with people electronically.
Visitors had to complete a risk assessment before visiting which included declaring if they had any symptoms of Covid-19. Temperature checks were carried out on staff and visitors upon arrival to the premises.
The provider had made appropriate arrangements to test people and staff for Covid-19 and was following government guidance on regular testing. Measures were in place to ensure the safety of staff and people should they have tested positive for Covid-19.
The provider had taken steps to ensure they had adequate supplies of Personal Protective Equipment (PPE). Staff had received training in the use of PPE and were seen to be wearing it during the course of the inspection.
Cleaning schedules were in place and there were systems for recording completed cleaning. These were checked daily by a member of the management team. Regular infection control audits were carried out at the service.
Cambridge Nursing Home is a care home that provides accommodation, personal and nursing care to 47 people. The service specialises in supporting people living with dementia and a physical disability, older people and younger adults.
People’s experience of using this service and what we found
People who used the service were protected from the risk of abuse because the provider had taken steps to identify the possibility of abuse and prevent abuse from happening. Risks to people had been assessed and identified as part of the care planning process. Staff recruitment process was robust. The provider employed sufficient staff so that they did not have to use agency staff. Medicines were given to people as prescribed, however, improvements were needed in ensuring medicines were in date and staff signed when witnessing medicines being administered to people. The provider had a system in place to record and monitor accidents and incidents. People were protected from the risks associated with the spread of infection.
People’s needs were assessed, and care and support were planned and delivered in line with their individual care plan. There was an on-going training programme for staff to ensure they were kept up to date and aware of current good practice. People were supported to access medical support from healthcare professionals to ensure their health and wellbeing was maintained. Staff supported people to eat and drink sufficient quantities. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People and their relatives commented staff were kind and compassionate and respected people’s privacy and dignity. Records confirmed people’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes. People were encouraged to remain as independent as possible and to do as much as they could for themselves. The importance of confidentiality was understood and respected by staff.
Care plans were personalised and provided staff with sufficient information to provide care to an appropriate level. Regular reviews of people’s care took place. People and their relatives were involved in the planning of their care and had access to activities to protect them from social isolation. The provider had a policy and procedure for dealing with any concerns or complaints. People had their end of life wishes discussed and recorded. This helped to ensure they receive the care and support when approaching the end of their lives.
There was an open and inclusive culture in the service, with staff, people, relatives and other external professionals encouraged to help improve the service provided to people. People and their relatives felt the management team was approachable and friendly. The quality of the service was monitored regularly through audit checks and receiving people’s feedback. The registered manager worked closely with other external organisations to ensure people's needs were met.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection:
At the last inspection the service was rated requires improvement (published 24 November 2018).
Previous breaches:
Following the last inspection, we found that the service was in breach of four regulations in relation to dignity and respect, need for consent, safe care and treatment and good governance. We asked the provider to complete an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider is no longer in breach of regulations.
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up:
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
Cambridge Nursing Home is a care home with nursing provided on three floors. The service is registered to accommodate a maximum of 49 people. The service specialises in supporting people living with dementia, physical disability, older people and younger adults. Cambridge Nursing Home 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. At the time of our inspection, 46 people were living at the service.
A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The provider did not ensure staff were deployed appropriately to meet people’s needs safely. There was lack of appropriate hand wash facilities in the communal toilets and bathrooms. People were at risk as the window restrictors were not safe.
The provider did not always work in line with the Mental Capacity Act 2005 principles and Deprivation of Liberty Safeguards to ensure people’s consent was sought in relation to care and treatment. The service's décor was not dementia friendly.
People told us some staff were not caring and did not always treat them with dignity and respect. Relatives felt unwelcomed as visiting times were restricted and did not always suit them.
There was lack of structured stimulating activities for people living with and without dementia.
The provider did not have efficient and effective auditing, monitoring and evaluating systems to ensure the quality and safety of the care delivery.
Risks to people were appropriately assessed and mitigated so that staff could provide safe care. Staff understood their responsibilities in safeguarding people against harm and abuse. People’s medicines were managed safely. Staff were recruited appropriately to ensure they were safe to support people.
People’s needs were assessed before they moved to the service. Staff told us they received appropriate, regular training and supervision to provide effective care. People’s individual dietary needs were met. Staff worked well with healthcare professionals to ensure people’s individualised needs were met effectively.
People’s cultural and spiritual needs were identified, recorded and met by staff. The provider had effective systems and processes to support people at end of life.
Care plans were individualised and detailed people’s likes and dislikes. Staff knew how to meet people’s personalised needs. Staff were trained in equality and diversity. The provider encouraged lesbian, gay, bisexual and transgender people to use the service. People knew how to raise concerns and the provider maintained clear and accurate complaints records.
Staff told us they found the management approachable and felt well supported and valued. Healthcare professionals told us the service was well managed. The registered manager submitted a detailed action plan to address issues raised during our inspection.
We found the registered provider was not meeting legal requirements and was in breach of four regulations. These were in relation to safe care and treatment, dignity and respect, need for consent and good governance. We have made recommendations about staff deployment, infection control procedures, dementia friendly environment and activities.
You can see what action we told the provider to take at the back of the full version of the report.
We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Cambridge Nursing Home on our website at www.cqc.org.uk.
Cambridge Nursing Home is a care home with nursing provided on three floors. The service is registered to accommodate a maximum of 49 people. At the time of the inspection, there were 49 people using the service.
There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At this inspection we found the registered provider had taken sufficient action to ensure people received their medicines as prescribed and medicines were managed safely.
This unannounced inspection took place on 14 April 2015. The service did not meet three regulations we inspected against at our last inspection on 8 September 2014. During this inspection we found that the service was now compliant with these regulations.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
In September 2014, our inspection found that the nursing home provider breached regulations relating to Care and welfare of people who use services, cleanliness and infection control and Assessing and monitoring the quality of service provision. Following this inspection the provider sent us an action plan to tell us the improvements they were going to make. During this inspection we looked to see if these improvements had been made.
Cambridge Nursing Home is a care home with nursing provided on three floors. The service is registered to accommodate a maximum of 49 people. At the time of the inspection there were 48 people using the service.
Medicines were not always safely managed. We saw the balance of medicines for five people did not match with the records. We noted there was not always a system in place to account for medicine and to check to ensure people had the right quantity of medication required, which left people at risk because medicines were not properly managed.
People and relatives told us they liked the home. They said the home was clean and staff were pleasant. People told us they felt safe in the home because staff quickly responded to their calls. Relatives felt that the home had enough number of staff deployed to support people. They said staff were kind and welcomed them when they visited the home.
Each person had a care plan which contained information about their needs including any allergies, nutrition, falls risk, wellbeing, manual handling and instruction for staff how to support people. People's healthcare needs such as their weight, blood pressure, and blood sugar level were monitored and recorded in their files. People were referred to dieticians, speech and language therapists, district nurses, and GPs as and when needed. This ensured that people received treatment healthcare intervention when they needed.
People talked positively about different aspects of the service. They told us the food provided was good and they had choices of what they wanted to have at breakfast, lunch and dinner. We saw staff provided assistance for those who needed support with meals. We observed staff sat by people and talked to them when helping them with their food. This showed staff treated people with respect.
Records showed staff had various training opportunities relevant to their roles. Staff told us they felt supported and enjoyed their work. They informed us they worked as a team; they had regular supervision and attended team meetings. Staff told us they shared experience with colleagues and supported each other.
There was a system in place for checking health and safety. Staff checked fire safety, emergency lights and the cleanliness of the home. Relatives, visitors and people were consulted about the quality of the service. This ensured that people's views were taken into account in provision and improvement of the service.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report.
The detailed evidence supporting our summary can be read in our full report.
Is the service safe ?
People and their visitors told us they felt safe. There were effective arrangements in place for staff to identify the possibility of abuse, prevent it from happening, and respond appropriately to any allegation of abuse. We observed that appropriate arrangements were in place to manage medicines safely and effectively.
Recruitment practice was safe and thorough. There was, however, limited evidence that people's care needs were taken into account when making decisions about the number, skills and experience of staff required when setting duty rotas.
There were some arrangements in place to deal with foreseeable emergencies, however these did not ensure that equipment and emergency medicines were readily accessible or that there were on-going equipment checks and systems to replace used items.
There were ineffective arrangements in place to protect people from the risk and spread of infection.
Is the service effective ?
People's health and care needs were assessed and there were care plans in place. There was limited evidence of people being involved in assessments of their needs and planning their care, or that specialist and expert advice was sought and acted upon. Some of the care plans had not been reviewed or updated regularly. It was therefore not possible to confirm all people's needs were being met. Staff did not have the opportunity to participate in on-going learning and development activities in some relevant topics, although they had regular supervision and appraisal.
Is the service caring?
People and their relatives told us that they were generally satisfied with the care provided within the home, that staff were kind, approachable, and kept them informed. We found staff acted in accordance with the wishes of people who used the service. Where people were able, they gave give valid consent to examination, treatment, care and support. Staff knocked on people's doors, explained care to people, gained their permission to provide care and treatment, and to receive visitors.
There was no designated person to co-ordinate activities for people using the service within the home, and no evidence that planned activities were available on a daily basis, or that they were evaluated.
Is the service responsive?
We found staff understood people's individual communication methods, enabling choice in their daily lives. We saw some examples of where staff worked collaboratively with other health and social care professionals and agencies, ensuring people received care in a co-ordinated way. People, their relatives and staff were all familiar with the processes to feedback comments and concerns about the service. However, we saw limited evidence that learning from feedback had taken place or that it had been acted upon.
Is the service well-led?
People, visitors and staff told us that they felt supported by managers, that managers were approachable and accessible, that communication was good, and that they felt listened to. There was limited evidence of an effective quality assurance system to identify, assess and address risks relating to the health, welfare and safety of service users and others who may be at risk. The quality assurance systems did not make sure that the knowledge and experience of people, or staff, was properly taken into account and acted upon or that shortfalls were appropriately addressed.
People were provided with a choice of suitable and nutritious food and drink. People said that they enjoyed the food and were given choices of food and drink. Measures were put in place where a risk of poor nutrition was identified. People said they felt safe at the home. One person said "I've never had any trouble" when asked if they felt safe there. Records showed that all staff had received training in safeguarding vulnerable adults within the last year. The home had a safeguarding policy in place.
Staff received appropriate professional development. They felt well supported by the management. One member of staff said "the manager is usually here so if there are any issues we can always tell them" and another said "I've learned a lot of things since I've been (working) here, I've grown a lot in this company."
The inspection team was led by a CQC inspector who was joined by an Expert by Experience people who have experience of using services and who can provide that perspective.
We used a number of different methods to help us understand the experiences of people using the service. A number of the people who lived at this care home had complex needs, which meant they were not always able to communicate verbally with us in a meaningful way. During the morning and at lunch we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.
The people who live in the home and their relatives all commented on the kindness of staff. People felt reassured in the knowledge that their care is provided by long established staff with whom they have a positive relationship. One relative told us they 'felt at peace' with their relative being in the home. However, at times some people did not always feel safe living in the home because other people had uninvited access to their rooms.
We received a variety of comments on the food provided to people in the home. Some said there was a lack of variety. When we asked one person to tell us about how they had a choice in the foods provided they said they had 'no real choice, but you know when it comes you can eat it'.
We did not have the opportunity to speak with any relatives or visitors to the home on the day of the inspection so we spoke to some on the phone following our visit.