Cymar House

Updated 30 June 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

This inspection was carried out by one inspector and an 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

Cymar House 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. [Care home name] is a care home [with/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

Our first inspection visit was unannounced. Our second inspection visit was announced.

Inspection activity started on 26 May 2022 and ended on 8 June 2022. We visited the location’s office/service on 26 May and 1 June 2022.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We reviewed information we held about the service including information about important events which the service is required to tell us about by law. We requested feedback from other stakeholders. These included the local authority safeguarding team, commissioning team, and Healthwatch Wakefield. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

We spoke with seven people using the service and four relatives about their experience of the care provided. We observed care in the communal areas to help us understand the experience of people. 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. We received feedback from one visiting healthcare professional.

We gathered information from several members of staff including the registered manager.

We reviewed a range of records. This included two people's care plans, risk assessments and associated information, and other records of care to follow up on specific issues. We also reviewed multiple medication records. We looked at three staff files in relation to recruitment, training, supervision and appraisals. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 30 June 2022

About the service

Cymar House is a care home which provides personal care to people. The home is registered to support 25 people and, at the time of the inspection the home was providing personal care to 25 people, most of who were living with dementia.

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

The service was not always managed well. Quality assurance systems were in place and happening regularly, however these had not always been effective in identifying the issues found at this inspection. We found consent for people who lacked capacity to make decisions about their care was not always sought or recorded in line with regulations and good practice. Recruitment was not always managed safely. We found adequate checks were not being completed regularly on equipment used to move people. These areas were being audited by the service but issues had not been identified or acted upon.

People told us staff asked their consent before supporting with care tasks. People were supported to have maximum choice and control of their lives and we did not find evidence of care not being delivered in people's best interests, however, for people who were not able to consent to their care, mental capacity assessments and best interest decisions were not always decision specific or being completed in line with regulations and best practice. We saw examples of relatives signing consent forms without having the lawful authority to do so.

We received mixed feedback about activities happening at the home. Some people told us they enjoyed the activity provision; other people told us there weren't many activities happening. There was a lack of evidence of regular activities for people who stayed in their bedrooms and for people living with dementia. We made a recommendation for the provider to review and implement good practice in this area.

Medicines were mostly well managed, and people received their medicines as prescribed. Improvements were required in relation to how people’s ‘as and when’ required medicines were recorded and how effective it had been.

Most people told us they felt safe and enjoyed living at the service; their comments included, “It’s lovely here, they are good to you.” Relatives shared mainly positive feedback as well.

People were supported by a consistent team who knew people well.

Infection and prevention measures were in place to ensure people, staff and visitors were safe. We received feedback indicating that visiting guidance was not always being followed but the registered manager told us they were updating this and there were no restrictions on visiting.

Risk managements to people's care were assessed and control measures put in place to manage those risks.

We received positive feedback regarding staff being kind and caring. Staff spoke kindly about people and knew about their and preferences needs.

Staff felt well supported by management. There was a system in place to ensure staff were inducted and shadowed other experienced members of staff. Staff received varied training to meet needs of people they were supporting.

The registered manager collaborated with this inspection, was receptive to the inspection findings and acted on the issues found or told us the action they would take to address the issues identified.

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 14 June 2021 and this is the first inspection.

The last rating for the service under the previous provider was good, published on 1 May 2019.

Why we inspected

This was a planned inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and effective sections of this full report.

Enforcement and Recommendations

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.

We have identified three breaches in relation to need for consent, good governance and fit and proper persons employed at this inspection.

We made one recommendation for the provider to review good practice guidance in relation to activities for people living with dementia.

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.