Combe Lea Community Resource Centre

Updated 29 October 2022

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

The inspection team was made up of one inspector, one bank 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.

Service and service type

Combe Lea Community Resource Centre 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. Combe Lea Community Resource Centre is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

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 used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well. We used all this information to plan our inspection.

During the inspection

We reviewed various records in relation to the running of the service, including recruitment files, health and safety checks and six care plans. We toured the premises and spoke with staff, including the deputy managers, care staff and senior care staff. We spoke with 19 residents and three relatives

After the inspection

We spoke with six relatives and continued to receive information from the management team. We made a referral to the local fire service in relation to fire safety concerns we identified during the inspection.

Updated 29 October 2022

About the service

Combe Lea Community Resource Centre is a residential care home, providing regulated activities accommodation for persons requiring nursing or personal care, to up to 30 people. The service provides support to people with dementia, older and younger adults and people with a physical disability. At the time of our inspection there were 24 people using the service.

Combe Lea Community Resource Centre is a purpose-built care home, the service is laid out over three floors that are accessible via lift or stairs. Living accommodation is found on the first and second floors, where people have access to communal lounges and dining areas. Bedrooms have en-suite facilities and there is level access to well-maintained outdoor spaces. The registered manager’s office is located on the ground-floor.

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

People were placed at increased risk of avoidable harm because the provider failed to act, and rectify fire safety shortfalls identified in October 2020. We contacted the local fire service about these concerns, who visited the service and planned a full audit. Sufficient numbers of staff were deployed across the service to meet the needs of people. We found transdermal patches were not always rotated in line with manufacturer instructions, and staff had not always assessed the efficacy of ‘as required’ medicines. There was no oversite of safeguarding in the service, however, staff spoke positively about how they would identify abuse and what they would do if abuse was witnessed or suspected. We were assured the provider had implemented measures to help prevent the spread of infection.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Audits and checks had not always been used effectively to identify shortfalls, including in relation to fire safety. There was no provider oversite to ensure sufficient scrutiny of care provision, and to help consistently drive improvement. The service was person-centred, inclusive and staff worked in partnership with others to support people to live their lives. The management team was aware of their responsibility to act openly and honestly when things went wrong.

Staff received training, supervision and appraisals to ensure they had the correct skills and knowledge to support people in the service. The premises was purpose built and designed to meet the needs of people requiring residential care. The GP visited weekly, and staff worked with external professionals to meet people’s needs. People were supported to eat and drink enough.

People told us the staff who supported them were kind and caring, relatives confirmed this. We observed kind and caring interactions between staff and people throughout our inspection. People were supported to express their views and their privacy and independence was respected.

People were supported to maintain relationships important to them and avoid social isolation. Staff were receiving training to help them provide end of life care effectively when needed. At the time of our inspection, no end of life care was being delivered. The provider had not received any recent complaints, there was a complaints process in place for people to use if they needed.

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

Rating at last inspection This service was registered with us on 01 October 2020 and this is the first inspection.

The last rating for the service under the previous provider was good, published on 03 May 2018.

Why we inspected

We undertook this inspection because the provider had recently changed, and we received information about medicines errors.

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.

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 found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report. We have identified breaches in relation to safe care and treatment, the Mental Capacity Act and governance at this inspection.

In response to concerns we raised about fire safety and the Mental Capacity Act, the senior management team attended the service on the second day of this inspection to discuss our concerns and plan what actions they would take to drive improvement.

Please see the action we have told the provider to take at the end of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Combe Lea Community Resource Centre on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.