Archived: Chimera Rest Home

Chimera is registered to provide accommodation and support for up to seven people. On the first day of the inspection the provider told us that six people lived at the home. On the second day of the inspection the provider told us that one person who lived at the home as a lodger had become a resident during the inspection.

At the last inspection we found that people were not safely supported because care was not planned in a way that met peoples’ needs or provided in a safe way, medicines were not safely managed, recruitment was not robust and there were not effective governance systems in place.

At this inspection we found three repeated breaches of the regulations and four new breaches of the regulations.

In particular, we identified the delivery of care posed risks to people, the management and administration of medicines was not consistently safe and recruitment checks were not always completed in accordance with current legislation.

Staff told us they were supported but training records showed some staff had not received adequate training to make sure people’s needs were met. In addition staff were not working in accordance with the principles of the Mental Capacity Act 2005 and whilst people had been supported to see their GP, nobody living at the home had seen a dentist.

People told us staff were caring and friendly and a member of staff said, “The residents are looked after really well”. Another member of staff told us, “The care is really good here”.

People told us that staff responded to their requests for support promptly. People’s needs had been assessed and there were care plans in place to meet their needs, however, there was limited evidence that people were supported to engage in meaningful activities.

The governance systems in place did not ensure people’s needs were safely and effectively met.

CQC is now considering the appropriate regulatory response to the shortfalls we found. Where providers are not meeting the fundamental standards, we have a range of enforcement powers we can use to protect the health, safety and welfare of people who use this service (and others, where appropriate). When we propose to take enforcement action, our decision is open to challenge by the provider through a variety of internal and external appeal processes. We will publish a further report on any action we take.

The overall rating for this service is ‘Requires improvement’. However, we are placing the service in 'special measures'. We do this when services have been rated as 'Inadequate' in any key question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

We also telephoned and spoke with relatives of two of the people who lived at the home and a visiting healthcare professional. This was in order to obtain their views about the service the home provided.

Everyone we spoke with expressed positive views about the attitude and approach of the home's staff, the support people received, food provided and cleanliness of the premises.

People said that staff were polite, treated them with respect and upheld their dignity and privacy. They said they received all the help they wanted. People said they had 'plenty to eat' and said the building was 'spick and span'. They said they knew who to complain to if they were unhappy about anything.

We followed up some outstanding matters from our last inspection of the home on 27 November 2012. They concerned the recruitment of staff, quality assurance procedures and record keeping. We found that the provider had made the necessary improvements.

The provider had measures in place to prevent and control infections and had made arrangements to check where and how the quality of the service could be improved.

We looked at people's records who lived at the home. We found their records were accurate, up to date and kept securely.

We also spoke with one of the care workers and a visiting relative during our inspection visit.

People who lived at Chimera were all complimentary about the service they received and particularly about the attitudes of the staff who worked at the home. They told us they received all the support they required to ensure their needs were met.

People said the accommodation they occupied was comfortable and well looked after. They told us they frequently spoke with the provider and felt able to influence the service they received.

We saw that the provider had arrangements in place that ensured the building was maintained properly. They also had arrangements in place that ensured equipment necessary for the safe care of people was regularly checked by appropriate contractors.

We found that the provider's arrangements for the employment of staff were not sufficiently robust.

We also found that the provider did not have comprehensive arrangements in for the following matters. To check whether their procedures were followed properly or to assess and manage risks to people living, working or visiting the home.

Records the provider kept that were about the care and support people received were not always accurate or completed properly.