60 Cobham Road

Updated 7 June 2023

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 consisted of 1 inspector and 1 specialist medicines inspector.

Service and service type

60 Cobham Road 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. 60 Cobham Road 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 7 February 2023 and ended on 19 March 2023. We visited the service on 7, 9 and 17 February 2023. We received further information on 19 March 2023.

What we did before the 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, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 20 December 2022 to help plan the inspection and inform our judgements. We sought feedback from Healthwatch. 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 this information to plan our inspection.

During the inspection

We communicated with 3 people who used the service and observed their responses. We spoke with 2 relatives about their experience of the care provided. We spoke with 9 members of staff including the registered manager, a support manager, an operations manager, a senior carer and carers. We observed interactions between staff and people who used the service. We sought feedback from 4 healthcare professionals and the local authority safeguarding team. We reviewed 5 people's care records, 5 people's medication administration records (MARs) and 5 staff files. We reviewed documentation relating to the management of the service.

Updated 7 June 2023

About the service

60 Cobham Road is a residential care home providing accommodation for up to 6 people requiring personal care. The service provides support to people with a learning disability, sensory impairments and/or autistic people in one residential property. At the time of our inspection, there were 5 people using the service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right Support, Right Care, Right Culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support:

Staff supported people to live as independently as possible and have a level of control over their lives. People were provided with a choice in their day-to-day decision-making and families were involved in people’s care. People's risks in relation to their care were generally managed and staff understood how to maintain and encourage people's independence. We observed there were sufficient staff to meet people’s needs. We were assured that the service were following good infection prevention and control procedures to keep people safe. Whilst there had been previous instances of delays in accessing healthcare professionals, staff were now working well with them to achieve positive outcomes for people. The provider had recently employed staff to support people with their activities in the local community.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

People told us they felt supported by staff in a kind, caring and dignified way and we observed this. People's differences were respected by staff and they had undertaken relevant training to support people. This included training for learning disabilities and autism awareness. Feedback from relatives was mixed as some felt that there had been delays in seeking medical attention and that the activities provisions offered were not enough. People's right to privacy was respected and staff encouraged people to provide feedback about the quality of care in a format they could understand. Care plans were personalised and included information on people's healthcare needs, communication needs, preferences and social history. Care plans included steps to take to ensure people had regular access to a dentist and were following good oral care guidelines, however this had not always been followed. People were supported to enjoy the diet of their choice and staff encouraged them to have a nutritionally balanced diet. The service was located in a residential street with minimal information to indicate that it was a care home. The service was of a similar size as neighbouring properties.

Right Culture:

The provider’s monitoring systems were not always effective in identifying and acting on shortfalls we found during the inspection. For example, we identified areas for improvement in relation to medicines documentation, some of which had not been identified by the provider’s governance systems. Other areas of improvement had been identified by the provider’s systems and there was an action plan to address these. Where we highlighted shortfalls, the registered manager took immediate action and implemented processes to ensure this would not happen again. People and their relatives told us they felt able to share concerns with the provider and that these would be addressed by the operations manager who was overseeing the service. Staff were complimentary about the registered manager and told us they were able to raise concerns.

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 this service was good (report published 14 March 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service and due to concerns received about medicines, staff failing to seek medical advice in a timely manner and staffing. A decision was made for us to inspect and examine those risks. Please see the effective and well-led sections of this full report.

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, which will help inform when we next inspect.