Background to this inspection
Updated 15 August 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
This inspection was carried out by 3 inspectors, a CQC pharmacy inspector and CQC support services shadowing.
Service and service type
Combs Court 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.
Combs Court 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.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 all this information to plan our inspection.
During the inspection
We visited the service on 17 May 2023 and 25 July 2023 during these inspection visits, we met with 7 people living at the service. We spent time in the communal areas observing the care and support people received.
We spoke with the registered manager, 2 provider representatives, the deputy manager and 5 care staff.
We reviewed 4 people's care records which included care plans, risk assessments and medicines records. We reviewed 5 staff recruitment records and other documents related to the running of the service which included staff rotas, audits, surveys, meetings, and quality assurance records.
After the site visits, we spoke with 7 relatives. We received electronic feedback from 4 staff members and 2 professionals involved with the service.
Inspection activity ended on 2 August 2023 when we gave feedback to the registered manager and a representative from the provider.
Overall inspection
Good
Updated 15 August 2023
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.
About the service
Combs Court is a residential care home that can accommodate up to 29 people with a learning disability and/or autistic people. The service comprises of four houses on one site and one house is further subdivided into individual flats. There are also two separate self-contained flats. At the time of the inspection there were 29 people living at the service.
People's experience of using this service and what we found
Right Support
People received safe care and they were supported by staff who knew how to protect them from the risk of harm and abuse. Staff were recruited safely and there were sufficient staff to meet people’s needs.
Staff supported people to take their prescribed medicines and to access healthcare services. Staff were aware of people's individual risks and followed plans to minimise these while maintaining people's independence.
People could choose how they wanted to spend their time, whether they wanted to be with other people or in their own space.
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
There was a relaxed atmosphere in the home where staff were respectful and supportive in their interactions with people. Where people required support with personal care this was provided in a discreet way and promoted people's dignity and privacy.
Right Culture
People were enabled to influence the care and support they received. Staff demonstrated a positive person-centred attitude, promoted people's rights and independence and supported people to have equal access to services.
Staff told us they felt supported in their role and enjoyed working at the service. We saw they had formed meaningful relationships with people they supported.
Rating at last inspection
The last rating for this service was good (published 13 May 2019).
Why we inspected
The inspection was prompted in part due to concerns received about staffing arrangements and management of medicines. A decision was made for us to inspect and examine those risks.
As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from these concerns.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings of this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk