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Cumnor Hill House Outstanding

Reports


Inspection carried out on 23 May 2018

During a routine inspection

We inspected this service on 23 May 2018. Cumnor Hill House is 72 bedded 'care home' registered for older people, some of whom may be living with dementia. People in care homes receive accommodation and 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 comprises of three floors, each of which have separate adapted facilities. On the day of our inspection there were 42 people living at the service.

At our last inspection on 18 April 2017 we identified concerns about medicine management and we found the provider’s quality assurance systems for monitoring and improving the service were not always effective. We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and we asked the provider to submit an action plan telling us how they were going to address these concerns. We received the action plan within the timescales given that showed the improvements had been achieved and how these were going to be sustained.

At this inspection we found the provider addressed the above concerns and the service improved to Good in Safe and Effective domains. There was overwhelming evidence available that demonstrated further improvements to Outstanding in Caring and Responsive domains. The significant improvements of people’s experiences were achieved because of excellent leadership provided by the provider and service’s management. We therefore also rated the Well-led domain as Outstanding and the service was rated Outstanding overall.

The service was now very well-led. There was a registered manager running the service who started working at Cumnor Hill House a week after our last inspection in April 2017. 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.

Cumnor Hill House had a clear management and staffing structure in place. There were various departments such as care staff, nursing staff and ancillary staff and worked well as a wider team. The staff aimed to provide a high quality of service and they had a sense of pride working at the service. The provider’s quality assurance systems were effective and there was evidence available where an area for improvement had been identified, a prompt action was taken to address it. The registered manager monitored service delivery on ongoing basis and effectively used feedback from people, relatives and staff to improve the systems, practices and people’s experiences.

We found the service was exceptionally responsive to people’s needs. There was a positive culture that reflected people were put first. Staff told us they would do anything for the people living there, and not because they had to but because they wanted to. The team at Cumnor Hill House had a clear vision about how they wished to improve people’s lives and well-being. Staff talked about recognising people's individual wishes how they want to live their lives and enabled people to live their lives to the full. People’s, relatives, and external professionals’ feedback reflected this approach was successfully demonstrated. The team ensured people had exceptional opportunities to enhance their social inclusion and they were supported to participate in activities that met their needs and took account of their preferences. We identified that the provision of activities enhanced people’s well-being and gave them a sense of purpose.

People's care plans were up to date, current and gave clear guidance to staff on how people wished to be supported. Staff knew people's needs well and they used this knowledge to provide people with personalised support that put their well-being first.

Peo

Inspection carried out on 18 April 2017

During a routine inspection

The inspection took place on 18 April 2017. Cumnor Hill House is a purpose built care home providing personal and nursing care for up to 72 people. The home registered with the Care Quality Commission in June 2016 and this was the first inspection. At the time of our inspection there were 40 people using the service.

There was no registered manager in post. 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. However, there was an interim home manager in post and the provider had recruited a new manager who had applied to register with the Care Quality Commission as the registered manager.

Medicines were not always managed safely. People did not always receive their medicines as prescribed and medicines were not always administered in line with the provider's policy.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, care records did not support this practice. We have made a recommendation in relation to the Mental Capacity Act 2005.

Systems for monitoring and improving the service were not always effective. Auditing systems had not identified the issues we found during the inspection. Incidents were not always investigated to identify actions needed to reduce the risk of further events.

There was a relaxed, cheerful atmosphere throughout the inspection. People and staff laughed together and clearly enjoyed each other's company. There was a person-centred culture that valued people as individuals and involved them in the running of the service. The provider took opportunities to obtain feedback about the service to guide improvements.

During the inspection people's requests for support were met in a timely manner However, people and relatives were not confident there were always enough staff to meet people's needs.

The provider had recruitment processes in place that ensure people were supported by staff who were suitable to work with vulnerable adults. Staff were supported through regular supervisions and had access to development opportunities. Staff completed training to ensure they had the skills and knowledge to meet people's needs. Staff were clear about their responsibilities to report any concerns to senior staff and were confident to do so.

Risks to people were identified and where necessary management plans were in place to manage risks. Staff understood the importance of promoting people's independence. The service responded to people's changing needs and where needed were supported to access health professionals.

People were supported by caring staff who treated them with dignity and respect. People were involved in developing their care plans to ensure their needs were met in a way they chose.

Nutritional needs were met and people were complimentary about the quality of the food they received. Friends and relatives were able to join people for meals at any time and received a warm welcome. The provider promoted the engagement of relatives and friends to encourage a sense of belonging for everyone.

There was a programme of activities available for people. The home manager had identified that improvements were still needed and had a plan in place to achieve the improvements.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.