CQC report explained · a residential care home
What the CQC found at Combe House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2022
Rated Requires Improvement; inspectors found safe, effective and kind care, but some people had too few meaningful activities and leadership was inconsistent.
Inspectors visited the home without notice on 26 November 2021. Two inspectors spoke with people, the manager and care staff. They also observed care, reviewed three people's records and medicines arrangements, and contacted three relatives.
The home was rated Good for Safe, Effective and Caring. Inspectors found safe medicines management, suitable recruitment checks, trained staff, healthcare support and respectful relationships. Infection control arrangements were also checked during the inspection.
The home was rated Requires Improvement for Responsive and Well-led. Some people with higher support needs did not have enough meaningful activities or opportunities to spend time as they wished. The provider had started making improvements, including increasing activities.
The overall rating was Requires Improvement. This was the first inspection under the current provider. The previous rating, under the former provider, was also Requires Improvement and was published on 12 November 2020.
Safe care
People told inspectors they felt safe. Staff understood safeguarding and risk assessments were reviewed when people's needs changed.
“People told us they felt safe at the home and when staff provided their care.” from the report
Medicines managed safely
Staff were trained and assessed before giving medicines. Medicines were audited, and errors were investigated with action taken.
“When medicines errors had occurred, appropriate action had been taken in response.” from the report
Training and healthcare
Staff had induction, role-specific training and supervision. People were supported to attend healthcare appointments and the home worked with health professionals.
“Staff had access to the training and support they needed to carry out their roles.” from the report
Kind and respectful relationships
People and relatives described positive relationships with staff. Staff respected people's dignity, privacy and decisions.
“People told us they liked living at Combe House and they got on well with the staff who supported them and enjoyed their company.” from the report
Communication and involvement
The home used pictures, easy-read information and social stories to support communication. People could give views at meetings and through keyworker discussions.
“People's individual communication needs were discussed and recorded during their initial assessment.” from the report
Too few meaningful activities
seriousSome people with higher support needs did not have enough activities that matched their preferences. One-to-one support sometimes focused on keeping people safe rather than helping them take part in meaningful activity.
“Some people did not have sufficient opportunities for engagement in activities that met their needs and preferences.” from the report
Restricted choice and community access
seriousSome people could not spend time outside the home as they wished because the staffing needed for this was not available. This led to a breach of Regulation 9.
“In some cases, one-to-one support was not sufficient to enable people to spend their time as they wished.” from the report
Agency staff and consistency
needs fixingThere were staff vacancies and agency staff were needed on most shifts. The provider used regular agency staff where possible, but relatives said staff turnover affected consistency.
“People's experience of care had been affected by the use of agency staff.” from the report
Leadership not always consistent
needs fixingThe manager had made improvements and quality monitoring systems were in place. However, inspectors found that the service did not always provide person-centred care that maximised people's choice and control.
“The service management and leadership was inconsistent.” from the report
- 01How will you provide meaningful activities for my relative, particularly if they have higher support needs?
- 02If my relative wants to go out, how many staff can support them and how often is this available?
- 03How many permanent staff currently work at the home, and how often are agency staff used?
- 04What changes have been made since the inspection to improve choice, control and community access?
- 05How will you show families that the Regulation 9 breach has been addressed?
This was an unannounced planned inspection covering all five key questions, including infection prevention and control measures, and it was the first inspection under the current provider. This explanation was written from the published report of 16 February 2022 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.
Every inspection of Combe House
5 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- February 2022Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2020Requires improvementstayed Requires improvementSafe: GoodWell-led: Requires improvement
- December 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- May 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2020
Registered with the Care Quality Commission on 21 September 2020.
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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77 live-in carers within about an hour of Surrey
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,250 a week. 66 can care for a couple. 11 years' experience on average.
“Without his support we wouldn't have been able to navigate bringing and keeping Dad at home.”
“Not only has she looked after him beautifully, she has also been great company for him with lively conversation, kindness and humour.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.