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Inspection Summary


Overall summary & rating

Good

Updated 19 September 2017

This inspection took place on 18, 19, 21 and 25 July 2017 and was unannounced on the first day. We told the registered manager we would be returning over the next three days. At the last comprehensive inspection in October 2014, with the inspection report being published in March 2015, the service was rated as ‘Good’.

The Chiswick Nursing Centre is a 146 bedded care home with nursing and provides care, accommodation and support for older people and younger adults, people who are living with dementia, people with mental health needs, people with complex neurological conditions, people with physical disabilities and people with learning disabilities. At the time of our inspection 141 people were living in the home.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People’s risks were managed and care plans contained appropriate and detailed risk assessments which were updated regularly when people’s needs changed. The service had a robust recruitment process and staff had the necessary checks to ensure they were suitable to work with people using the service. Recruitment was ongoing with the aim to reduce the number of agency workers.

People who required support with their medicines received them safely from staff who had completed in-depth training in the safe handling and administration of medicines, which was refreshed annually. Staff completed appropriate records when they administered medicines and these were regularly checked to minimise medicines errors.

The majority of people who used the service and their relatives told us they felt safe using the service and all staff had a good understanding of how to protect people from abuse. Staff were confident that any concerns would be investigated and dealt with. All staff had received training in safeguarding adults from abuse and had a good understanding of how to identify and report any concerns. One person felt they were at risk in relation to fire evacuation procedures because of their poor mobility. The provider had consistently reassured them that there was a plan in place to manage any emergency and their potential evacuation.

Staff demonstrated a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff were aware of the importance of asking people for consent and the need to have best interests meetings in relation to decisions where people did not have the capacity to consent to their care. The provider was aware when people had restrictions placed upon them and notified the local authority responsible for assessment and DoLS authorisations.

Staff were aware of people’s dietary needs and food preferences and provided support to those who required it during mealtimes. If people had questions or concerns about their food the provider met with them to discuss their preferences and to find alternative options.

Registered nurses and care assistants told us they contacted other health and social care professionals, such as occupational therapists, psychiatrists and speech and language therapists, if they had any concerns about people’s health. We saw evidence of these referrals in people’s care records. People had regular access to a GP who visited at least three times a week, was available for emergency ‘house calls’ on a daily basis and was also available outside of normal surgery hours.

There was a comprehensive induction and training programme in place to support staff in meeting people’s needs effectively. New staff shadowed more experienced staff and had their competency signed off by senior staff before they started to deliver personal care or s

Inspection areas

Safe

Good

Updated 19 September 2017

The service remains Good.

Effective

Good

Updated 19 September 2017

The service remains Good.

Caring

Good

Updated 19 September 2017

The service remains Good.

Responsive

Good

Updated 19 September 2017

The service remains Good.

Well-led

Good

Updated 19 September 2017

The service remains Good.