Chepstow House

Updated 18 May 2022

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 one inspector and a specialist advisor in nursing.

Service and service type

Chepstow House 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. Chepstow House 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

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. We sought feedback from the local authority and professionals who work with the service. 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. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service and one relative about their experience of the care provided. We also spoke to eight staff including the registered manager, interim manager, deputy manager, senior care staff and care staff members. We also spoke with a social care professional.

We reviewed a range of records. This included three people’s care records and medication records. We looked at a variety of records relating to the management of the service, including recruitment files, audits, training data, accident and incidents and policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at the minutes from people’s meetings, estate plans and policies and procedures.

Updated 18 May 2022

About the service

Chepstow House is a residential care home, providing personal care and accommodation. People living at Chepstow House live with dementia, learning disabilities or autistic spectrum disorders, mental health conditions, sensory impairments or physical disabilities. Care and accommodation is offered to older and younger people. There were 10 people living at the home at the time of our inspection.

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

People were supported by a well-established staff team that knew them well and how to keep them safe. Staff were trained in safeguarding and demonstrated a good understanding of recognising signs of abuse. Staff knew how to report any concerns and told us they would be acted on appropriately by the management team.

Risks to people had been identified. Staff had a good understanding of individual people's risks and how best to support people to reduce these.

People were supported to take their medicines as prescribed by trained staff. Staff understood how people preferred to take their medicines and action to take should an error occur with medicines.

Areas of the home environment were undergoing a refurbishment and required completion of the refurbishment, to ensure the likelihood of the spread of infection was reduced.

Staff were able to debrief following any incidents and any lessons learnt were shared with the staff team to drive through further improvements in people’s care.

People’s care and support was personalised and tailored to meet their needs. Staff showed a good understanding of people; their likes/dislikes, routines, and how they communicate.

Staff were provided with training and regular refresher training to enable them to carry out their roles effectively. Staff told us they felt they were supported.

Where possible people were encouraged to be involved in menu planning. Staff supported people to eat and drink enough to remain healthy. Staff were ensuring people’s eating and drinking intake was recorded.

The staff team ensured people’s health needs were met and sought appropriate healthcare when required.

People had been included and involved in the refurbishment works and chosen their own colours for their bedrooms.

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.

A variety of audits and monitoring systems were in place to maintain oversight of the service and to further drive through improvements.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Based on our review of key questions Safe, Effective and Well-led, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support: Model of care and setting maximises people’s choice, control and Independence. People were supported to live their lives how they wanted to and were supported to continue doing things that interested them.

Right care: People were supported by staff that were kind and caring. Staff were passionate about their roles and the people they were supporting. They knew people well and knew their likes, dislikes, needs and preferences. This allowed staff to provide personalised care that met people’s needs.

Right culture: There was a positive culture in the service that promoted independence. The staff team spoke positively about each other and the support they received from the management team.

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 good (published 29 January 2019).

Why we inspected

We received concerns in relation to the management of people’s care needs, meeting people’s needs effectively and management oversight. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of this inspection.

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.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective and well-led sections of this full report.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.