You are here

Reports


Inspection carried out on 22 January 2016

During a routine inspection

Chaseley is a residential nursing home in Eastbourne, providing care for people with severe physical disabilities. Chaseley also provides long and short term respite care. There is an on-site gym with designated therapy staff providing support to people in their rooms and in the gym environment as appropriate. The gym is accessible for use by people in the community who may require specialist equipment for rehabilitation and daily fitness as well as people living at Chaseley.

Chaseley is registered to provide care for 55 people. At the time of the inspection there were 40 people living at the home, including one person staying at Chaseley for a period of respite care.

At the last inspection 18 and 19 November 2014 we asked the provider to make improvements for notifications after incidents occurred, training for staff around Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS), confidentiality of records and assessing and monitoring the quality of service provision. The provider sent us an action plan stating these issues would be addressed. At this inspection we found that actions had been taken to ensure all regulations had been met.

This was an unannounced inspection which took place on the 22 and 25 January 2016.

Chaseley had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The manager was in day to day charge of the home, supported by the deputy and human resources business partner. People and staff spoke highly of the manager and told us that they felt supported by them and knew that there was always someone available to support them when needed. Staff told us that the manager and deputy made a good team and had made a number of positive changes.

Staff felt that training provided was effective. Registered Nurses had received further training to ensure they were able to meet specific nursing needs for people. Care staff felt they received effective training and this ensured they were able to provide the best care for people. Competencies checks and workshops took place to ensure staff training was relevant and up to date. Robust recruitment checks were completed before staff began work, and staff completed a full induction when they commenced employment at Chaseley. There a programme of supervision and appraisals for staff, this meant that staff felt continually supported.

Medicine administration, documentation and policies were in place. These followed best practice guidelines to ensure people received their medicines safely. Regular auditing and checks were carried out to ensure high standards were maintained. People were supported to self-medicate if deemed safe for them to do so and this was regularly reviewed.

There were robust systems in place to assess the quality of the service. Maintenance checks had been completed. Fire evacuation plans and personal evacuation procedure information was in place in event of an emergency evacuation.

Peoples nursing and care dependency levels were assessed and reviewed to ensure appropriate care provision was in place. Staffing levels were reviewed regularly.

Care plans and risk assessments had been completed to ensure people received appropriate care. Care plans identified all nursing and care needs and had been reviewed regularly to ensure information was up to date and relevant. Staff had a good understanding around the principles of MCA and DoLS. People were asked for their consent before care was provided and had their privacy and dignity respected. Feedback was gained from people this included questionnaires and regular meetings with minutes available for people to access.

People were encouraged to remain as independent as possible and supported to participate in daily activities. Regular therapy was provided when appropriate and people had access to the on-site gym.

Staff demonstrated a clear understanding on how to recognise and report abuse. Staff treated people with respect and dignity and involved people and their families in decisions.

People’s nutritional needs were monitored and reviewed. People had a choice of meals provided and staff knew people’s likes and dislikes. People gave positive feedback about the food and visitors told us they had eaten with their relative and found the food to be of a very high standard.

Referrals were made appropriately to outside agencies when required. For example GP and hospital referrals, dentists and speech and language therapists (SALT).

Notifications had been completed to inform CQC and other outside organisations when events occurred.

Inspection carried out on 18 & 19 November 2014

During a routine inspection

Chaseley is a residential nursing home in Eastbourne, providing care for people with severe physical disabilities. Chaseley also provides long and short term respite care. There is an on-site gym with designated therapy staff providing support to people in their rooms and in the gym environment as appropriate. The gym is accessible for use by people in the community who may require specialist equipment for rehabilitation and daily fitness as well as people living at Chaseley.

Chaseley is registered to provide care for 55 people. At the time of the inspection there were 40 people living at the home, including one person staying at Chaseley for a period of respite care.

At the last inspection 18 and 19 November 2014 we asked the provider to make improvements for notifications after incidents occurred, training for staff around Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS), confidentiality of records and assessing and monitoring the quality of service provision. The provider sent us an action plan stating these issues would be addressed. At this inspection we found that actions had been taken to ensure all regulations had been met.

This was an unannounced inspection which took place on the 22 and 25 January 2016.

Chaseley had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The manager was in day to day charge of the home, supported by the deputy and human resources business partner. People and staff spoke highly of the manager and told us that they felt supported by them and knew that there was always someone available to support them when needed. Staff told us that the manager and deputy made a good team and had made a number of positive changes.

Staff felt that training provided was effective. Registered Nurses had received further training to ensure they were able to meet specific nursing needs for people. Care staff felt they received effective training and this ensured they were able to provide the best care for people. Competencies checks and workshops took place to ensure staff training was relevant and up to date. Robust recruitment checks were completed before staff began work, and staff completed a full induction when they commenced employment at Chaseley. There a programme of supervision and appraisals for staff, this meant that staff felt continually supported.

Medicine administration, documentation and policies were in place. These followed best practice guidelines to ensure people received their medicines safely. Regular auditing and checks were carried out to ensure high standards were maintained. People were supported to self-medicate if deemed safe for them to do so and this was regularly reviewed.

There were robust systems in place to assess the quality of the service. Maintenance checks had been completed. Fire evacuation plans and personal evacuation procedure information was in place in event of an emergency evacuation.

Peoples nursing and care dependency levels were assessed and reviewed to ensure appropriate care provision was in place. Staffing levels were reviewed regularly.

Care plans and risk assessments had been completed to ensure people received appropriate care. Care plans identified all nursing and care needs and had been reviewed regularly to ensure information was up to date and relevant. Staff had a good understanding around the principles of MCA and DoLS. People were asked for their consent before care was provided and had their privacy and dignity respected. Feedback was gained from people this included questionnaires and regular meetings with minutes available for people to access.

People were encouraged to remain as independent as possible and supported to participate in daily activities. Regular therapy was provided when appropriate and people had access to the on-site gym.

Staff demonstrated a clear understanding on how to recognise and report abuse. Staff treated people with respect and dignity and involved people and their families in decisions.

People’s nutritional needs were monitored and reviewed. People had a choice of meals provided and staff knew people’s likes and dislikes. People gave positive feedback about the food and visitors told us they had eaten with their relative and found the food to be of a very high standard.

Referrals were made appropriately to outside agencies when required. For example GP and hospital referrals, dentists and speech and language therapists (SALT).

Notifications had been completed to inform CQC and other outside organisations when events occurred.

Inspection carried out on 10 June 2014

During an inspection to make sure that the improvements required had been made

We carried out this inspection to look at the care and treatment that people living at the home received. At the last inspection on 21 January 2014 we found that there were concerns with regard to assessing and monitoring the quality of service provision and records.

The service currently has an embargo on admissions implemented by the local authority.

As part of our inspection we spoke with six care and nursing staff, the registered manager, clinical lead and further senior staff member responsible for safeguarding. Throughout the inspection we were able to speak with eight people who lived in the home and one visitor to the service.

Three inspectors carried out this inspection.

The inspector considered the inspection findings to answer questions we always ask:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

Is the service safe?

We saw that the home carried out regular maintenance and equipment checks for the service. The home had implemented some quality assurance systems to assess and monitor quality of the service provided, however these were not robust, and actions had not been completed.

We saw that there were unsafe practices in relation to medication administration errors and discrepancies within the medication records. We looked at incident/accident reports and complaints.

Is the service effective?

We spoke with people living at Chaseley. We were told “It is fine for me I am well looked after.” Another told us “No issues personally, I am off to the café, I like it down there.” People told us that the food was “Nice, plenty of choice for me, I have no complaints.” And “It is usually very good.”

One person we spoke with told us they did not feel that they were listened to or that staff responded when they raised concerns.

Is the service caring?

We saw staff speaking to people and providing care and support. Staff spoken with were able to tell us about people and their individual needs.

We saw that one person who received one to one care at all times had sticky eyes. However, no information or guidance had been included in their care file regarding this. We also observed a member of staff reading the newspaper whilst providing one to one care to this person in their room. We discussed this with senior staff who told us that this should not be taking place, and staff should use the time spent in the room observing the individual or completing documentation regarding that person.

Is the service responsive?

We looked at accidents and incidents reporting within the service. We saw that the system in use meant that there could be a delay from an incident being reported to a senior staff member responding and taking appropriate action.

Is the service well-led?

The home had a registered manager, clinical lead and one further senior staff member who were responsible for the running of the service, and a second location which also belonged to the provider.

We identified by direct observation that all three senior staff were working long hours and appeared to be very busy throughout the inspection dealing with day to day issues at both locations. We were told that the Nominated Individual provided support for three days a week, this was again over both locations.

We were shown that the service asked people who used the service for their feedback, and the results of these surveys, were used to improve the service.

Inspection carried out on 21 January 2014

During an inspection to make sure that the improvements required had been made

We carried out this inspection to follow up on a number of compliance actions set in previous inspections.

We saw that staff had attended safeguarding training, and were able to demonstrate a good understanding around how to recognise and report safeguarding concerns.

The organisation had been actively recruiting nursing and care staff. Agency staff had been used to maintain staffing levels. An induction and competencies for agency staff had been introduced.

A number of audits had taken place. However, we saw that some actions identified had not been taken forward and rectified.

People’s care documentation did not provide appropriate information in relation to the care and treatment needs of the individual. Gaps were seen in daily charts and care plans had not been reviewed and maintained to an appropriate standard.

Inspection carried out on 28 August 2013

During an inspection to make sure that the improvements required had been made

We carried out this inspection to follow up on a warning notice issued as a result of concerns identified at the last inspection.

We looked at care plans and further care documentation identified in the warning notice. We spoke with staff and people living in the home. We found that concerns identified in the warning notice had been addressed.

Inspection carried out on 26 July 2013

During an inspection in response to concerns

We used a number of different methods to help us understand the experiences of people using the service, because some of the people using the service had complex needs which meant they were not able to tell us their experiences. We observed care and looked at documents

During our inspection we found that documentation in people’s care files did not detail their care needs. Gaps and inconsistencies were seen. This meant that people were at risk of receiving inappropriate care and treatment.

Staffing levels were being maintained by the regular use of agency staff. Due to the lack of relevant documentation and inadequate daily records it was unclear how the provider had ensured that all staff were aware of people’s needs.

The provider had implemented a number of changes to assess and monitor the quality of the service. However actions taken to address concerns raised was not always clear. Time was needed to allow monitoring to become fully embedded.

Inspection carried out on 24 April 2013

During an inspection in response to concerns

At the time of our inspection there was no registered manager employed at Chaseley. The organisation had informed us that the previous manager had left. However, the previous manager had not deregistered with CQC at the time of the inspection, therefore their name still remains on any reports until such time that this information is received.

People living at Chaseley had complex needs which meant that some people were not able to tell us their experiences. Those who could told us they were happy living at Chaseley. One person told us “Staff do a wonderful job here.”

During our inspection we found that people were involved in decisions made about the care they received. The provider had robust recruitment procedures to follow for new staff. However, not all staff were aware of correct safeguarding procedures. Documentation in people’s care files had not been completed correctly, with gaps and inconsistencies seen.

Inspection carried out on 23 October 2012

During an inspection to make sure that the improvements required had been made

At the time of our inspection there was no registered manager employed at Chaseley. The organisation had informed us that the previous manager had left. However, the previous manager had not deregistered with CQC at the time of the inspection, therefore their name still remains on any reports until such time that this information is received.

People living at Chaseley had complex needs which meant that some people were not able to tell us their experiences. Those who could told us they liked living at Chaseley. One person told us “I enjoy the activities, and I really like my room, I have all my own things around me."

During our inspection we found that care plans clearly documented the needs of people, and the general standard of cleanliness was of an appropriate standard.

Inspection carried out on 25 June 2012

During a routine inspection

People living at Chaseley had complex needs which meant that some people were not able to tell us their experiences. Those who were, told us they liked living at Chaseley. Visitors spoken with were happy with the level of care provided. We were told “staff are very caring and do all they can”. Another visitor spoken with told us “I cannot fault the care staff, but the bedroom, although cleaned regularly, needs attention to detail, I often tidy up myself when I visit”

Inspection carried out on 1 November 2010

During an inspection in response to concerns

All of the people we spoke to said that the home offers the support and care they need, in a flexible way that enables them to be as independent as possible. They said that the staff were kind, patient and always around to talk to. People said the food was good, several choices were offered for each meal and special diets were catered for. They felt they could be involved in decisions about how the home is run if they wanted to, and some changes have been made following suggestions from people using the service and their relatives.