The Chiswick Nursing Centre

Updated 15 February 2023

Inspection team

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.

Inspection team

The inspection was carried out by an inspector, a pharmacy inspector, a specialist professional advisor 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. The specialist professional advisor worked as a nurse.

Service and service type

The Chiswick Nursing Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.

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 a registered manager in post.

Notice of inspection

This inspection was unannounced on the first day. The provider knew we would be returning on subsequent days.

What we did before the inspection

We used the information the provider sent us in the provider information return. 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 spoke with a contracts manager from the local authority and reviewed the provider’s action plan following the findings of the last inspection.

We reviewed information we held on the service, including records of complaints and serious incidents the provider is required by law to tell us about.

We used all of this information to plan our inspection.

During the inspection

Inspection activity started on 17 January 2023 and ended on 2 February 2023. We visited the service location on 17, 24 and 25 January.

We made observations of care and support throughout the service. We spoke with the registered manager, clinical lead, training manager, matron and the person in charge. We spoke with 5 nurses and 4 health care assistants, 8 people who used the service and 7 family members.

We reviewed records of care and support for 23 residents and records of recruitment for 5 staff members. We looked at records of medicines management for 16 people. We reviewed records relating to the management of the service such as handover documents, engagement with people and their families, team meetings and records of training and audit.

After the inspection

We requested certain documents from the provider including audits, staff rotas and contacted the provider to ask questions relating to these. We made calls to family members of people who used the service and staff members. We attended a routine information sharing meeting between the provider, local authority and local health services.

Updated 15 February 2023

About the service

The Chiswick Nursing Centre is a residential care home providing personal and nursing care to up to 146 people. The service provides support to older people, people living with dementia and younger people with physical disabilities. At the time of our inspection there were 139 people using the service.

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

People told us they felt safe living in the service and felt well respected by staff. A family member told us, “I’m very pleased with the home, the staff are absolutely lovely.”

The service had delivered an action plan to improve how it managed medicines, and this was now carried out safely. There were suitable processes for managing risks and protecting people from avoidable harm. Staff understood their responsibilities to report suspected abuse and the provider worked with the local authority to safeguard people and investigate reported concerns.

The service ensured there were enough staff on duty to meet people’s needs. People told us staff responded promptly to call bells and there were systems of regular checks to ensure people’s wellbeing. Where incidents had taken place the provider ensured people’s needs were reviewed to prevent a recurrence.

The service had worked with local health agencies to respond to and contain outbreaks. There were suitable infection control measures to protect people from infectious disease which at times exceeded national requirements.

The service was continuously improving and developing, through participating in research and redesigning areas of the building to promote a more stimulating and pleasant environment. Staff told us they felt well supported by their managers and colleagues and described the home as a good place to work. There were good systems of communication and audit to ensure that standards were maintained and areas for development identified.

People’s family members told us the service communicated well with them and kept them updated on their relative’s wellbeing. People felt confident raising concerns or queries with managers and that these were acted on appropriately.

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 information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 22 June 2022).

Why we inspected

We carried out an unannounced focussed inspection of this service on 17 March 2022. A breach of legal requirements was found in relation to the safe management of medicines. We issued a warning notice requiring the provider to make improvements.

We undertook this focused inspection to check if the provider had made improvements and if they were now meeting the legal requirements. This report only covers our findings in relation to the key questions Safe and well-led.

For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating.

At this inspection we found improvements had been made and the provider was now meeting this regulation.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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

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.

Follow up

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