All inspections: Chelmsford Nursing Home

Chelmsford Nursing Home provides accommodation, personal and nursing care for up to 64 people, some of whom were living with dementia. There are external and internal communal areas for people and their visitors to use and the service is split over two floors. Nursing care, including palliative care is carried out on the first floor and people living with dementia reside on the ground floor of the home.

This unannounced focused inspection was undertaken on 22nd March 2016. There were 59 people receiving care at the time of inspection.

The provider had received their first ratings inspection at this location in December 2015 and the service was found to be good in all key areas. However, since the previous inspection we had received intelligence that care practices had become unsafe. The registered manager had been dismissed and the service no longer had a registered manager in position.

There had been a number of changes at the service since their last inspection. The provider had also recently changed. We found that staff morale was low and that staff felt they did not have the right amount of safe and skilled staff to care for people in an individualised way. The service relied heavily on the use of agency staff who were often deployed to manage highly complex people's needs, often isolated away from regular staff. There had been some safeguarding incidents regarding agency staff and people at the service, however, managers had not assured themselves that agency staff had the appropriate skills.

The service had not learnt from incidents of falls, challenging behaviour and recent safeguarding, and reactively managed risk rather than identifying and managing common themes. There was a lack of strong leadership at the service and the deputy manager was covering the manager position as well as their own. However, on the day of our inspection a new manager had started at the service and had made the appropriate notification’s to register with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’.

The management team failed to monitor, assess, and take action to make any changes to improve the service based on feedback and incidents.

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.

You can see what action we told the provider to take at the back of the full version of the report.

Chelmsford Nursing Home provides accommodation and personal and nursing care for up to 64 people, some of whom were living with dementia. There are external and internal communal areas for people and their visitors to use.

The provider registered this service with the Care Quality Commission in February 2015. This unannounced comprehensive inspection was undertaken on 21 December 2015. There were 58 people receiving care. This was the provider’s first inspection at this location.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission 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.

Staff were only employed after the provider had carried out comprehensive and satisfactory pre-employment checks. Staff were well trained, and well supported, by their managers. There were sufficient staff to meet people’s assessed needs. Systems were in place to ensure people’s safety was effectively managed. Staff were aware of the procedures for reporting concerns and of how to protect people from harm.

People received their prescribed medicines appropriately and medicines were stored safely. People’s health, care and nutritional needs were effectively met. People were provided with a balanced diet and staff were aware of people’s dietary needs.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. We found that there were formal systems in place to assess people’s capacity for decision making and applications had been made to the authorising agencies for people who needed these safeguards. Staff respected people choices and staff were aware of the key legal requirements of the MCA and DoLS.

People received care and support from staff who were kind, caring, sensitive, and respectful. Staff supported people to meet their religious and cultural needs and supported people to maintain relationships.

People and their relatives had opportunities to comment on the service provided and people were involved in every day decisions about their care. Care records were detailed and provided staff with sufficient guidance to provide consistent care to each person. Changes to people’s care was kept under review to ensure the change was effective. People were supported to spending their time in meaningful ways and encouraged to visit the local community, preventing social isolation.

The registered manager was supported by senior staff, including registered nurses, care workers, and ancillary staff. The service was well run and staff, including the registered manager, were approachable. People and relatives were encouraged to provide feedback on the service in various ways both formally and informally. People’s views were listened to and acted on.

Archived: Chelmsford Nursing Home

All Inspections

22 March 2016

During an inspection looking at part of the service

21 December 2015

During a routine inspection