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Coombe End Court nursing home still 'requires improvement' as regulator highlights staff shortage

 

 Coombe End Court Nursing Home in London Road, Marlborough has again been rated as 'requires improvement' by the Care Quality Commission (CQC).  The report records a worrying shortage of staff and reliance on agency staff.

 

The CQC report follows an inspection earlier in the year over three days - the first day was unannounced.  The overall rating remains as 'requires improvement' - a rating which also covers the home's service as being safe, effective, responsive and well-led.  In answer to the question 'Is the service caring?' the inspector gave the rating ' good'.

When the home was inspected by the CQC in April 2015, it was found that the home's service was 'inadequate' and enforcement measures were put in place to ensure the necessary improvements took place. An unannounced inspection in January 2016 found there were 'insufficient improvements in all areas.'  

The home, which is run by The Orders of St John Care Trust, provides accommodation for up to 60 older people and has a unit supporting people living with dementia.

The report states: "A significant number of staff had left the service and we were told there were 21 full time equivalent care staff vacancies."  At one point the home's manager and the head of care had both left.

Coombe End CourtCoombe End Court"A member of staff told us 'we are fighting a losing battle and there are some staff that have bad habits. We don't need just anybody [staff]. It's not safe, even agency staff have complained'."

The main impact of the loss of staff and reliance on agency workers was in the levels of safety.  For example: "Incidents and accidents were not taken seriously and acted upon."

Another safety risk came from the administration of medicines: "People were at risk from unsafe medicine systems."  Intervals between doses were not always correct and records of doses not fully maintained.

 "A pharmacist visited to assess medicine systems on the 24 January 2017. The pharmacist identified shortfalls in the ordering of medicines, in the systems for checking received medicines and in the recording of medicines administered. The pharmacist documented that processes for ordering medicines was not robust. The registered manager told us an action plan was to be developed."

The registered manager who had been in post since November 2016 told the inspector that "...recruitment of suitable staff and the retention of staff was a challenge. It was stated that more staff 'will make a difference' and good
practice will increase and be built on as staff complete the Care Certificate."

However, the inspection found that the level of care was 'good' and permanent staff were 'kind and caring'.  Several people - including relatives of those in the home - mentioned the good attitude of staff members.  And many mentioned that the food was good - even 'beautiful'.

However, the overall impression of the report is summed up in the final action the home has been told to take.  The regulations concerning the provision of accommodation for persons who require nursing or personal care were breached because "There were insufficient numbers of staff to deliver care and treatment in a consistent manner."

The full CQC report can be read here.

Marlborough.news has received (August 30) the following statement:

Referring to the recently published CQC (Care Quality Commission) inspection of The Orders of St John Care Trust’s Coombe End Court Care Centre in Marlborough, Assistant Operations Director Aaron Whitehead commented: “After the CQC report was published in April 2017 we entered into dialogue with CQC which due to their processes resulted in the recent republication of the original report. We would like to stress that the home has only been inspected once, in January 2017. Since then we have made good progress in implementing a comprehensive action plan to address the issues raised during the inspection in January 2017."
 
“We would like to reassure residents and their relatives that their loved ones are safe and well cared for at Coombe End Court and we encourage them to talk to the home manager at any time if they have any concerns.”

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  • Town-Hall-2011-05-03 08-
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  • Silbury-Sunset---10-06-08-----07