24 August 2022
During an inspection looking at part of the service
The Cumberland is a residential care home providing the regulated activity of personal care to up to 29 people. The service provides support to people living with dementia. At the time of our inspection there were 16 people using the service. The service is a large, converted property and accommodation is arranged over three floors.
People’s experience of using this service and what we found
People told us they felt safe living at The Cumberland. Relatives told us their loved ones were well cared for. Long standing staff knew people well and supported them in the way they preferred. However, some risks to people had not been assessed and mitigated. Guidance had not been consistently provided about people’s needs and the support they required. This was important as the provider used agency staff to cover staff vacancies and there was a risk they would not know how to provide people’s care. People’s medicines were not stored safely or managed consistently.
There were not always enough staff to meet people’s needs. The manager supported staff to care for people at times and this took them away from managerial tasks. The provider had not developed the environment to support people living with dementia to remain independent, including the use of signs to help people move around without support. However, staff supported people to continue to look after themselves as much as they wished. We have made a recommendation about best practice in dementia environments.
The provider’s checks and audits had not identified all the shortfalls at the service. Actions planned to address shortfalls the provider identified had not always been completed in the timescales they set out. The manager was realistic about the improvements needed and the action required to achieve them. The service was clean, however action had not been taken to protect people from all infection risks.
The manager had been working at the service for several months and had not applied to be registered with CQC. Staff told us they manager had made positives changes to the culture of the service and to people’s lives. They had worked with mental health professionals to reduce people’s anxiety and agitation and this had improved the quality of people’s lives.
Relatives and staff had shared their views, and these had been acted on to develop the service. Lessons had been learnt when things went wrong and action had been taken to reduce the risk of incidents occurring again. Staff had been recruited safely and checks had been completed on staff’s conduct in previous roles. Staff had the skills they needed to meet people’s needs.
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
The last rating for this service was good (published 24 May 2018).
Why we inspected
This inspection was triggered in part by potential risks around the management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
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.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
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 Cumberland 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 the management of risks and medicines, staff deployment, care records and the effectiveness of the provider’s checks and audits at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.