The Care Quality Commission
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  • Care home

Archived: The Cambridge Care Home

Overall: Good read more about inspection ratings

5 High Street, Chesterton, Cambridge, Cambridgeshire, CB4 1NQ (01223) 323774

Provided and run by:
Bupa Care Homes (ANS) Limited

Important: The provider of this service changed. See new profile

All Inspections

13 January 2015

During a routine inspection

The Cambridge Nursing Centre is registered to provide accommodation, nursing care and personal care for up to 90 older people. There were 61 people living at the home at the time of our inspection.

This unannounced inspection took place on 13 January 2015. At our previous inspection on 14 April 2014 we found the provider was not meeting all the regulations that we looked at. We found concerns in relation to infection control, medicine administration, supporting staff, care and welfare of people, quality assurance, safeguarding, meeting nutritional needs and consent to care and treatment. A warning notice was served around infection control. A further inspection was conducted on 12 June 2014 to check that the provider had met the required standard for infection control. Whilst we found that improvements had been made the auditing process in respect of infection control they were not being consistently completed and some audits were still to be introduced. Therefore we required further action to be taken to make the required improvements.

At the time of this inspection the home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

During this inspection we found that there had been improvements in all of the areas where were previously identified concerns, with the exception of the environment where we found that one area still had malodour and a programme of refurbishment was still in progress.

We found that staff treated people in a way that they liked and there were sufficient numbers of staff to safely meet people’s needs. People received care which had maintained their health and well-being. Relatives were very happy with the care provided

Medicines were stored correctly and records showed that people had received their medication as prescribed. Staff had received appropriate training for their role in medicine management.

Staff supported each person according to their needs. This included people at risk of malnutrition or dehydration who were being supported to receive sufficient quantities to eat and drink.

Staff respected people’s privacy and dignity. They knocked on people’s bedroom doors and waited for a response before entering. People told us that staff ensured doors were shut when they were assisting them with their personal care.

People’s needs were clearly recorded in their plans of care so that staff had the information they needed to provide care in a consistent way. Care plans were regularly reviewed to ensure they accurately reflected people’s current needs.

People confirmed they were offered a variety of hobbies and interests to take part in and people were able to change their minds if they did not wish to take part in these

Effective quality assurance systems were in place to monitor the service and people’s views were sought and used to improve it. The registered manager had been bringing about change to support staff to ensure that people were receiving a good quality of care and support.

14 April 2014 and 12 June 2014

During an inspection looking at part of the service

We carried out an unannounced comprehensive inspection of this service on 14 April 2014. A breach of legal requirements was found. As a result we undertook a focused inspection on 12 June 2014 to follow up on whether action had been taken to deal with the breach.

You can read a summary of our findings from both inspections below.

Comprehensive Inspection of 10 October 2014

The Cambridge Nursing Centre is a care home providing accommodation and nursing care for up to 90 adults. There were 81 people living there when we visited. The care home provided a service for people with physical nursing needs and for people who lived with dementia. There was a manager registered at the service who assisted us on the day of the inspection.

We found that not all aspects of the home were safe.

Where people lacked capacity to make decisions, the Mental Capacity Act 2005 was not being fully adhered to, to ensure staff made decisions based on what was in people’s best interests.

Systems in place for the cleanliness and hygiene of the home did not protect people from acquiring a health care related infection.

People were not always receiving their medication as prescribed and staff were not effective in supporting people when people who displayed behaviour which staff may find challenging became agitated or upset.

We found improvements had been made to the frequency staff were being given training and we saw that staff recognised the importance of supporting people with privacy and dignity.  The changing needs of people were sometimes recognised and planned for, with the appropriate referrals to external health professionals made. We saw that there were plans in place for people to receive end of life care.

However we found that people were not always supported to maintain good nutrition and hydration. Some risks in relation to mobility and pressure ulcer prevention and care were not being managed appropriately.

We received some positive comments about the staff and the care people were receiving and we saw some good interactions between staff and people living in the home, including one person who refused their meal. The carer was very concerned, fetching several different options in the hope the person would eat something.  Eventually, the carer said, “I know they like sweet things” and went and got rice pudding with jam.

However some of our other observations were not as positive. For example, one person we found was distressed and had been left with their medicines as the nurse had told them not to take them until they returned. The nurse however had forgotten to return.

Some people we spoke with were not aware of how to make a complaint. However we saw that when people did make a complaint these had been investigated and responded to by the manager in line with the complaints procedure.

People we spoke with told us that they were able to make everyday choices. However our observations did not support that people were always given choices. For example, we observed one person saying that the tea wasn’t sweet enough but they were not offered any more sugar.  We also observed the same person at lunchtime asking for a tea with more sugar but this was again not responded to by staff.

We found there were not enough meaningful activities offered to people which would meet their individual needs. All of the people we spoke with said either that they were unaware of any activities or that there was, “not much going on.” We received comments such as this from people in all of the four units of the home. We also had concerns about the risk of social isolation for people who were in their bedrooms for long periods of time.

We found there had been some improvements to the provider’s systems of monitoring the quality of the service in some areas but the systems were still not effective.  Although there were visits made by the provider’s quality team and the manager also completed audits in the home, these had not identified the concerns we found during this inspection.

We found there was no system in place to show how staffing levels had been assessed to ensure that numbers were sufficient to meet the needs of the people who used the service and all of the people we spoke with raised concerns about the low numbers of staff in the home. One person told us, “They [staff] often do not come quickly enough when I ring the bell and I get so desperate I end up having to urinate into my pads.”

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS), and to report on what we find. (The deprivation of liberty safeguards are a code of practice to supplement the main Mental Capacity Act 2005 Code of Practice.)

We looked at whether the service was applying the Deprivation of Liberty safeguards (DoLS) appropriately. These safeguards protect the rights of adults using services by ensuring that if there are restrictions on their freedom and liberty these are assessed by professionals who are trained to assess whether the restriction is needed. The manager told us there was no one living in the home currently that needed to have these safeguards in place. However we saw evidence to suggest that two people who lived in the home were being deprived of their liberty. 

We found the location was not meeting the requirements of the Deprivation of Liberty Safeguards.

We found there were a number of breaches in regulation of the Health and Social Care Act 2010 at The Cambridge Nursing Centre and you can see what action we told the provider to take at the back of the full version of the report.

Focused inspection of 12 June 2014

We carried out this inspection to follow up on the warning notice that we served on 30 April 2014 as the provider was failing to meet the requirements of Regulation12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010- cleanliness and infection control

During this inspection we found that a number of improvements had been made and the overall cleanliness of the home had improved. We noted that whilst audits ensuring the cleanliness and infection control processes were in place, these had not been consistently completed and some were yet to be introduced. We found that not all aspects of the home were safe.

14 April 2014

During an inspection

14/04/2014

During a routine inspection

The Cambridge Nursing Centre is a care home providing accommodation and nursing care for up to 90 adults. There were 81 people living there when we visited. The care home provided a service for people with physical nursing needs and for people who lived with dementia. There was a manager registered at the service who assisted us on the day of the inspection.

We found that not all aspects of the home were safe.

Where people lacked capacity to make decisions, the Mental Capacity Act 2005 was not being fully adhered to, to ensure staff made decisions based on what was in people’s best interests.

Systems in place for the cleanliness and hygiene of the home did not protect people from acquiring a health care related infection.

People were not always receiving their medication as prescribed and staff were not effective in supporting people when people who displayed behaviour which staff may find challenging became agitated or upset.

We found improvements had been made to the frequency staff were being given training and we saw that staff recognised the importance of supporting people with privacy and dignity.  The changing needs of people were sometimes recognised and planned for, with the appropriate referrals to external health professionals made. We saw that there were plans in place for people to receive end of life care.

However we found that people were not always supported to maintain good nutrition and hydration. Some risks in relation to mobility and pressure ulcer prevention and care were not being managed appropriately.

We received some positive comments about the staff and the care people were receiving and we saw some good interactions between staff and people living in the home, including one person who refused their meal. The carer was very concerned, fetching several different options in the hope the person would eat something.  Eventually, the carer said, “I know they like sweet things” and went and got rice pudding with jam.

However some of our other observations were not as positive. For example, one person we found was distressed and had been left with their medicines as the nurse had told them not to take them until they returned. The nurse however had forgotten to return.

Some people we spoke with were not aware of how to make a complaint. However we saw that when people did make a complaint these had been investigated and responded to by the manager in line with the complaints procedure.

People we spoke with told us that they were able to make everyday choices. However our observations did not support that people were always given choices. For example, we observed one person saying that the tea wasn’t sweet enough but they were not offered any more sugar.  We also observed the same person at lunchtime asking for a tea with more sugar but this was again not responded to by staff.

We found there were not enough meaningful activities offered to people which would meet their individual needs. All of the people we spoke with said either that they were unaware of any activities or that there was, “not much going on.” We received comments such as this from people in all of the four units of the home. We also had concerns about the risk of social isolation for people who were in their bedrooms for long periods of time.

We found there had been some improvements to the provider’s systems of monitoring the quality of the service in some areas but the systems were still not effective.  Although there were visits made by the provider’s quality team and the manager also completed audits in the home, these had not identified the concerns we found during this inspection.

We found there was no system in place to show how staffing levels had been assessed to ensure that numbers were sufficient to meet the needs of the people who used the service and all of the people we spoke with raised concerns about the low numbers of staff in the home. One person told us, “They [staff] often do not come quickly enough when I ring the bell and I get so desperate I end up having to urinate into my pads.”

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS), and to report on what we find. (The deprivation of liberty safeguards are a code of practice to supplement the main Mental Capacity Act 2005 Code of Practice.)

We looked at whether the service was applying the Deprivation of Liberty safeguards (DoLS) appropriately. These safeguards protect the rights of adults using services by ensuring that if there are restrictions on their freedom and liberty these are assessed by professionals who are trained to assess whether the restriction is needed. The manager told us there was no one living in the home currently that needed to have these safeguards in place. However we saw evidence to suggest that two people who lived in the home were being deprived of their liberty. 

We found the location was not meeting the requirements of the Deprivation of Liberty Safeguards.

We found there were a number of breaches in regulation of the Health and Social Care Act 2010 at The Cambridge Nursing Centre and you can see what action we told the provider to take at the back of the full version of the report.

11 December 2013

During an inspection looking at part of the service

The purpose of this inspection undertaken on 11 December 2013 was to assess improvements in relation to shortfalls identified during our inspection on 14 August 2013.

During our inspection on 11 December 2013 we found that improvements had been made to the property and that people who lived in the home now had appropriate opportunities, encouragement and support to promote their independence by engaging in regular meaningful activities.

We found that actions had been taken to ensure that staff were adhering to the provider's policies and procedures when they administered medicines to people who lived in the home. We found that actions had been taken to ensure that medicines were now stored in an environment which was conducive to maintaining the viability of medicines. This meant that that people had been protected against the risks associated with medicines.

We found that some improvements had taken place to ensure that people were protected from the risk of infection. Appropriate staff training had been undertaken and the standard of hygiene in several areas of the home in relation to odour and environment had improved. However, we found that there were areas that still required improvement in relation to how infection prevention and control was managed in the home.

14 August 2013

During a routine inspection

During our inspection on 14 August 2013 we spoke with six people who lived in the home and seven relatives. People gave us a mixed response in relation to how involved they felt in their care and the care of their relative. One person told us: "Staff are very kind and involve me" and another person told us: "We always have to ask what is going on and find someone that knows". We found that attention was required to areas of the home in relation to the environment and that there was a limited amount of activities available for people on a regular basis.

We found that care records were current and reflected the needs of people who lived in the home.

We found that staff were out of date with their infection control refresher training and there was no ongoing review or observation in regard to clinical practice of infection control and prevention procedures.

We observed the administration of medicines within the home and found that staff were not adhering to the providers policies and that medicines were not stored in an appropriate room.

The provider had a recruitment procedure in place to ensure that only people suitable to work with vulnerable people were employed.

We found that there were significant gaps in staff training and that clinical staff did not have regular appraisals of their performance or supervision sessions.

We found that there was a system in place to check that people were satisfied with the service and that the provider had various monitoring checks on a number of aspects of the service to ensure that standards were maintained. However, during our inspection we found that medication checks carried out had not alerted the provider to a discrepancy in the number of tablets in stock for people. We were also told by the manager that clinical staff had not had a recent appraisal of their practice which meant that the quality of the service provided to people by clinical staff who worked in the home was not monitored.

There was an effective system in place to deal with any complaints people who lived in the home or their relatives might raise.

20 November 2012

During a routine inspection

During our inspection we spoke with some of the people who lived at the home. However, we were not able to speak with everyone who lived there as they had complex needs which meant that they were not able to tell us about their experiences. Therefore, we spent time observing the care that was provided to people in two of the units within the home.

People told us that they liked living at the home and that they were offered choices about a range of issues affecting them. They said that they felt that they were involved in the planning of their care. People also told us that there had been improvements in the meals that were provided.

At the time of our last inspection, in January 2012, we had identified several areas that were in need of improvement. During this inspection, on 20 November 2012, we could see that action had been taken to make the necessary improvements and that further improvements were planned. Record keeping had improved with care plans providing clearer guidance for staff about how to meet people's individual needs. A lot of recruitment had taken place so there were more permanent staff on duty and the use of agency staff had decreased. Staff were now receiving more regular training and supervision to enable them to carry out their roles more effectively.

4 January 2012

During a routine inspection

We spoke with four people who used the service who told us that staff were, "Very good," "Respectful" and, "Kind" and were able to meet their needs. One person told us that they were able to go out regularly with a relative and they enjoyed the activities available within the home.

Regular residents meetings are held and one person told us they felt able to speak freely about any issues of concern and that the staff always listened to them.

People that we spoke with told us that the food provided at the home was not very good. We were informed by staff that some improvements have been made to the menu and further improvements are planned.