The Cumberland

Updated 29 October 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was completed by two inspectors, two medicines inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Cumberland is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Cumberland is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with three people and 10 friends and relatives about their experiences of the service. We spoke with seven staff including the manager, operations manager, administrator and four care staff. We reviewed a range of records. This included seven people’s care records, multiple medication records and four staff files in relation to recruitment. A variety of records relating to the management of the service, including checks and audits were reviewed.

Updated 29 October 2022

About the service

The Cumberland is a residential care home providing the regulated activity of personal care to up to 29 people. The service provides support to people living with dementia. At the time of our inspection there were 16 people using the service. The service is a large, converted property and accommodation is arranged over three floors.

People’s experience of using this service and what we found

People told us they felt safe living at The Cumberland. Relatives told us their loved ones were well cared for. Long standing staff knew people well and supported them in the way they preferred. However, some risks to people had not been assessed and mitigated. Guidance had not been consistently provided about people’s needs and the support they required. This was important as the provider used agency staff to cover staff vacancies and there was a risk they would not know how to provide people’s care. People’s medicines were not stored safely or managed consistently.

There were not always enough staff to meet people’s needs. The manager supported staff to care for people at times and this took them away from managerial tasks. The provider had not developed the environment to support people living with dementia to remain independent, including the use of signs to help people move around without support. However, staff supported people to continue to look after themselves as much as they wished. We have made a recommendation about best practice in dementia environments.

The provider’s checks and audits had not identified all the shortfalls at the service. Actions planned to address shortfalls the provider identified had not always been completed in the timescales they set out. The manager was realistic about the improvements needed and the action required to achieve them. The service was clean, however action had not been taken to protect people from all infection risks.

The manager had been working at the service for several months and had not applied to be registered with CQC. Staff told us they manager had made positives changes to the culture of the service and to people’s lives. They had worked with mental health professionals to reduce people’s anxiety and agitation and this had improved the quality of people’s lives.

Relatives and staff had shared their views, and these had been acted on to develop the service. Lessons had been learnt when things went wrong and action had been taken to reduce the risk of incidents occurring again. Staff had been recruited safely and checks had been completed on staff’s conduct in previous roles. Staff had the skills they needed to meet people’s needs.

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; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 24 May 2018).

Why we inspected

This inspection was triggered in part by potential risks around the management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Cumberland on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the management of risks and medicines, staff deployment, care records and the effectiveness of the provider’s checks and audits at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.