The Care Quality Commission
  • Services in your home
  • Homecare service

Archived: 11 Cullum Road

Overall: Good read more about inspection ratings

Cullum Road, Bury St Edmunds, Suffolk, IP33 3PB (01284) 705486

Provided and run by:
Orbit Group Limited

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

All Inspections

15 January 2015

During a routine inspection

This was an announced inspection carried out on the 15 January 2015. The service provides personal care to people living in sheltered accommodation and there was a registered manager in place. 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 2008 and associated Regulations about how the service is run.

At the last inspection on 19 September 2014. We found that people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines. We also found that the provider did not have an effective system to regularly assess and monitor the quality of service that people received or to identify, assess and manage risks to the health, safety and welfare of people who used the home. We issued the provider with a warning and required them to take action to improve these elements of the service. At this inspection we saw that improvement had been made to meet the relevant requirements.

Medication was stored securely and since our last inspection significant action has been taken to put systems in place to audit medication, detect errors and take action promptly should any errors arise.

The staff had received training in the safeguarding of people, promoting dignity and respect and in the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS).

Before moving to the service people took part in an assessment of their needs from which a care plan was written and reviewed regularly. The care plan determined how many visits the person required each day and hence the number of staff required to be on duty.

Staff had worked with people to support them to access and be visited by healthcare professionals when they had been unwell and also to arrange on-going appointments to maintain their well-being when long standing illnesses had been diagnosed.

Staff had supported people to maintain and improve their independence after periods of illness. There were regular activities arranged for people and support with hobbies. Many of the communal walls had been decorated with drawings and paintings by the people who lived at the home.

There were systems in place for replying to people’s concerns. People told us that they were confident in the manager and senior staff who they saw regularly.

19 September 2014

During a routine inspection

We carried out our last inspection of this service on 30 May and 2 June 2014. We found that the poor practice related to the administration of medication and the lack of effective quality monitoring procedures placed people at risk. We made two compliance actions and returned to see that actions outlined in the action plan submitted by the service had been put in place.

During our inspection on 19 September 2014 we spoke with four people who used the service, one relative, three members of staff and the registered manager. We observed staff providing care and support and administering medication. We also looked at the medication records for six people. Other records we reviewed included quality and monitoring records. We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is the summary of what we found:

Is the service safe?

We found that there continued to be a significant number of medication errors. We saw that some people had not received their prescribed medication on several occasions and that there was no clear process in place to address this issue and reduce the frequency of medication errors. This meant that we were not assured that people were receiving their medication safely.

We saw that a monthly audit identified how many falls had occurred at the service but there was no analysis of the figures to establish if everything had been done to ensure people were safe.

Is the service effective?

The high numbers of medication errors meant that the service was not effective in delivering medication to people promptly and safely.

We found that systems to monitor the delivery of the service were not effective as they did not analyse events and put measures in place to reduce the risks for people who used the service.

We were concerned that one person's care plan for medication had not been written even though they had been resident for several weeks.

Is the service caring?

We observed very warm and respectful interactions between staff and the people who used the service. One person told us, 'They're wonderful here. I couldn't fault them'. Another person said, 'They are good to me ' everyone is very friendly'.

Is the service responsive?

We were concerned that a situation where one person was at risk of regularly receiving medication which was not prescribed for them had not been responded to more promptly and measures put in place to safeguard the person.

Is the service well led?

The service had introduced new quality assurance measures but we found some of these were merely logging information rather than using it to make improvements which would ensure people were safe.

We were concerned that the service still had no effective procedures which related to medication errors. This placed people at risk.

30 May and 2 June 2014

During a routine inspection

During this inspection we spoke with ten people who used the service, five care staff, the registered manager and the area business manager. We looked at four people's care records and three staff records. Other records we reviewed included staff training, medication and quality and monitoring records. We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is the summary of what we found:

Is the service safe?

Care records were person centred and were updated to ensure that people received the care they needed to keep them safe. We found one record which had not been updated to reflect a person's changing needs.

The service worked with other healthcare professionals to help meet people's healthcare needs.

Staff received training to help them carry out their roles safely.

We found that the service was not keeping people safe when administering medication. We found medication practices were poor and that several errors had not been picked up by the manager. We were concerned that action had not been taken when an error occurred to make sure the person was safe as the GP had not been contacted or other advice sought.

We looked at rotas and found that there were enough trained and experienced staff on duty to meet people's needs.

Is the service effective?

We found that some staff were not fully aware of their responsibilities under the Mental Capacity Act 2005.

People's health and care needs were assessed in consultation with either the person themselves or relatives. People's care plans reflected their healthcare needs and the service worked in conjunction with support from outside professionals to meet them.

People who used the service told us that staff were reliable and came on time to support them.

Is the service caring?

People were supported by staff who were kind, caring and respectful.

People who used the service told us they were happy with the care provided and spoke positively about the staff. One person told us, 'Anything I need they get me. I don't have to worry about it. They help me with my tea and my dinner. Anything you want they do for you. It's wonderful here. I have never been in such a good place'.

One person who needed help with their mobility told us, 'The carers are nice ' they always make sure I am comfortable (at night) before they leave me'.

Is the service responsive?

People's care records showed that where concerns about an individual's wellbeing had been identified, staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance promptly from other health care professionals. We observed a new hoist being delivered on the day of our inspection and noted that the service had worked with local healthcare services promptly when someone's mobility deteriorated.

People's preferences and choices had been recorded in their care plans and we observed that care and support was delivered in accordance with people's wishes.

Activities were provided in response to people's requests.

Is the service well led?

The service did not have an effective quality assurance system in place.

We saw that there was no audit in place related to health and safety, falls, infection control or medication. We found that the lack of an effective audit system meant that serious medication errors had occurred repeatedly and nothing had been put in place to reduce the risk to the people who used the service.

We were concerned that the manager was not in regular attendance at the service and that they, and other senior managers, could not be contacted by staff during our inspection. This meant that we could not be assured that there was effective management support available to staff at all times.

23 October 2013

During a routine inspection

We spoke with eight people using the service, who told us that they received a good service. Four people confirmed that staff were sometimes delayed in delivering routine care to them, but that they were confident that staff would attend to them quickly in an emergency. One person said, "I am very happy living here and I cannot fault the staff." Another person told us, "Sometimes I am in discomfort when waiting for staff to come and support me to the toilet."

We found that the service was meeting people's needs, but that routine care was sometimes delayed. Staff demonstrated a good knowledge of the people using the service and also a passion for their duty of care. Training for staff was up to date. Line management arrangements had changed and were more remote. We saw that this was impacting on staff morale.

People were protected from unsafe or unsuitable equipment because the provider had put systems in place to ensure that equipment was maintained, suitable for purpose and used correctly and safely. We saw evidence that health and safety checks were routinely undertaken to protect people from the risks associated with gas, electricity and legionella bacteria.

People knew how to feedback any comments and complaints they had, although they told us that they would appreciate having more face to face time with the registered manager.

11 October 2012

During a routine inspection

We spoke with five people using the service. They all told us that they were happy and felt safe. One person said, "Staff are superb. They are polite and respectful towards me. They help me to have a shower three times a week and I can have more if I feel like it. Staff are always punctual and I look forward to seeing them as they make me smile." Another person said, "I like the facilities and the activities. There is a communal library. We can join in with gardening, exercise classes, visits from schools and knitting."

We found the service to be compliant with the outcomes we looked at. Staff were knowledgeable about the needs and preferences of people using the service. They made sure that people were able to access other support services. Care records were clear and up to date and risk assessments were in place where appropriate. People were able to suggest ways to improve the service and these were acted on.