Chalfont Lodge

Updated 27 November 2019

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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector one assistant inspector 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 service.

Service and service type

Chalfont Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. 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.

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 in March 2018. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We spoke with 11 people using the service and six relatives about their experience of the care provided. We contacted five relatives by telephone following our visit. We spoke with six members of staff including the registered manager. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records including each person’s medication administration record (MAR), six people’s care plans and records relating to their care plans. In addition, we reviewed a range of records relating to the way the service is run.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We were told by the local authority about concerns that had been raised to them. This was in relation to unsafe levels of staffing. This investigation is ongoing and will not be referred to further in the report.

Updated 27 November 2019

About the service

Chalfont Lodge is a nursing home which is registered to provide support for up to 119 people. The service is divided into three units over two floors. The home is divided into three units and the Memory Lane community supporting people with dementia is divided into two sections. At the time of our inspection there were 102 people using the service.

We undertook an unannounced comprehensive inspection on 10 and 11 July 2019.

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

Although there were enough staff to meet peoples’ basic needs, people and staff told us there were not enough staff to ensure staff were able to spend quality time with people.

We found medicines were not being managed in line with current best practice. Some people had not received their medicines due to lack of stock.

Risk assessments were mostly completed for people who needed support relating to malnutrition and mobility.

Quality audits were completed but did not capture issues we found in relation to medicines and risk assessments.

Care plans were not consistently person centred and there was a lack of detailed guidance within some people’s care plans for staff to follow.

People had access to healthcare professionals when required.

Activities were provided for people to avoid social isolation and people had access to local community events.

We observed positive interactions between staff and people using the service. Staff received an induction when starting at the service and had regular training specific to their role.

A complaints procedure was in place. Formal complaints were responded to according to the provider’s policy.

Accidents and incidents were reviewed, and action taken as required.

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.

The provider made applications to the local authority to protect the rights of people living in the home in line with the Mental Capacity Act 2005. DoLS applications were made for people who required them.

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 requires improvement (published June 2018), at the last inspection we made a recommendation, but there were no breaches of the regulations. At this inspection we found improvements had not been made and there were breaches of the regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last four consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the management of medicines and good governance. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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