CQC report explained · a nursing home
What the CQC found at Camberley Manor
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were identified and managed, accidents and safeguarding concerns were monitored, and medicines were given as prescribed. There were enough skilled staff and the home was clean and well maintained.
- Effective?
- Good
- Staff received induction, training and supervision. People's nutrition, hydration and healthcare needs were supported, and staff followed the Mental Capacity Act and Deprivation of Liberty Safeguards processes.
- Caring?
- Good
- Staff knew people well and provided personalised care with kindness and compassion. Inspectors saw people's privacy, dignity, independence, cultural needs and relationships being respected.
- Responsive?
- Good
- Care plans gave staff detailed guidance about people's needs, preferences and life histories. Activities were varied and personalised, and complaints were recorded, investigated and responded to.
- Well-led?
- Good
- Inspectors found visible leadership, a positive culture and quality checks that identified and addressed shortfalls. People, relatives and staff were able to share their views about the home.
What inspectors found, August 2018
Rated Good and out of special measures; inspectors found safe, kind and personalised care after major improvements.
The inspection was unannounced and took place on 14 June 2018. Inspectors spoke with 12 people living in the home, five relatives, nine staff members and the registered manager. They observed care and reviewed care plans, medicines records, staff files, complaints and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough trained staff, safer medicines systems, better risk monitoring and care plans that reflected people's needs and preferences. People were treated with kindness, dignity and respect, and had activities and support linked to their interests.
The home had previously been placed in special measures after serious concerns and legal breaches in 2017. At this inspection, inspectors found significant improvements and no breaches of legal requirements. The home was therefore taken out of special measures.
More consistent staffing
The home had recruited a full staff team and had largely stopped using agency staff. Inspectors found that people received more timely support from staff who knew them well.
“The use of agency staff had largely been eliminated and a full staff team had been recruited.” from the report
Safer systems
Daily clinical handovers, risk reviews and medicines checks helped staff identify concerns quickly and take action.
“Robust systems had been implemented to monitor risks to people's safety.” from the report
Personalised care
Care plans included people's likes, dislikes and life histories. Staff used this information to support people in ways that suited them.
“People were supported by staff who knew their needs well and provided highly personalised care.” from the report
Kind and respectful staff
Inspectors saw staff spending time with people and supporting their privacy, dignity and independence.
“At this inspection we found that significant improvements had been made and people were now receiving care from kind and attentive staff.” from the report
Activities and interests
People could join group activities or receive individual support to continue hobbies and interests.
“People had access to a wide range of activities which were personalised to their individual needs.” from the report
Some concerns about food
minorMost people said the food had improved, but some still found it too rich. The report says alternatives were available.
“The majority of the people we spoke with told us that the food at Camberley Manor had improved although some people said they still found it too rich for their pallet.” from the report
- 01How have you maintained the stable staffing team and reduced the use of agency staff since this inspection?
- 02How are risks, accidents, incidents and safeguarding concerns reviewed now, and how are families told about relevant concerns?
- 03How are medicines checks and staff competency assessments carried out now?
- 04How are menus adapted for people who find the food too rich, and what alternatives are available?
- 05How are care plans, end-of-life wishes and activities reviewed with each person and their family?
This was an unannounced inspection looking at the overall service and all five key questions, including the accommodation and care provided. This explanation was written from the published report of 18 August 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk. The report was longer than we could read in one go; the later sections may not be reflected.
What inspectors found, January 2018
Rated Inadequate and placed in special measures; inspectors found serious safety and leadership failures despite some improvements.
Inspectors visited on 5 and 10 November 2017. The first visit was unannounced. They spoke with people, relatives and staff, observed care, and checked care records, medicines records, staff files and other documents.
The home had improved staffing stability, food, healthcare support and care for people living with dementia. However, inspectors found safeguarding concerns were not always reported, accidents and injuries were not properly investigated, medicines records and administration were not always safe, and moving and handling was sometimes unsafe.
People were not always treated with dignity. Complaints were not recorded reliably, some care records were out of date, and staff training and supervision were incomplete. There had also been frequent management changes and quality checks had not led to sustained improvement.
The overall rating was Inadequate. Safe and well-led were rated Inadequate, while effective, caring and responsive were rated Requires Improvement. The home was placed in special measures, meaning CQC said it would be closely monitored and inspected again.
Healthcare support
People had access to a range of healthcare professionals and appointments were recorded. Staff also monitored some health conditions and acted when people's weight changed significantly.
“People had access to a range of healthcare professionals and appointments were recorded.” from the report
Activities
The home offered group and individual activities, including outings, games, entertainment and exercise. Activities were linked to people's personal preferences.
“People had access to a wide range of activities in line with their personal preferences.” from the report
Privacy and independence
Inspectors saw staff respecting privacy and supporting people to make choices and do what they could for themselves.
“People were supported to maintain their independence.” from the report
Clean environment
The building was clean and maintained. Inspectors found infection control procedures, cleaning schedules and equipment servicing in place.
“The building was cleaned to a high standard.” from the report
Safeguarding failures
seriousSome safeguarding concerns, including incidents of aggression and people wearing two continence aids, were not reported to the local safeguarding authority or acted on appropriately.
“Safeguarding concerns were not always identified and appropriately reported.” from the report
Injuries not investigated
seriousAccidents, bruising and skin tears were not consistently recorded, investigated or reviewed to reduce the risk of recurrence.
“There was no evidence to show that the cause of these injuries had been investigated or action taken to help reduce the risk of them happening again.” from the report
Medicines and hydration
seriousInspectors found gaps in medicines recording, a missed dose and incomplete information for covert medicines. Fluid intake was also not monitored well, including for people at risk of dehydration.
“The failure to effectively monitor accidents and incidents, to manage risks to people's safety and to ensure that safe medicines processes were in place is a repeated breach of regulation 12” from the report
Dignity and personal care
seriousSome people did not receive appropriate mouth care, and inspectors saw staff interactions that were not respectful. Records also showed repeated incidents involving two continence aids being worn at once.
“The failure to ensure that people's dignity was respected at all times was a continued breach of regulation 10” from the report
Weak leadership and oversight
seriousFrequent management changes created instability. Audits identified problems, but actions were not brought together or followed through effectively.
“Quality assurance systems were not monitored and not effective in driving improvements.” from the report
Complaints not tracked
needs fixingThe complaints log did not include all concerns or clearly show what action had been taken. This meant the home could not reliably identify patterns or show that care had improved.
“The lack of recording of complaints meant we could not be confident that the information received reflected the number of complaints made and if concerns were being addressed.” from the report
- 01How have you stopped safeguarding concerns, aggression incidents and unexplained bruising from being missed or left unreported?
- 02What checks now confirm that medicines are given, recorded and reviewed correctly, including missed doses and covert medicines?
- 03How do you monitor people's fluid intake and identify and respond to dehydration risks?
- 04What has changed in staff training, supervision and moving and handling practice since this inspection?
- 05Who is now responsible for the home, and how are complaints, audits and care-record updates checked and followed through?
This was a comprehensive inspection covering all five key questions, prompted by concerns about staffing and the care people were receiving. This explanation was written from the published report of 14 January 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Camberley Manor
4 rated inspections over 2 years: the service has held its Good rating throughout.
- August 2018Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2018Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- August 2017Requires improvementdown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- November 2015
Registered with the Care Quality Commission on 6 November 2015.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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