CQC report explained · a residential care home
What the CQC found at Cymar House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Recruitment checks were not always completed before staff started work. Call bell response times were not routinely monitored, and equipment used for moving people had not passed a required check on the first visit.
- Effective?
- Requires improvement
- Mental capacity assessments and best-interest decisions were not always decision-specific or completed properly. The effectiveness of some medicines given when needed had not been reviewed with relevant healthcare professionals.
- Caring?
- Good
- People and relatives described staff as kind and caring. Inspectors observed respectful interactions, and people’s privacy and dignity were protected.
- Responsive?
- Requires improvement
- Activities were not always consistent or suitable for people living with dementia. Care plans also lacked detail in some areas, including how to support a person whose behaviour could be challenging.
- Well-led?
- Requires improvement
- Audits and management checks had not identified or dealt with several problems found during the inspection. Records were not always accurate or complete, although the manager was approachable and responsive to the findings.
What inspectors found, June 2022
Rated Requires Improvement; inspectors found kind care but gaps in consent, recruitment, activities and management oversight.
Inspectors visited on 26 May and 1 June 2022. The first visit was unannounced and the second was announced. They spoke with people living at the home, relatives, staff and a visiting healthcare professional. They also observed care and checked care plans, risk assessments, medicines records, staff files and management records.
People were generally treated kindly and with dignity. Staff knew people well, and most people and relatives said they felt safe. Food and drink needs were well managed, infection control measures were in place, and healthcare referrals were made in a timely way.
However, inspectors found important weaknesses. Some staff checks were incomplete, moving equipment checks were not up to date on the first visit, and records about medicines given when needed were not detailed enough. Mental capacity assessments and best-interest decisions were not always completed properly, and some relatives signed consent forms without lawful authority.
The overall rating was Requires Improvement. Safe, Effective, Responsive and Well-led were all rated Requires Improvement, while Caring was rated Good. The home must improve its systems and was found to be in breach of three regulations. CQC said it would continue to monitor the home.
Kind and respectful care
People and relatives gave positive feedback about staff. Inspectors observed kind, helpful and respectful interactions, including staff offering choices and protecting privacy.
“We observed kind and helpful interactions between staff and people.” from the report
Staff knew people well
People were supported by a consistent team. Staff knew people’s needs and preferences and adjusted their approach when needed.
“People were supported by a consistent team who knew people well.” from the report
Food and drink
People’s nutrition and hydration needs were assessed, recorded and monitored. People said they enjoyed the meals and could choose what and when to eat.
“People's nutritional and hydration needs were well managed.” from the report
Infection control
Inspectors were assured that the home had appropriate measures for preventing and managing infection, including safe use of protective equipment.
“We were assured that the provider was using PPE effectively and safely.” from the report
Consent records
seriousMental capacity assessments and best-interest decisions were not always completed for the specific decision involved. Some relatives signed consent forms without having the lawful authority to do so.
“Systems were either not in place or robust enough to demonstrate consent was sought and recorded appropriately.” from the report
Recruitment checks
seriousSome staff started work before references from previous social care employment had been obtained. Employment histories also did not always show dates clearly enough to identify gaps.
“Some staff had started working before relevant references from previous employment in social care being sought.” from the report
Management checks
seriousAudits were happening but did not identify several issues found by inspectors. This included problems with staff files, medicines records, care plans and consent records.
“Quality assurance systems were in place and happening regularly, however these had not always been effective in identifying the issues found at this inspection.” from the report
Activities
needs fixingActivities took place, but not consistently and not always in a dementia-friendly way. There was little evidence of activities for people in their bedrooms or people who could display behaviour seen as challenging.
“There were activities happening at the home, but the provision wasn't always consistent or dementia friendly.” from the report
Medicines given when needed
needs fixingGuidance for staff about medicines given when needed lacked detail, and staff did not record how effective these medicines were.
“Overall, medication was managed safely. We found guidance for staff when administering 'as required' medication lacked detail and staff were not recording how effective this medication had been.” from the report
- 01What has been changed to make sure every staff member has the required references and a complete employment history before starting work?
- 02How do you now complete and record decision-specific mental capacity assessments and best-interest decisions?
- 03How do you check that medicines given when needed are effective, and how is this recorded?
- 04What regular activities are now available for people living with dementia and for people who spend time in their bedrooms?
- 05How do your audits now identify problems with care plans, medicines records, consent and equipment checks?
This was a planned first inspection of the newly registered service, covering all five key questions, care and premises, and infection prevention measures; the previous Good rating was for the service under a previous provider in 2019. This explanation was written from the published report of 30 June 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 Cymar House
3 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- June 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- August 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2021
Registered with the Care Quality Commission on 14 June 2021.
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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