Archived: Comberton Nursing Home

Prior to our inspection we had received concerns about the care of people who lived in Comberton Nursing Home. These were about the management of infection control, staffing numbers and how they ensured people ate enough. We spoke with ten of the 31 people who used the service, three nursing and care staff, the maintenance person and cook.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People we spoke with told us they felt safe and comfortable living at the service. One person who used the service told us, "I am well cared for, it's a nice home, and the staff know what I need'.

No applications for the Deprivation of Liberty Safeguards had been submitted by the service. Systems were in place should these be required to keep people safe.

Systems were in place to make sure that managers and staff learned from events such as accidents, incidents and complaints. For example one person had been trapped in their bed rail and suffered an injury. As a result of this the provider had purchased specialist equipment to minimise the risk to the person's safety. We saw that an appropriate re-assessment of the person's needs and risks had taken place. This helped to reduce the risks to people and helped the service to improve.

Prior to our inspection we had received concerns about the management of infection control. We saw that the systems for promoting infection control had improved; the provider had purchased some new equipment such as beds, toilet seats and chairs. We saw worn flooring in bathroom and toilet areas as well as concerns with the sluice room which meant these areas were hard to clean effectively. A strong odour was present around toilet and sluice areas. People were not protected against the risk of contamination from a healthcare associated infection.

People we spoke with said they were not kept waiting for assistance and we saw staff were responsive to people's needs.

Is the service effective?

We saw some evidence of the service cooperating with others, such as the district nurse service, or mental health team to promote people's wellbeing. This meant that staff took into consideration external professional advice in order to promote people's health and wellbeing.

We saw that people's care needs and the risks they faced to their health had been assessed. However, we did find gaps in care records. Care plans provided staff with some guidance to meet people's needs but did not always contain all the relevant information, including people's personal choices or routines.

Some people had been assessed at high risk of developing sore skin areas but the care plan did not specify the type of mattress being used or that the person used a cushion for pressure relief. We saw that this equipment was being used and that staff were aware of the person's needs so the gap in records did not impact on the person's care. We found that care plans and risk assessments had been evaluated but not all had been re-written so that they reflected people's current needs.

Is the service caring?

We observed staff interacting with people and saw that these interactions were positive and caring. People were complementary about the staff. One person told us, 'I haven't felt too well today but the staff are keeping an eye on me'.

People told us they were able to talk with staff about any concerns or complaints they had.

We saw care plans were in place to guide staff in supporting those people at risk of not eating enough. People who used the service told us that they enjoyed the food. One person told us, "It's alright, if I didn't like something they would offer an alternative'. We saw some people had an alternative option but only one main meal was cooked at lunch time which limited people's choice.

Is the service responsive?

People told us that there was enough stimulating activity to keep them interested. We saw some people engaging in a craft activity which they appeared to enjoy. One person told us, 'We do have lots of activities, quizzes, craft, reading, it's quite good'. The activities worker kept a record of activities and who engaged in them. We saw that people cared for in bed were also provided with some dedicated time whereby they had stimulation.

There were some gaps in essential staff training to ensure staff had the skills to meet people's needs. Effective action was taken when people's needs could not be met.

People we spoke with said they were not kept waiting for assistance and we saw staff were responsive to people's needs.

Although no recent complaints were recorded, people told us they would feel confident to speak the manager if they did have a concern.

We saw records for the reporting of accidents, incidents or safeguarding concerns demonstrated the manager had systems in place for the reporting and sharing of information. The manager told us they reviewed such information in their managers' meetings so that any lessons to be learnt or risks to people were identified and minimised. This meant that people could be sure action was taken to keep people safe.

Is the service well-led?

The service has a registered manager. The provider had a quality assurance system but this was not effective in promoting improvements. For example the provider had not taken action on some of the concerns raised regarding the replacement of bathroom and toilet flooring to prevent the risk of infection to people. Gaps in care records and staff training had not been picked up with clear actions plans for improvement.

We saw people were asked for their consent about the care they received although records did not always reflect this.

People were consulted about their care choices and care plans detailed their preferences. Risks to people's health were identified and managed but records did not always reflect these changes.

People told us they felt safe and staff were aware of how to report any suspicion of abuse.

There were enough staff to meet people's needs and we saw that people did not have to wait for support. One person living there told us, "I'm very happy here, the staff are very nice".

Staff had the support they needed to carry out their care tasks to an appropriate standard. One person told us, "The nursing and care staff are really good; they know what they are doing". A visiting relative said, "The staff understand people's needs and are responsive, I'm very pleased".

People had been supported to raise complaints and the provider had acted upon these.

We found that people who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises, because a planned programme of renewal of the carpets and arm chairs had taken place.