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Chiltern View Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 9 July 2019

About the service:

Chiltern View is a residential care home that provides personal care to 36 people aged 65 and over. At the time of the inspection on 30 May 2019, 25 people were receiving care. On 3 June 2019, 23 people were receiving care.

People’s experience of using this service:

Governance systems and provider oversight were not sufficiently robust to have identified the issues we found.

Not all areas of the service were safe for people to access when we arrived. The registered manager and deputy manager took immediate action to make these areas safe. The four communal bathrooms were in poor decorative condition and people were not able to use three of them for bathing or showering. Processes were not effective to prevent the spread of infection.

Staff were very busy, and people were left unsupervised and unoccupied. People were not offered baths or showers at the frequency suggested in their care plans. Staff were not always following people’s care plans, and they were not reviewed when people’s needs changed.

People did not always receive their meals evenly spaced throughout the day. Staff were not sufficiently supervising people at mealtimes. The provider had not encouraged a culture that supported staff and promoted a service centred on the people that used it. Staff discussed people’s care in front of other people.

Staff were aware of safeguarding processes and how to reduce risk of harm. Staff had access to disposable protective equipment, such as gloves and aprons, and cleaning materials.

The provider had a system in place to make sure they only employed staff once they were satisfied of their suitability to work with people who used the service. Staff engaged openly with outside agencies to address safeguarding concerns. People received their prescribed medicines safely and in line with the prescriber’s instructions.

Staff were competent, knowledgeable and skilled to carry out their roles. Staff used equipment appropriately to help people move. Some areas of the service had benefitted from redecoration and some refurbishment. The garden had been redesigned to stimulate the senses, but as people were only able to access it with staff or visitor assistance, it’s use was limited.

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. Staff supported people in a kind, friendly and respectful way. Staff knew people, and their preferences, well.

People and their relatives confirmed they were involved in the assessment and care planning process. Staff supported people to maintain relationships that were important to them and encouraged people’s relatives and friends to visit the them. Staff recognised and respected people’s end of life wishes.

The provider had systems in place, including a complaints procedure, to deal with any concerns or complaints. People and their relatives were given opportunities to comment on the service. The registered manager recognised and rewarded staff who provided an exceptional level of service with a staff recognition scheme. The registered manager told us that they kept themselves up to date with developments and best practice in health and social care.

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

Rating at last inspection:

The service was rated good at the last inspection (the last report was published on 21 December 2016).

Why we inspected:

This was a planned inspection based on the last rating.

Enforcement:

We have identified breaches in relation to staffing levels and the monitoring of the service at this inspection.

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

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If we receiv

Inspection areas

Safe

Requires improvement

Updated 9 July 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 9 July 2019

The service was not always effective.

Details are in our effective findings below.

Caring

Requires improvement

Updated 9 July 2019

The service was not always caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 9 July 2019

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 9 July 2019

The service was not always well-led.

Details are in our well-Led findings below.