Archived: Cambridge Park Care Home

Updated 27 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was prompted in part by notification of a serious incident. The incident was brought to the attention of Humberside Police and North East Lincolnshire Safeguarding Adults Team who are not taking any further action. However, the information shared with the Care Quality Commission (CQC) about the incident indicated potential concerns about the management of risks. This inspection examined those risks.

The inspection took place on 8 and 9 August 2018 and was unannounced. On the first day of the inspection, the team consisted of two inspectors and an inspection assistant. The second day of the inspection was completed by one inspector.

Before the inspection we reviewed the information we held about the service. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. This included the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally required to let the Commission know about.

We contacted the local authority safeguarding and commissioning teams. We also contacted the local Healthwatch. Healthwatch is the local consumer champion for health and social care services. They give consumers a voice by collecting their views, concerns and compliments through their engagement work. Information provided by these professionals was used to inform the inspection.

During the inspection we used the Short Observational Framework Tool for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who used the service. We observed staff interacting with people and the level of support provided to people throughout the day, including activities and meal times.

We spoke with eight people who used the service and four relatives who were visiting the service during our inspection. We also spoke with the registered manager and a selection of staff; these included the deputy manager, team leaders, five support workers, the cook, the laundry assistant, the activity coordinator and a member of the housekeeping staff.

We looked at six people's care records, three staff recruitment files and reviewed records relating to the management of medicines, complaints, staff training, records in relation to maintenance of the premises and equipment. We checked how the registered manager and provider monitored the quality of the service; we also looked around the environment.

Updated 27 September 2018

This inspection took place on 8 and 9 August 2018 and was unannounced on the first day.

At the last inspection in July 2017, the service was rated Requires Improvement and the provider was in breach of three regulations. These related to risk management and safeguarding adults in the key question safe, person-centred care in responsive and governance in well-led. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when, to improve these key questions to at least good. We checked to see that the action plan had been completed and found progress in some areas but further improvements were required in others. We identified new concerns. This was the second Requires Improvement rating for the service.

Cambridge Park Care Home accommodates up to 60 people across two floors. Evergreen Suite on the first floor provides residential support and Courtyard Suite on the ground floor specialises in providing care to people living with dementia. The building is purpose built with lift and stair access to the first floor. All the bedrooms are for single occupancy and the majority have en-suite facilities. At the time of our inspection there were 35 people using the service.

Cambridge Park Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a new registered manager in post. A registered manager is a person who has registered with the 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.

Although we found some improvements had been made at this inspection, concerns remained in several areas. We found continued regulatory breaches in relation to safe care and treatment and good governance. We also identified a new breach in relation to staffing. You can see what action we told the provider to take regarding the above areas at the back of the full version of the report.

The provider's systems to assess, monitor and improve the quality of the service provided had not been effective in identifying and addressing all the issues highlighted during our inspection or consistently driving improvements in line with their own action plans.

Sufficient staff were not on duty to meet people’s needs at all times. Staff were not visible in communal areas on the Courtyard Suite for long periods of time and inspectors had to seek staff support to manage incidents on two occasions, where people’s behaviour challenged the service.

We found shortfalls with the standards of hygiene and cleaning in areas of the home. There were mal odours and we found items of furniture, fittings and equipment which were damaged and could not be cleaned effectively. The shortfalls in staffing and hygiene standards had also impacted on some people’s dignity.

People were supported to make their own decisions and choices. They had 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 had assessments of capacity and best interest decisions made on their behalf if they lacked capacity; documentation regarding best interest decisions showed all relevant persons were involved.

Staff demonstrated a good awareness of safeguarding procedures and knew who to inform if they witnessed or had an allegation of abuse reported to them. The registered manager was aware of their responsibility to liaise with the local authority where safeguarding concerns were raised and such incidents were managed well.

Staff had a good understanding of people’s needs and risk assessments were in place to guide them on how to provide consistently safe care. The registered manager closely monitored any accidents and incidents that occurred to identify any actions that could be taken to prevent a reoccurrence and keep people safe. People received their medicines as prescribed; the registered manager confirmed the provision of air conditioning units had been requested, to ensure medicines were stored safely.

Safe recruitment systems continued to be in place. Staff received sufficient training, development and support to ensure they were skilled and competent.

People gave positive feedback about the food provided and staff supported people to make sure they ate and drank enough. Staff worked closely with healthcare professionals to make sure the care and support met people’s needs and they received medical attention when necessary.

People’s care plans were person-centred and were regularly reviewed. Work was in progress to reassess each person’s needs to support the development of new electronic care records.

The provider had adapted the building to make sure it was suitable and met people’s needs. Dementia friendly décor supported people’s orientation and wellbeing. There were themed communal areas and accessible outdoor spaces for people to use and enjoy. Some redecoration had taken place but we also observed areas of the service were looking tired and in need of refreshing. The provider had a renewal programme in place.

People who used the service and their relatives were complimentary about staff approach. They said staff were kind and caring and respected people’s privacy. Staff had a good knowledge of what people could do for themselves, how they communicated and where they needed help and encouragement.

People were encouraged to participate in a range of activities within the service and local community, although these had been more limited recently due to changes in activity staff. Relatives told us they could visit anytime and staff supported people to maintain relationships.

There were systems in place to enable people to share their opinion of the service provided. People told us they felt able to make a complaint in the knowledge that it would be addressed.

We received positive feedback about the management of the service. People, relatives, professionals and staff told us the registered manager was caring, approachable and responsive to feedback.