Coumes Brook Home Limited

Updated 23 May 2019

The inspection:

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.

Inspection team:

This inspection was completed by two adult social care inspectors.

Service and service type:

Coumes Brook Home Limited is a 'care home'. People in care homes receive accommodation and personal care. 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 manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

This inspection was unannounced.

What we did:

Before this inspection we reviewed the information we held about the service, such as any feedback we had received since the last inspection and information we had received from the provider. Providers are required by law to notify us of certain events, such as when a person who uses the service suffers a serious injury. We took this information into account when we inspected the service.

We contacted social care commissioners who help arrange and monitor the care of people living at the service. We used the feedback from these organisations to plan our inspection.

During this inspection we spoke with six people living at the service. We spoke with seven members of staff and three visiting health and social care professionals.

We looked at three people's care records in detail and seven people’s medicine records. We looked at three staff files which included recruitment checks, supervisions, appraisals and training records. We also looked at other records relating to the management of the service, such as quality assurance audits.

We spent time observing the daily life in the service and we looked around the building to check environmental safety and cleanliness.

Updated 23 May 2019

About the service:

Coumes Brook Home Limited is a 24 bedded service providing nursing or personal care to older people and people living with dementia. At the time of our inspection there were 22 people using the service.

People’s experience of using this service:

• Staff were very caring. Everyone we spoke with was very complimentary about the staff. There was a strongly embedded culture within the service of treating people with dignity, respect, compassion and love.

• Activities were available to keep people occupied both on a group and individual basis. Trips out were also organised in line with people’s preferences.

• Medicines were being administered safely and people’s dietary and healthcare needs were met. However, minor improvements were required with medicines management to ensure it was delivered in line with best practice guidance.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the polices and systems in the service supported this practice. Although this was not relevant at the time of inspection as everyone could consent to their care and treatment, improvements were required to the systems which support people who are not able to make these types of decisions themselves.

• Staff were recruited safely and there were enough of them to keep people safe and to meet their care needs. We found the system for calculating safe staffing levels was not robust, which was an issue raised at the previous inspection. Staff were receiving appropriate training which was good and relevant to their role. Staff said they felt supported by the manager.

• Care plans were up to date and detailed the care and support people wanted and needed. Risk assessments were in place and showed what action had been taken to mitigate any risks which had been identified. Appropriate referrals were being made to the safeguarding team when this had been necessary.

• There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received.

• Without exception people, staff and visiting professionals said the registered manager was very approachable and organised. We identified times where the service was not always well led and the registered manager had failed to adequately address all feedback from the last inspection. We were satisfied the registered manager had clear improvement plan in place to address this.

• As the key areas ‘safe’ and ‘well-led’ had deteriorated to requires improvement, the service achieved a rating of requires improvement overall.

For more details, please see the full report which is on the CQQ website at www.cqc.org.uk

Rating at last inspection:

At the last inspection the service was rated as good (report published 5 November 2016).

Why we inspected:

This was a planned inspection to check the service remained good.

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.