Combe House

Combe House is a care home providing accommodation and personal care for up to seven people with learning disabilities. There were seven people living at the home at the time of our inspection.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. The principles of Right support, right care, right culture are as follows:

Right support:

• Model of care and setting maximises people’s choice, control and independence

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

The service was not always able to demonstrate how they were meeting these principles. Some people’s experience of care at the home did not reflect the values of Right support, right care, right culture. For example, some people’s choices about how they spent their time were restricted due to their support needs, which meant the model of care did not maximise people’s choice and control over their lives.

People received safe care. The consistency of some people’s care had been affected by the use of agency staff, although the provider had minimised the impact of this by using regular agency staff wherever possible. The provider operated robust recruitment procedures, which helped ensure only suitable staff were employed.

Staff understood their responsibilities in protecting people from abuse and knew how to report any concerns they had. Risk assessments were carried out to identify and manage any risks to people who used the service and staff. These were reviewed regularly to take account of any changes in people’s needs.

Records of accidents and incidents were reviewed to ensure learning was taken from adverse events. People’s medicines were managed safely. Any errors that occurred were investigated and action taken to address them.

Staff received the induction, training and support they needed to do their jobs. This included training specific to people’s needs in addition to mandatory training and regular one-to-one supervision with the registered manager.

People’s needs had been assessed before they moved into the home. Assessments considered what people could do for themselves and their how they preferred their care to be provided. A personalised care plan was developed from the initial assessment which contained details for staff about how people’s care should be provided.

Staff supported people to access healthcare services when they needed them. This included helping people make appointments and liaising with healthcare professionals if necessary.

People told us they got on well with the staff who supported them and had established positive relationships with them. Staff treated people with respect and dignity and ensured they had privacy when they wanted it. People were encouraged to be independent where possible and to be involved in their care.

The provider had effective systems to monitor the quality and safety of the service, including audits and regular monitoring of key aspects of the service. Quality monitoring systems also included seeking the views of people who used the service, their relatives and staff. The service had established effective working relationships with other agencies and professionals involved in people’s care, including commissioners and healthcare professionals.

Staff supported people 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 the service under the previous provider was Requires Improvement, published on 12 November 2020.

Why we inspected

This was a planned inspection based on the date of the service’s registration under the new provider.

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.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.