Archived: Combe House

Updated 25 August 2016

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.

This unannounced inspection took place on 1 August 2016 and was unannounced. The inspection was carried out by two adult social care lead inspectors.

During the inspection we spoke with seven of the people living there, the registered manager, the home’s operations manager, two of the supervisors on duty during the day and five care staff.

Some people living at the Combe House could not easily give us their views and opinions about their care. We used the Short Observational Framework for Inspection (SOFI). This is a specific way of observing care to help us better understand the experiences of people who could not easily talk with us. It is a useful tool to help us assess the quality of interactions between people who use a service and the staff who support them.

As part of the inspection we also looked at records and care plans relating to the use and storage of medicines. We also looked at care records, which included looking at five people’s care plans and risk assessments in detail and case tracking these to help us see how their care was being planned with them and delivered.

We looked at the staff rotas for the previous month, staff training and supervision records, recruitment records and records relating to the maintenance and the management of the service and regarding how quality was being monitored.

Before our inspection we reviewed the information we held about the service. We looked at the information we held about notifications sent to us about incidents affecting the service and the people living there. We looked at the information we held on referrals that had been made to the local authority safeguarding team, any concerns raised with us and any applications the manager had made under Deprivation of Liberty Safeguards (DoLS).

Before the inspection, the registered manager completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make.

Updated 25 August 2016

This unannounced inspection took place on 1 August 2016. We last inspected Combe House in July 2014. At that inspection we found the service was meeting all the regulations that we assessed.

Combe House is a residential care home providing personal care and accommodation for up to 40 older persons, some of whom may be living with dementia. The residential home is on one level and divided into four separate units, each for ten people to live in. All units have a communal lounge/dining room and kitchenette area and sufficient bathing and toilet facilities for the people living there. The home is in a residential area of Walney Island, close to local bus routes and public amenities. There are gardens for people to use and enjoy. There is parking to the front of the home for staff and visitors. At the time of the inspection 24 people were living in the home.

The service had a registered manager in post. 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 and associated Regulations about how the service is run.

We spoke with all people who lived at Combe House and they made many positive comments about their home. They told us that care staff were available to help them when they needed assistance and that staff respected their privacy and treated them with “respect” and “kindness”.

We saw that the staff on duty approached people in a friendly and respectful way and everyone we spoke with told us that they felt safe living there and were “happy” and “being well looked after” living at the home.

People had a choice of meals and drinks and they told us the food was “good” and that they enjoyed their meals. People were involved in discussions and feedback about food at their ‘residents’ meetings.

People who lived at Combe House told us about the organised activities that went on in the home and that they discussed these at their own meetings. There was a programme of organised activities for people to take part in if they wanted to.

People who lived in the home told us that they felt safe there and that they were “well looked after”. There were systems in place to make sure people living there were protected from abuse and avoidable harm. The staff we spoke with understood their responsibilities in protecting people from harm or abuse and had received training on this.

They service had safe systems for the recruitment of staff to make sure the staff taken on were suited to working there. We saw that care staff had received induction training and on going training and development and had regular supervision and annual appraisal.

During this inspection we looked at the way medicines were managed and handled in the home. We found that medicines were being safely stored and administered and records were being kept of the quantity of medicines kept in the home and those disposed of.

The service worked with local GPs, district nurses and health care professionals and external agencies to provide appropriate care to meet people’s different physical, psychological and emotional needs.

The service followed the requirements of the Mental Capacity Act 2005 Code of practice and Deprivation of Liberty Safeguards. This helped to protect the rights of people who were not able to make important decisions themselves.

We made a recommendation to look at best practice in relation to providing evidence of who held Power of Attorney (PoA) for individuals to help ensure that the right people had been involved in making decisions on people’s behalf.