Cheriton Care Home

Updated 1 March 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors over two days. An Expert by Experience was on site on day two of the inspection and another Expert by Experience carried out calls to relatives after the inspection.

An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Cheriton Care home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Cheriton Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there were two registered managers in post. The nominated individual is also one of the registered managers. They are responsible for supervising the management of the service on behalf of the provider and was present during the inspection.

Notice of inspection

This inspection was unannounced.

What we did before the inspection.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. The last PIR on file was dated the 17 March 2022, which was during the time of the previous inspection.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

During the inspection

We spoke with one relative and eight people who used the service about their experience of the care provided. We spoke with nine staff which included a senior carer, two care staff, the cook, deputy manager, registered manager, group compliance manager, a director and the maintenance staff member. We spoke with a visiting professional. We observed lunch and 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 walked around the service and reviewed the environment. We reviewed a range of records relating to people's care which included, multiple medicine records and nine care plans. We reviewed three staff recruitment files and a variety of records relating to the management of the service, including fire, health and safety, accident/incidents, safeguarding, and audits were reviewed, and other records were requested.

Following the visit to the service we sought feedback from relatives, staff, community professionals and continued to seek clarification from the registered manager. We received written feedback from a health professional, two s

Updated 1 March 2023

About the service

Cheriton Care Home is a residential care home, providing the regulated activity accommodation and personal care to up to 27 people. The service provides support to older people, including people with dementia. At the time of our inspection there was 15 people using the service.

Cheriton Care Home accommodates people in one building, over two floors.

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

People told us they felt safe and were accepting of their care. Relatives were happy with their family member's care. They commented “I’m very happy and pleased with the service.” Relatives felt their family members got safe care and were well looked after, with their health and care needs met. Relatives commented “I am very happy that he is safe. They(staff) do a fantastic job.”

Whilst risk management had improved, not all risks had been identified and mitigated.

Staff were not suitably deployed which impacted on the care given, access to person centred activities and the cleanliness of the service.

Areas of the service had been refurbished. However, further improvements are necessary to ensure the service is safe, clean and fit for purpose.

Records had been organised and systems set up to make them accessible. However, some records were contradictory, incomplete and not suitably maintained. Auditing had commenced. Further improvements are needed to ensure the audits are picking up the issues we found, so that these are addressed in a timely manner.

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.

People’s care plans were under review and development to make them person centred. Regular person- centred activities were not established. We have made a recommendation to address this.

Safe medicine practices were promoted. People’s health and nutritional needs were met. Systems were in place to safeguard people, including review and oversight of accident and incidents to mitigate the risk of reoccurrence.

Staff were suitably inducted, trained and supervised in their roles.

Systems were in place to enable people and their relatives to raise concerns. Issues raised were investigated and addressed.

The service had a new registered manager whom had made improvements to the service. They worked closely with the group compliance manager in setting up systems, auditing, and in developing the person-centred software. They had established links with relatives and were working with staff to develop and support them to improve practice to benefit people.

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

Rating at last inspection and update: The last rating for this service was inadequate (published 20 May 2022) and there was breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made however, the provider remained in breach of regulations.

At our last inspection we recommended that the provider works to best practice in relation to learning from accidents and incidents, to improve their approach to developing staff and promoting good practice, to follow good practice to improve people's mealtime experiences, to seek advice from a reputable source about improving the environment for people with dementia, to be compliant with the Accessible Information Standard, to develop staff to become end of life champions and to improve their understanding of the duty of candour requirement.

At this inspection we found the provider had acted on the recommendations, made improvements and further improvements were planned.

This service has been in Special Measures since 20 May 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on the 4 March and 4 April 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements.

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.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, caring, responsive and well- led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cheriton Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, staffing, environment, dignity and respect and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.