CQC report explained · a residential care home
What the CQC found at Combs Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found sufficient staff, safe recruitment, regular risk reviews and systems to protect people from abuse. They identified gaps in some medicines records and guidance, and were only somewhat assured about some hygiene practices.
- Effective?
- Good
- This area was not assessed during this focused inspection. Its rating was carried forward from the previous inspection.
- Caring?
- Good
- This area was not assessed during this focused inspection. Its rating was carried forward from the previous inspection.
- Responsive?
- Good
- This area was not assessed during this focused inspection. Its rating was carried forward from the previous inspection.
- Well-led?
- Good
- Inspectors found person-centred leadership, regular feedback and meetings, effective audits and action plans, and good partnership working with health and social care professionals.
What inspectors found, August 2023
Combs Court is rated Good; inspectors found safe, respectful care, but some medicines records and guidance were incomplete.
This was an unannounced focused inspection. Inspectors visited on 17 May and 25 July 2023, then completed inspection activity on 2 August. They spoke with people, relatives, staff and professionals, observed care, and checked care records, medicines, recruitment files, staffing information and quality checks.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safe recruitment, suitable risk assessments, secure medicines storage and systems to protect people from abuse. People were supported to make choices, stay independent and access healthcare.
There were some medicines shortfalls. Records did not always show when unused medicines had been disposed of, some guidance for medicines given when needed was incomplete, and advice had not been obtained about some medicines given hidden in food or drink. Inspectors were also only somewhat assured about some hygiene practices, but action was taken during the inspection.
Enough suitable staff
Inspectors found enough staff for people's assessed needs, including one-to-one support. Recruitment checks helped ensure staff were suitable to work at the home.
“There were sufficient staff deployed to keep people safe and for the assessed level of support people required.” from the report
Respect and dignity
Staff were respectful and supportive. Personal care was provided discreetly, while people's privacy, choices and independence were promoted.
“There was a relaxed atmosphere in the home where staff were respectful and supportive in their interactions with people.” from the report
Responsive management
The manager encouraged feedback from people, relatives and staff. Comments were followed up and used to develop the service.
“Feedback about the service was encouraged by the registered manager and where people, relatives and staff had shared their views, through satisfaction surveys, care reviews and meetings their comments were followed up” from the report
Unused medicines records
needs fixingWhen medicines were not given, records did not always show that they had been disposed of. This could make it harder to track medicines accurately.
“However, we noted that when medicines were not given to people, they were not always recorded as disposed of.” from the report
Incomplete as-needed medicines guidance
needs fixingSome written guidance for medicines given when needed was missing or did not contain enough person-specific information. The manager said this was being addressed through a new electronic system.
“However, when people were prescribed medicines on a when required basis (PRN), for some medicines there was a lack of written guidance” from the report
Advice about hidden medicines
needs fixingAlthough assessments and best-interest decisions were in place, advice had not been obtained from an appropriate clinician about whether each medicine could safely be mixed with the relevant food or drink.
“However, advice had not been taken from an appropriate clinician (e.g. pharmacist) to ensure that the preparation of each medicine in respective foods or drink was appropriate and safe.” from the report
Some hygiene inconsistencies
minorInspectors were not fully assured about safety linked to the layout and hygiene practices of the premises. The manager was given guidance and action was taken.
“We were somewhat assured that the provider was promoting safety through the layout and hygiene practices of the premises.” from the report
- 01Have all medicines that were not given been recorded as disposed of, and how do you check this now?
- 02Has the written guidance for medicines given when needed been completed with person-specific information?
- 03Has advice now been obtained from an appropriate clinician about medicines given hidden in food or drink?
- 04What changes were made to the layout and hygiene practices after inspectors identified inconsistencies?
This was a focused inspection of Safe and Well-led only; the other ratings and the overall rating were carried forward from the previous inspection. This explanation was written from the published report of 15 August 2023 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.
What inspectors found, May 2019
Rated Good; inspectors found improvements in all areas, with kind, safe and more personalised care.
This was an unannounced inspection on 4 April 2019. One inspector reviewed records, observed care and spoke with people, relatives, staff and managers. The inspection looked at both the home and the care provided.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, suitable risk assessments and respectful care. People were supported to make choices, keep their independence and take part in activities and outings.
The home had improved since the previous inspection on 31 January 2018, when it was rated Requires Improvement overall. Inspectors found better care planning, more activities and stronger checks on the quality of care.
Improved care
The home had made clear progress since the previous inspection. Inspectors found improvements in all five rated areas.
“At this inspection we found improvements had been made and the service is now rated good overall and in all key questions.” from the report
Safe staffing and medicines
There were consistently enough staff for people's assessed needs. Medicines records showed that people received medicines as prescribed, with guidance for medicines given when needed.
“There were consistently enough staff to meet people's assessed needs.” from the report
Kind and respectful care
People told inspectors that staff were kind and took time to support them. Staff respected privacy, dignity and preferred names.
“People were treated with compassion by knowledgeable staff who respected people by addressing them by their preferred name.” from the report
More activities and outings
The home had increased opportunities for activities, shopping, leisure interests and evening events. It had reopened an activities room and employed a driver.
“At this inspection, we found improvements had been made, for example the service had employed a driver to take people to events in the evenings.” from the report
Stronger management checks
The management team had introduced better monitoring and recording systems. These were used to check that care and medicines support had been provided.
“At this inspection of 4 April 2019, improvements had been made and the quality assurance systems were now effective in identifying and rectifying shortfalls in the service.” from the report
Still working towards national principles
minorThe report says the home was not originally developed in line with the principles and values of Registering the Right Support. It was working towards these principles at the time of inspection.
“At the time of registration the service was not developed in line with the principles of and values of Registering the Right Support however the service is working towards these principles.” from the report
- 01What further work has been done to follow the principles of Registering the Right Support, including choice, independence and inclusion?
- 02How are one-to-one support hours recorded when a person does not want the support at the planned time?
- 03What activities, outings and evening events are currently available for someone with my relative's interests?
- 04How do you check that medicines given when needed are administered consistently and appropriately?
- 05How will my relative and our family be involved in reviewing the care plan and changing daily activities?
This was an unannounced inspection covering all five key questions, including both the premises and care provided; the home does not provide nursing care. This explanation was written from the published report of 11 May 2019 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 Combs Court
4 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- August 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- April 2018Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- February 2012
Registered with the Care Quality Commission on 5 February 2012.
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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23 live-in carers within about an hour of Suffolk
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 £1,020 to £1,260 a week. 17 can care for a couple. 7 years' experience on average.
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