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Archived: Chaseley Bungalows

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Inspection report

Date of Inspection: 13, 21 August 2014
Date of Publication: 18 September 2014
Inspection Report published 18 September 2014 PDF | 107.7 KB

There should be enough members of staff to keep people safe and meet their health and welfare needs (outcome 13)

Not met this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by sufficient numbers of appropriate staff.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 13 August 2014 and 21 August 2014, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with staff, reviewed information given to us by the provider and reviewed information sent to us by commissioners of services. We reviewed information sent to us by other authorities, talked with commissioners of services and talked with other authorities.

Our judgement

There were not enough qualified, skilled and experienced staff to meet people’s needs

Reasons for our judgement

We looked at the staff rota for the week of and the week prior to our inspection. The deputy manager told us that there was on going recruitment in progress. However, the home had struggled to find appropriate trained staff to fill vacant positions. We saw agency staff were being used by the home on a daily basis. This included nursing and care staff.

We spoke with people living at the Bungalows. Everyone told us they liked living there. However, inconsistent staffing meant that people did not have their care provided by staff who they knew. Due to care documentation not being up to date and the high use of agency staff this meant that people had to tell staff how to provide their care. One person told us, “Last night there was an agency nurse that had never been here before and the night before there was an agency nurse that had never been here before.” We looked at documentation and saw evidence that this person had needed to tell staff how to provide their care.

Another person we spoke with told us that they felt that things had recently improved and they were happier now. People told us that the lack of permanent staff was affecting the care they received as staff did not know them or their needs.

Overall people we spoke with were happy living at the Bungalows and appreciated that the management had been making changes to improve things. The provider had commenced a rotation of staff from their other registered location. People felt that this was a positive improvement and told us, “They seem to be getting there. Things are looking up and X seems to have their finger on the button they are better than some of the others.” We were told by people using the service that, “There are staffing difficulties. There is no stable team of staff.” And, “There are no permanent staff any more they have all gone.”

The deputy manager confirmed that there had been recent staffing changes. Due to this turnover of nursing staff the service had needed to use a number of agency staff.

We saw a new staff/agency induction log used by the service when an agency worker came to work their first shift. This form was to be completed by a Chaseley staff member and used as a checklist whilst inducting the new worker to the service. We saw that these were two pages long and included reading care documentation, fire evacuation information, an effective handover, location of policies, first aid, on call numbers, procedure for administration of controlled drugs, introduced to one resident and had their equipment explained to them, able to carry out catheter procedures, how to use handover sheet allocation of staff and how to deal with messages.

We saw that the two nights prior to our inspection a new agency nurse had worked each night shift. We asked to see the induction logs. Both had been completed by a member of care staff. We spoke with one who told us they spent as long as they were able to go through the details on the form and showing the nurse around the site. This was normally about 15 minutes. For the medical questions if the agency nurse said they did not know how to do something they would tell the nurse in charge. It was unclear how this assessed an agency nurses competencies, or ensured that they would be able to provide care and treatment safely and effectively to people living in the Bungalows.

We looked at the training matrix. This identified when staff had attended training or training updates were scheduled. We saw that when people had not attended training no evidence was in place to show that this had been followed up. We also found that the dates staff confirmed they had attended mandatory training had not been updated on the matrix. Therefore the training matrix did not give a clear accurate picture. It was therefore unclear how the provider had ensured that staff were suitably skilled and had received appropriate training to carry out their role within the service.

Discrepancies found during the inspection questioned s