CQC report explained · a residential care home
What the CQC found at Comfort House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, robust recruitment checks, good risk management and suitable safeguarding arrangements. Medicines were generally managed safely, but the provider was advised to regularly change the medicines room code.
- Effective?
- Good
- People received suitable support with food, drinks, health needs, training and consent. Inspectors noted that some care information was not fully detailed and that parts of the building needed improvement.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff supported people's independence, involved relatives and helped people make choices, although further work was needed to support choices for some people living with dementia.
- Responsive?
- Good
- Care was personalised and activities were available, including support for people living with dementia. A small number of care plans needed updating, and further work was planned to use picture formats at mealtimes.
- Well-led?
- Good
- Inspectors found an open culture, improved staff morale and better quality monitoring since the previous inspection. Communication with some outside professionals had recently declined, and the manager was addressing this.
What inspectors found, February 2020
Rated Good; inspectors found kind, safe care, with improvements still needed to medicines storage, records and parts of the environment.
This was an unannounced inspection on 13 and 14 January 2020. Inspectors spoke with people living in the home, relatives, staff and health and social care professionals. They also observed care and checked care, medicines, staff and management records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People and relatives spoke positively about the kindness of staff, the friendly atmosphere and the care provided. Inspectors found enough staff, suitable training, good infection control and safe support with food, healthcare and activities.
There were some areas to improve. The provider was asked to strengthen medicines storage, update some care records and follow best practice for the building's design and decoration. The dining experience upstairs was not as good as on the ground floor, but this was addressed immediately. The home had improved from Requires Improvement at the previous inspection, published on 6 March 2019.
Kind and welcoming care
People and relatives praised the kindness of staff. Inspectors saw a warm atmosphere, with staff spending time talking to people and treating them respectfully.
“People and relatives had many positive comments about the service provided. They praised the care and kindness shown by staff.” from the report
Enough trained staff
There were enough staff to meet people's needs. Recruitment checks, induction, training, supervision and appraisals were in place.
“The provider had enough skilled staff on duty to meet people's needs.” from the report
Support with food and health
People were supported with special diets, poor appetites, fluids and healthcare appointments. Care records described individual nutritional needs and preferences.
“People were well supported to eat and drink to maintain a healthy diet, including anyone on special diets.” from the report
Improved management
The provider and home manager had worked to improve the service since the previous inspection. Inspectors found improved morale and updated quality checks.
“Since the last inspection the provider, registered manager and staff had worked hard to make improvements to the service.” from the report
Personalised activities and support
Activities helped people avoid social isolation, and a new activity coordinator was in place with experience of supporting people living with dementia.
“A new activity coordinator had been employed with many years' experience of working with people who lived with dementia.” from the report
Medicines room security
needs fixingA healthcare professional had been able to enter the medicines room using a key code. The code was changed immediately, but the provider was advised to change it regularly.
“We recommend the provider regularly change the code on the medicines room to ensure continued security of medicines.” from the report
Some records needed updating
needs fixingA small number of care plans and one person's records were not fully detailed or up to date. The manager said this would be addressed.
“A small number of plans needed an update.” from the report
Building improvements outstanding
minorSome areas needed decoration and refurbishment. Plans were in place for work to lounge and reception areas, general redecoration and the garden.
“The premises needed further decoration and refurbishment.” from the report
Upstairs dining experience
minorPeople dining in the recently converted upper dining area did not receive the same experience as people on the ground floor. The issue was discussed with the manager and addressed immediately.
“However, on the recently converted upper dining room area, people did not receive the same experience.” from the report
Communication with professionals
minorTwo health and social care professionals reported a recent decline in communication. The manager was aware and was addressing this with staff.
“However, two professionals said there had been a recent decline.” from the report
- 01How often is the medicines room code changed now, and who is allowed to access the room?
- 02Have all care plans and records identified in the inspection been updated and checked?
- 03What refurbishment and garden work has been completed since the inspection?
- 04How do you make sure people dining upstairs receive the same experience as people on the ground floor?
- 05What has been done to improve communication with health and social care professionals?
This inspection looked at the premises and care and rated all five CQC questions: Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 12 February 2020 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, March 2019
Rated Requires Improvement; inspectors found kind, effective care and major progress, but some safety records and management checks still needed improvement.
This was an unannounced inspection over 28 and 29 January 2019. Inspectors spoke with people, relatives, staff and health professionals. They observed care and reviewed care records, medicine records, incident information and quality checks.
The home had improved greatly since its previous inspection, when it was rated Inadequate and placed in special measures. Staffing, care planning, training, activities and leadership had improved. People and relatives were positive about the changes.
The home was rated Good for Effective, Caring and Responsive care. It was rated Requires Improvement for Safe and Well-led. Inspectors found some medicine recording problems, an unsecured entrance, gaps in pressure damage training and some complaints outcomes that were not recorded.
The home was no longer rated Inadequate and was taken out of special measures. Inspectors said more time and monitoring were needed to show that the improvements would continue.
Improved staffing
Inspectors found enough staff, safer recruitment and quicker responses to call bells. Use of agency staff had also reduced.
“Staffing levels were sufficient and call bells were answered quickly.” from the report
Kind and respectful care
People and relatives spoke positively about the staff. Inspectors observed kind care and found that privacy, dignity and independence were respected.
“Staff were observed to be kind and caring to the people they supported.” from the report
Personalised activities
Activities had increased and included entertainment, games, exercise and crafts. People, relatives and staff valued the activity programme.
“There were a range of activities in place, including entertainers, games, exercise and crafts.” from the report
Better leadership
The registered manager was visible, knew people and families, and had introduced more checks and staff involvement. Staff morale had improved.
“The registered manager promoted an open and honest culture and actively praised staff for the work they had done, which was absent until recently.” from the report
Medicine records
needs fixingMedicines were generally managed safely, but some patch and cream records were incomplete. The home said this was corrected and would be closely monitored.
“We did find several recording issues including not always ensuring patch application charts and topical (creams and ointments) medicine charts were fully completed.” from the report
Entrance security
seriousAn inspector was able to enter without being checked because of problems with the front door and locking system. Contractors were expected to replace the doors by 11 February.
“On arrival, one of the inspection team was able to walk into the service unchecked.” from the report
Pressure damage training
needs fixingPeople at risk of skin damage were supported, but some staff were unsure how often one person should be repositioned. Inspectors recommended a review of training.
“However, some staff were less aware of how often a person should be repositioned.” from the report
Complaint records
needs fixingComplaints were investigated, but the home did not always record the outcome or show that a written response had been sent to relatives.
“However, there was not always an outcome recorded or evidence of a written communication with relatives.” from the report
- 01Have the front door and locking system been replaced, and how do you now check visitors entering the home?
- 02How do you check that patch and cream medicine records are completed correctly every time?
- 03What extra training have staff received about repositioning people and preventing pressure damage?
- 04How are complaint outcomes now recorded and communicated to relatives?
- 05How will you show that the improvements found at this inspection have been maintained?
This was an inspection of all five key questions, including the care provided and the premises, following the previous Inadequate rating and special measures status. This explanation was written from the published report of 6 March 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 Comfort House
5 rated inspections over 4 years: the service has held its Good rating throughout.
- February 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2019Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2018Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- November 2011
Registered with the Care Quality Commission on 1 November 2011.
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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