Archived: Chaffinch Residential Care Home

Improvement action plan issued following the previous inspection

Where we asked the provider to complete an improvement action plan following the last inspection, include the text below, adapting where necessary:

'Following the last inspection, what they would do and by when to improve the key question(s) to at least good.' Then describe at a high level what you found, adding detail in the detailed findings section for the relevant key question(s).

Focused inspection

'We undertook an announced / unannounced focused inspection of on . This inspection was done to check that improvements to meet legal requirements planned by the provider after our inspection had been made. The team inspected the service against of the five questions we ask about services: is the service well led, , (more as needed)? This is because the service was not meeting some legal requirements.

No risks, concerns or significant improvement were identified in the remaining Key Questions through our ongoing monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection'

Comprehensive or focused inspection

Where breach topic has moved to a different key question in Next Phase

When we completed our previous inspection on DD/MM/YYYY we found concerns relating to . At this time this/these topic area(s) was/were included under the key question of . We reviewed and refined our assessment framework and published the new assessment framework in October 2017. Under the new framework this/these topic area(s) are included under the key question of . Therefore, for this inspection, we have inspected this key question and also the previous key question of to make sure all areas are inspected to validate the ratings.

Provide a brief overview of the service (e.g. Type of care provided, size, facilities, number of people using it, whether there is or should be a registered manager etc).

Service Types and descriptions

Care at Home services

Domiciliary care agency

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community [and specialist housing]. It provides a service to [older adults], [younger disabled adults], [children].

Provider of care to people living in specialist housing

Location proving care to people housed under supported living arrangements

This service provides care and support to people living in [a] [insert number of] 'supported living' setting[s], so that they can live in their own home as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Location proving care to people living in extra care housing

This service provides care [and support] to people living in specialist 'extra care' housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is [bought] [or] [rented], and is the occupant’s own home. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people's personal care [and support] service.

Describe the specialist housing setting[s] people live in, there are some examples below:

People using the service lived in…

[number] ordinary flats and bedsits across [town/city/area]

a single 'house in multi-occupation' shared by [number] people

[number] of [bedsits], [flats], [houses], [and] ['houses in multiple occupation'] across [town/city/area]

a large gated community on the outskirts of [city]

Where the service supports people living in houses in multiple occupation (HMOs), add:

Houses in multiple occupation are properties where at least three people in more than one household share toilet, bathroom or kitchen facilities.

Give a summary description of the houses, the facilities that are shared, and either the number or the range of numbers who share them. Include information about any office or sleep in arrangements. Give less detail and more summarised information where larger numbers of HMOs are supported.

Do not provide a detailed, estate agent style description of the premises lived in by people using the service; only an outline summary able to broadly explain the context in which it provides regulated activity

All Care at Home services

Where needed, explain that not everyone using the service receives personal care, for example:

Not everyone using [service name] receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

Residential care home

[Care home name] is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Describe the care home's premises, for example:

(The care home) accommodates xx people in one adapted building.

(The care home) accommodates xx people across three separate units, each of which have separate adapted facilities. One of the units specialises in providing care to people living with dementia.

Do not provide a detailed, estate agent style description of the premises; only an outline, broad summary.

Services for people with learning disabilities and autism

'The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.' Registering the Right Support CQC policy

You will need to reflect where a service does not conform to Building the Right Support and Registering the Right Support guidance. It is very difficult for large services for people with autism to meet the standards.

Complex or multiple service location

If you are inspecting a complex, multiple service type location you will need to adapt and edit the above paragraphs as needed, probably substantially.

N.B. If there is or should be a registered manager include this statement to describe what a registered manager is:

'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.'

Give a summary of your findings for the service, highlighting what the service does well and drawing attention to areas where improvements could be made. Where a breach of regulation has been identified, summarise, in plain English, how the provider was not meeting the requirements of the law and state 'You can see what action we told the provider to take at the back of the full version of the report.' Please note that the summary section will be used to populate the CQC website. Providers will be asked to share this section with the people who use their service and the staff that work there.

Chaffinch Residential Care Home is a care home providing support for up to five people who have mental health needs.

A registered manager was in post. 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.

The people we spoke with told us that they got on well together and they felt safe at the home. People we spoke with said, “Yeah I am safe here. When I was on my own I was scared of people. I am not scared here, I am just happy” and “I am happy here. I have a good friend in [person who used the service]. They are like a sister to me.”

We saw that there were recruitment and selection procedures in place to protect people who used the service from coming into contact with potential staff who were unsuitable to work with vulnerable people.

People’s medicines were managed well and the home was seen to be clean and tidy throughout.

People who used the service had the capacity to make decisions about their day to day lives and what they did with their time.

People told us they were happy with the food provided. They said, “The food is alright” and “If we don’t like something we can have something else.”

Arrangements were in place to request health and social care services to help people keep well and advice was sought when needed.

The relationships we saw between people who used the service and the staff supporting them were warm and friendly. The atmosphere was calm and relaxed. People we spoke with told us that the service was, “Nice and friendly,” “It’s warm, friendly and quiet,” and “I just like it here. I am happy and I have got friends.”

We saw that to ensure people’s right to privacy they had keys to their bedrooms

People told us they had a range of individual activities that they participated in within the local community; these included, for example, going to the local college, out with Contact (a local social group), and visiting family. One person said, “I enjoyed going on holiday with Contact and I hope to go again this year.” Another said, “I like to go out on my own on bus rides. I prefer not to join in.”

We found people who used the service were encouraged to maintain their independence, wherever possible. People took responsibility for household tasks such as keeping their bedroom tidy, doing their laundry and drying up after meals.

Systems were now in place to regularly assess and monitor the service provided and the provider had notified us of any incidents that occurred as required.

People who used the service and staff reported that the provider and the registered manager were approachable and supportive. Resident and staff meetings were held which gave people the opportunity to raise any issues or concerns that they had.

Before our inspection visit we contacted the local authority commissioning and safeguarding teams. They informed us they had no concerns about the service provided.

' Is the service safe?

' Is the service caring?

' Is the service effective?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on speaking with people who used the service, speaking with staff who supported them, observation and looking at records.

Is the service safe?

We spoke with two people who used the service. They told us they could speak to any member of staff if they had any worries or concerns. They said they were confident that the staff member would do their best to resolve the issue.

We checked the employment records of two staff members. Records showed that the appropriate checks had been undertaken to ensure staff were suitable to work with vulnerable people. The provider had renewed the criminal checks recently to ensure that there had been no changes.

Is the service caring?

The manager knew the people they cared for well, including their backgrounds and personal preferences. People spoke positively about the staff team.

We saw there were frequent and friendly interactions between people who used the service and the manager who was supporting them.

The manager showed concern for people's wellbeing for example by taking action in an emergency situation.

Is the service effective?

People who used the service were treated as individuals and took part in community activities that they liked to be involved in. One person told us, 'I have a really good social life and being busy suits me'.

The manager told us they promoted people's independence and encouraged them to do whatever they could for themselves.

Is the service responsive?

People were supported, wherever possible to maintain relationships with family and friends.

People were confident they would receive the support they needed quickly should their health needs change.

Is the service well led?

The provider was a former psychiatric nurse manager who had many years experience working with people with mental health support needs.

The home had a manager who was registered with the Care Quality Commission and who was qualified to undertake the role.

There were systems in place to ensure that people were happy with the service they received and to ensure their health and safety was protected.

The new plans looked at the support each person needed from their point of view.

We looked round some parts of the home. We saw that the home was clean and tidy. Paper towels and liquid hand wash were available for people to use to help prevent the spread of infection. We saw that the home was decorated and furnished to a satisfactory standard.

Training records we saw showed that most staff members had completed staff training in first aid, food safety awareness, fire awareness, medication and health and safety.

People told us that if they had any worries or concerns that they could speak to any member of staff. They were confident that they would do their best to sort the problem out. They said that staff were supportive and approachable.

Prior to our visit we contacted the local safeguarding and commissioning teams. They informed us that they had no concerns about the home at this time.

We spoke with three people about their health. One person told us that they were going to make every effort to live a healthy lifestyle. Another person confirmed that they had access to an optician, a doctor, a social worker and a psychiatrist should they need health care support. One person said 'I've not been in hospital now for eight years so it's all good news.'

People told us that they had no concerns or worries about living at the home. People said that if they did they would speak to the provider, the manager or their family and they were confident that the situation would be taken seriously and sorted out.

Before our visit we contacted the local safeguarding and commissioning teams. They confirmed that they had no concerns about the service at this time.

Some staff had not received basic mental health training to help them support people living at the home safely and effectively. This training was particularly important because staff worked alone at the home with people who had specific mental health needs.