Cumbria House Care Home

Updated 22 August 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.

This inspection took place on 1 August 2018. The inspection was unannounced. The inspection was carried out by one inspector and one expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we asked the provider to complete 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 improvements they plan to make. We also looked at notifications about important events that had taken place in the service which the provider is required to tell us by law. We used this information to help us plan our inspection.

We spoke with 13 people who lived at the service and five relatives, to gain their views and experience of the service provided. We also spoke to the registered manager, the deputy manager and three staff. We received feedback from one healthcare professional.

We spent time observing the care provided and the interaction between staff and people. We looked at three people’s care files, medicine administration records, three staff records including recruitment and supervision as well as staff training records, the staff rota and staff team meeting minutes. We spent time looking at the provider’s records such as; policies and procedures, auditing and monitoring systems, complaints and incident and accident recording systems. We also looked at residents and relatives meeting minutes and surveys.

We asked the registered manager to send us information following the inspection and they sent this within the time requested.

Updated 22 August 2018

The inspection took place on 1 August 2018. The inspection was unannounced.

Cumbria House Care Home is a ‘care home’. People in care homes receive accommodation and nursing and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Cumbria House Care Home provides accommodation and support for up to 32 older people. There were 24 people living at the service at the time of our inspection. People had varying care needs. Some people were living with dementia, some people had diabetes or had Parkinson’s disease, some people required support with their mobility around the home and others were able to walk around independently.

A registered manager was employed at the service by the provider. 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 our last inspection on 5 July 2017, the service was rated as ‘Requires Improvement’. We found a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Peoples preferences and requirements around their food and how this was delivered was not always person centred. We also made a recommendation to the provider that they provide better evidence of their oversight of all aspects of service delivery. At this inspection we found the provider and registered manager had made the necessary improvements to meet the regulations and achieve a rating of ‘Good’.

People were now complimentary about the food and snacks available. There was variety and choice at mealtimes. People told us they had access to plenty of drinks throughout the day. People’s specific dietary needs were known about and catered for.

Staff were now careful to make sure they recorded the food and fluids people had, where this was required, to ensure people maintained their health.

A comprehensive range of quality auditing processes were in place to check the safety and quality of the service provided. Action was taken where improvements were needed. The provider now held a governance meeting once a month to ensure their clear oversight of the service they provided.

Staff were aware of their responsibilities in keeping people safe and reporting any suspicions of abuse. Staff knew what the reporting procedures were and were confident their concerns would be listened to by the registered manager.

Individual risks were identified and steps were taken to reduce and control risk. Staff had the guidance they needed to support people to maintain and improve their independence while at the same time preventing harm. Accidents and incidents were appropriately recorded by staff; action was taken and followed up by the registered manager.

The procedures for the administration of people’s prescribed medicines were managed and recorded appropriately so people received their medicines in a safe way. Regular audits of medicines were undertaken to ensure safe procedures continued to be followed and action was taken when errors were made.

The registered manager and deputy manager carried out a comprehensive initial assessment with people before they moved in to the service. People were fully involved in the assessment, together with their relatives where appropriate. Care plans were developed and regularly updated and reviewed to consider people’s changing needs. People’s specific needs were taken account of and addressed in care planning to ensure equality of access to services.

People had access to a range of activities to choose from. Some people preferred their own company and wished to spend time in their room reading or watching TV and this was respected by staff. People were asked their views of the service and action was taken to make improvements where necessary.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible according to the basic principles of the Mental Capacity Act 2005. The policies and systems in the service supported this practice.

People were supported to access healthcare professionals when they needed advice or treatment. The registered manager had developed good relationships with local health care professionals and referred people when they needed.

There was clear evidence of the caring approach of staff. People and their relatives were happy about the staff who supported them, describing them as caring, saying they were confident in the care they received. Staff knew people well and were able to respond to their needs on an individual basis.

Suitable numbers of staff were available to provide the individualised care and support people were assessed as requiring. The provider used safe recruitment practices so only suitable staff were employed to work with people who required care and support.

Staff were supported well by the registered manager and the deputy manager. Staff told us they were approachable and listened to their views and suggestions. Training was up to date and staff were encouraged to pursue their personal development. Staff had the opportunity to take part in one to one supervision meetings to support their success in their role. Regular staff meetings were held to aid communication within the team and to provide updates and feedback.

All the appropriate maintenance of the premises and servicing of equipment was carried out at suitable intervals.

People and their relatives thought the service was well run. People knew the registered manager and the deputy manager well and were very happy with the service provided.

Further information is in the detailed findings below.