CQC report explained · a nursing home
What the CQC found at Coombe Dingle Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, staffing levels met people's needs, and medicines and infection control were handled safely. A concern about access to thickener was fixed during the inspection.
- Effective?
- Good
- People received care based on assessments, staff training and professional guidance. The home supported nutrition, healthcare access, communication needs and lawful decision-making.
- Caring?
- Good
- People and relatives described staff as kind and caring. Inspectors saw staff respecting privacy, dignity and personal choices while encouraging independence.
- Responsive?
- Good
- Care plans reflected people's likes, dislikes, routines and health needs. The home offered activities and communication support, involved families and followed a complaints process.
- Well-led?
- Good
- The manager was visible and knew people and relatives well. Audits, meetings and feedback were used to identify and complete improvements.
What inspectors found, February 2020
Rated Good; inspectors found safe, kind and personalised care, with one minor security issue fixed during the visit.
The inspection took place without notice on 09 January 2020. Two inspectors and a specialist nurse spoke with people, relatives and staff. They observed care and reviewed care, medicines, staffing and management records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough experienced staff, safe medicines procedures, good infection control and well-managed risks.
Care plans recorded people's needs, choices and preferences. Staff supported people with food, activities, communication, healthcare and end of life care. People were treated with dignity and encouraged to remain as independent as possible.
The previous inspection was also rated Good, published on 13 July 2017. Inspectors found one possible risk with a cupboard containing thickener, but the manager fitted a padlock and secured the key during the inspection.
Safe staffing
Inspectors found enough staff with suitable experience and skills. People were supported by a consistent team who knew their needs well.
“People were supported by a consistent team of staff that knew their needs well.” from the report
Personalised care
Care plans recorded individual preferences, routines and health needs. Staff followed guidance about how to support people, including when someone became anxious.
“Care plans were person centred with details of people's likes and dislikes.” from the report
Kind and respectful support
People were treated with dignity and respect. Staff knocked before entering bedrooms and encouraged people to do what they could for themselves.
“People were treated with dignity and respect and encouraged to be as independent as possible.” from the report
Good communication and activities
The home supported different communication needs and offered activities based on people's interests. It also helped people maintain links with family, friends and the local church.
“People were supported with their communication needs.” from the report
Responsive management
The manager used audits, feedback and incident reviews to make improvements. Inspectors saw an identified security risk dealt with immediately.
“This was all completed during the inspection showing the provider and registered manager's positive attitude towards responding to any concerns raised.” from the report
Thickener cupboard was not initially secure
minorInspectors noticed that a cupboard containing thickener could be opened by anyone who unlocked its bolt. The manager fitted a padlock and secured the key during the inspection.
“During the inspection it was noted that thickener was locked in a cupboard with a bolt on the door so anybody could open the cupboard.” from the report
- 01How will you assess and manage my relative's specific risks, including falls, swallowing or behaviours that may be challenging?
- 02How will you support my relative's communication needs if they cannot communicate verbally?
- 03How will you involve me and my relative when care needs or preferences change?
- 04What activities and one-to-one support would be available for my relative's interests and preferred routine?
- 05How are medicines, thickener and other items that could pose a risk stored securely?
This was a planned, unannounced inspection covering all five CQC questions, including the premises and the care provided; all ratings were given at this inspection. This explanation was written from the published report of 18 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, July 2017
Coombe Dingle Nursing Home: Rated Good; inspectors found major improvements, with minor gaps in capacity assessments and following one medicines plan.
This was an unannounced, fully comprehensive inspection on 14 June 2017. Inspectors spoke with people living in the home, relatives, staff and health professionals. They observed care and reviewed care plans, staff files, medicines records and other documents.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, suitable medicines systems, kind and respectful care, detailed care plans, activities and stronger management checks.
The inspection followed four breaches found in April 2016. Inspectors said there had been significant improvement in all areas. They still found a couple of capacity assessments needed completing and one medicines instruction was not being followed, but the manager took action.
Medicines
Medicines records checked by inspectors were complete and accurate, with no gaps or mistakes.
“We checked people's MARs and saw they were completed correctly with no gaps or mistakes.” from the report
Staffing and safety
Inspectors found enough staff to respond promptly and safely. Staff were regularly checking on people.
“Staff were constantly moving around the communal areas checking people were okay.” from the report
Kind and respectful care
Staff knew people well and supported them gently, while respecting privacy, dignity and independence.
“People were treated with respect and dignity and cared for by staff who knew them.” from the report
Activities
People could take part in activities such as music, games, dancing and time in the garden. Staff respected people's choice not to join in.
“We found people had access to activities.” from the report
Capacity assessments
needs fixingInspectors found a couple of areas where people's mental capacity still needed to be assessed in relation to their care. The manager said this would be dealt with immediately and later sent evidence of action.
“We did identify a couple of areas were people's capacity still needed to be assessed in relation to the care they were receiving” from the report
Following medicines instructions
needs fixingStaff were not following one person's care plan about how their medicines should be taken. The manager acted during and after the inspection.
“We did note however that staff were not following one person's care plan in relation to how they took their medicines.” from the report
- 01How do you check that every person's mental capacity has been assessed for each relevant care decision?
- 02How do you make sure staff follow each person's medicines instructions exactly?
- 03Who currently leads activities, and what activities are available each day and each week?
- 04How are care plan audits reviewed to make sure any actions have been completed?
- 05How do you decide the number of staff needed on each shift, including when people need two staff for personal care?
This was an unannounced, fully comprehensive inspection of the whole service, including all five rating areas, following four breaches identified at the April 2016 inspection. This explanation was written from the published report of 13 July 2017 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 Coombe Dingle Nursing Home
5 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- February 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2015Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 18 November 2010.
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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