Background to this inspection
Updated
5 January 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
Three inspectors carried out this inspection.
Service and service type
The Cambridge Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Cambridge care home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with five people who used the service about their experience of the care provided. We also spoke with the registered manager, deputy manager, regional director, two senior carers and two health care assistants and the daily activities coordinator.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
Updated
5 January 2023
About the service
The Cambridge Care Home provides accommodation, nursing and personal care to up to 90 older people, some of whom are living with dementia. The service is set over two floors and has various communal rooms and a secure garden available for people to use. At the time of our inspection there were 36 people living at the service.
People’s experience of using this service and what we found
At the previous inspection we found that care was task led rather than focussing on the person. During this inspection we found that not enough improvement had been made. We saw that there was very little staff interaction with people other than when care and support tasks needed completing. People told us that staff did not have time to chat with them and they sometimes had to wait considerable times for assistance. Staff did not always treat people with respect and dignity.
Action had not always been taken to mitigate risks to people. However, a lack of action meant that there was an increased risk to people living at the home. We found no evidence that people had been harmed but further action was needed to ensure people were safe. Procedures were in place to assess if people were at risk of dehydration and/or malnutrition. However, these procedures were not always followed by staff to encourage people to eat/drink more when they had not met their food and drink intake targets.
Not enough improvements had been made since the previous inspection to ensure that people received a good service. The issues we found during this inspection had not been identified by the homes quality monitoring systems. The regional director, registered manager and deputy manager at The Cambridge Care Home had all changed since the previous inspection. The current management team acknowledged the feedback given during the inspection and put plans in place to make the necessary improvements. However, it was too soon for these actions to be embedded.
There was a high use of agency staff in the home however permanent staff were being recruited
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update.
The last rating for this service was requires improvement (report published 02 March 2022). The service remains rated requires improvement. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.
Why we inspected
We received concerns in relation to staffing, safety and the quality of care provided to people. As a result, we undertook a focused inspection to review the key questions of safe, caring and well-led only. We have found evidence that the provider needs to make improvements. Please see the safe, caring and well-led sections of this report. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively. You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Cambridge Care Home on our website at www.cqc.org.uk
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to reducing risks to people’s safety, treating people with dignity and respect and identifying areas for improvement and making the necessary improvements at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.