CQC report explained · a residential care home
What the CQC found at Gombards
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks, medicines, safeguarding and the environment were managed safely. Relatives mentioned some staffing issues, although staff said there were enough people to meet residents' needs safely.
- Effective?
- Good
- People had assessed needs and regularly reviewed care plans. Staff had suitable training and supported people with nutrition, healthcare and decisions about their care.
- Caring?
- Good
- Staff had positive relationships with people and supported their choices, privacy, dignity and independence. Inspectors observed warm interactions and relatives spoke positively about the care.
- Responsive?
- Good
- Care plans recorded people's preferences, communication methods and support needs. People were supported with activities, family relationships, complaints and meaningful involvement in care reviews.
- Well-led?
- Good
- The management team knew the service and people's needs well, and staff felt supported. Audits were completed, but it was not always recorded when identified actions had been completed.
What inspectors found, March 2020
Gombards was rated Good overall, with inspectors finding safe, kind and personalised care, although some records of completed improvement actions were missing.
Inspectors made two visits, on 04 February and 11 February 2020. The first visit was unannounced. They spoke with staff, relatives and a health or social care professional, observed care and checked care, medicine, training and management records.
The home supported eight people with learning and physical disabilities. Inspectors found enough staff, suitable training, safe medicines, clean and adapted surroundings, and care plans that were regularly reviewed. People were supported with food, healthcare, communication, choice and activities.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This was the same overall rating and the same rating in each area as the previous inspection, published on 05 July 2017.
Choice and control
People were supported to make choices and were cared for in the least restrictive way possible. Staff involved families and professionals in best-interest decisions when needed.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests;” from the report
Kind relationships
Inspectors saw warm interactions and found that staff understood how to communicate with people. Relatives also described the care positively.
“People and their relatives told us staff were kind and caring.” from the report
Personalised care
Care records included people's likes, dislikes and preferences. Staff supported people to try activities and maintain relationships with their families.
“People's care records were personalised and there was clear information about people's likes, dislikes and preferences.” from the report
Suitable environment
The home was clean and adapted for wheelchairs, hoists and other equipment. Bedrooms reflected people's individual tastes and the setting had a homely feel.
“People lived in a clean environment which was adapted for the use of wheelchairs, hoists and other specialist equipment people needed for their safety and wellbeing.” from the report
Staffing issues
needs fixingRelatives reported some staffing problems. Agency staff were sometimes used to cover vacancies, although the home said it aimed to use regular agency workers who knew the service.
“Relatives told us that the service had experienced some staffing issues.” from the report
Audit actions not always recorded
needs fixingAudits identified actions for improvement, but records did not always show when those actions had been completed. The manager was aware of this and said it was an area for improvement.
“Appropriate actions were identified but it was not always recorded when these had been completed.” from the report
- 01What staffing vacancies are currently open, and how often are agency staff being used?
- 02How do you make sure agency staff understand each person's needs and communication methods?
- 03How are actions from audits recorded, checked and signed off as completed?
- 04How will you involve our relative in reviews and decisions if they cannot communicate verbally?
- 05What activities and family visits would be suitable for our relative?
This was an unannounced planned inspection covering all five CQC questions, including the premises and the care provided. This explanation was written from the published report of 25 March 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, August 2017
Gombards: Rated Good; inspectors found kind, personalised care, but medicines storage needed improvement.
The inspection was unannounced and took place on 05 July 2017. One inspector spoke with four staff members and the registered manager, received feedback from two relatives, and reviewed two care plans. Most people could not communicate with the inspector, so staff communication and care were also observed.
The home supported eight younger adults with learning and physical disabilities. Inspectors found that people were treated kindly and supported in ways that reflected their communication, health needs, preferences and routines. People were supported to take part in activities, trips, holidays and community life.
The overall rating was Good, with Good ratings for Safe, Effective, Caring, Responsive and Well-led. This was the same overall rating as at the previous inspection on 29 July 2015. Inspectors identified one shortfall: medicines storage needed better temperature control and compliance with the law.
Understanding communication
Staff understood people's body language, facial expressions and sounds, including how people showed consent, pain, happiness and sadness.
“People`s care plans were personalised and described in detail their body language and facial expressions for staff to be able to ascertain if people consented to the care they received” from the report
Kind and respectful care
Inspectors saw staff supporting people with kindness and found that staff understood their personalities, needs and behaviour.
“We saw that staff had developed positive and caring relationships with the people they cared for.” from the report
Active lives
People were supported to enjoy activities at home and in the community, including trips, holidays and meaningful interests.
“People had a busy lifestyle and they were encouraged and supported to access the community, go on holidays and helped do other activities they enjoyed.” from the report
Staff training and support
Staff received role-related training, supervision and opportunities to request further training. Inspectors found them knowledgeable about people's needs.
“Staff received the training and support they needed to carry out their role effectively.” from the report
Medicines storage
needs fixingThe arrangements for storing medicines did not provide enough assurance about temperature control and compliance with current legislation. The report says medicines were administered and recorded safely.
“However the arrangements for the storage of medicines needed improvement to ensure appropriate temperature control and compliance with current legislation.” from the report
Staff vacancies
minorThe home was recruiting to fill staff vacancies. Agency staff were being used temporarily, although inspectors found enough staff on the inspection day.
“The registered manager told us they were currently recruiting to fill staff vacancies; however these vacancies temporarily covered by agency staff who were regularly working at the home.” from the report
- 01How was the medicines storage problem fixed, and how are storage temperatures checked now?
- 02Have all the staff vacancies mentioned in the report been filled, or is agency staff still being used?
- 03How do staff learn and keep up to date with each person's individual signs for consent, pain, sadness and happiness?
- 04What progress was made with the planned sprinkler system and other environmental improvements?
- 05How are relatives involved in care planning, reviews and feedback about the service?
This was an unannounced inspection covering all five CQC questions and the overall rating; the report says the previous overall rating from 29 July 2015 remained Good. This explanation was written from the published report of 5 August 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 Gombards
3 rated inspections over 5 years: the service has held its Good rating throughout.
- March 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 6 December 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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