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Inspection carried out on 12 June 2018

During a routine inspection

This inspection took place on 12 June 2018 and was unannounced. At the last inspection we found two breaches of the regulations and the service was rated as requires improvement in safe and well-led. Following the last inspection, we asked the provider to complete an action plan to show what they would do, and by when, to improve the key questions of safe and well led to at least good. At this inspection we found there had been improvements to the quality of care provided, and the service is now rated as good. The service was no longer in breach of legal requirements.

The Chase Rest Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. People had care needs relating to their mental health, dementia or older age.

The Chase Rest Home can accommodate up to 24 people. There were 16 people living in the home at the time of our inspection. Each person had their own private room with toilet and sink, and there were shared bathroom facilities.

The service had a registered manager. A registered manager. 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.

As far as possible, people were protected from harm and abuse. Staff knew how to recognise the signs of abuse and what they should do if they thought someone was a risk. The home was clean, and people were protected from the risks of poor infection and prevention control.

There were enough staff to support people to stay safe and meet their needs. Staff knew how to report incidents and accidents, and if these did occur, they were properly investigated. Information about these types of incidents were shared, so staff could learn from mistakes. Risk assessment and risk management practices were robust.

People were supported to eat and drink enough, and specialist dietary needs were met. People gave us positive feedback about the quality of the food. People were able to access the healthcare they needed to remain well and their medicines were safely managed.

People were supported to express their choices and preferences and staff supported people in the least restrictive way possible. People led the lives they wanted to and were able to maintain contact with those people that were important to them. People were able to participate in a range of activities, and go out when they wanted to.

People experienced care that met their needs, and were supported by kind, caring staff. People had their privacy and dignity respected, and staff knew what to do to make sure people’s independence was promoted. People experienced person centred care and were supported to make their end of life care wishes known.

People had their care needs regularly assessed, and people were involved in their care reviews. People experienced care and support that was in line with current guidance and standards. Staff made sure they worked within the organisation and with others, to make sure people received effective care. The building and environment was properly adapted to meets the needs of the people who lived there.

Staff were properly supported with training, supervision and appraisals to make sure they had the skills they needed to provide good quality care. Specialist training had been arranged where needed, for example dementia care.

People were asked for their consent before any care was given, and staff made sure they always acted in people’s best interests. The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). These provide legal safeguards for people who may be deprived of their liberty for their own safety or unable to make informed choices about their care.

People had access to a complaints process, and said they would be happy to raise a complaint if they ever needed to. There had been no recent formal complaints, but the registered manager and staff knew what action to take if a complaint were made.

The service was well-led and staff felt supported. People’s views were sought and acted on to improve the service. Regular checks and audits were carried out to make sure people experienced good quality care and staff provided good support. The registered manager had notified the CQC of events that were reportable. The service had met all the fundamental standards and the registered manager and staff had improved the service so it was now good. Further information is in the detailed findings below.

Inspection carried out on 12 April 2017

During a routine inspection

The Chase Rest Home is registered to provide accommodation for up to 24 older people. Providing care for people including those who live with a dementia or mental health diagnosis. This was an unannounced inspection which took place on 12 and 18 April 2017.

The Chase Rest Home was inspected in January 2016. No breaches of regulation were found but we identified some areas of improvement we asked the provider to make to ensure peoples care met best practice at all times. At this inspection we found the provider was not meeting all regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The Chase Rest Home had a registered manager who had just recently completed their registration. 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.

Systems in place to assess and monitor the quality of service provided were not robust. Maintenance and infection control issues found during the inspection had not been identified during recent audits completed by the registered provider and registered manager. Premises and equipment had not been kept clean, suitable for the purpose for which they were being used, properly used and properly maintained.

Medicines policies and procedures were in place; however some areas of medicine practice needed to be improved to ensure that people received their medicines in a safe and consistent manner.

Recruitment processes needed to be improved to ensure that adequate checks and references were in place before people commenced work at the home. There were enough staff to keep people safe. Staff had received training to ensure they had the knowledge and skills to meet the needs of people living at the service. Staff felt supported and had regular staff meetings and individual supervision and appraisals. Staff told us that improvements being implemented were positive.

Staff knew people well. Interaction between staff and people were open and friendly. We saw that staff were kind and patient when providing care. People were always treated with dignity and people’s personal choices were supported.

Risks relating to people’s individual needs were identified and managed to help ensure people remained safe. Staff had a good understanding about how to recognise and report safeguarding concerns.

Management and staff had an understanding regarding mental capacity assessments (MCA) and Deprivation of Liberty Safeguards (DoLS). People were actively involved in day to day choices and decisions around how they received their care. Care was assessed and reviewed regulary to ensure it was person centred and information about the person was up to date. Staff made sure people did not become socially isolated and worked with other outside professionals to improve people’s day to day lives.

Meal choices were provided and people gave positive feedback regarding the meals. People had access to fruit, savoury snacks and drinks when they wished. Kitchen staff were aware if people had any specific dietary needs, allergies or preferences.

Many people went out alone regularly or with relatives. People were encouraged to maintain their independence as much as possible. Staff were involved in providing daily activities for people his included games, quizzes and exercise. The registered manager was looking at further ways to improve activity provision. Staff were aware of people who may be at risk of becoming socially isolated and worked hard to involve people and encouraged them to come to the communal lounge.

People were involved in gaining and providing feedback about the home. Information fed back was used to make changes and improvements. A complaints procedure was available for people to access if needed.

We found two breaches of the Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 14 January 2016

During a routine inspection

The Chase provides accommodation and personal support for up to 24 older people with mental health needs. Some people were independent and required little assistance while others required assistance with personal care and daily living; or support with health care such as diabetes and some were living with dementia. There were 18 people living at the home during the inspection.

The home was a converted older building and the accommodation was on four three floors, a lift enabled people to access most of the home. There were large communal seating areas on the ground floor; people using walking aids were able to access the large garden to the rear and a slope enabled people easy access to the pavement at the front.

A registered manager was responsible for the day to day management of the home. 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 inspection took place on the 14 January 2016 and was an unannounced, which meant the provider and staff did not know we were coming.

A quality assurance and monitoring system was in place and, had identified the issues we found during the inspection, in relation to care plans and mental capacity assessments. There was an action plan in place to address the issues and staff training had been arranged to ensure these were addressed.

People said they felt safe and involved in decisions about the support provided. Risk had been assessed to ensure people were able to take risks. Staff provided support if required, such as assisting people to keep mobile with the use of mobility aids and, where appropriate additional support was provided to enable people to go into the town safely. There was guidance for staff to follow, staff knew people really well and they had a good understanding of people’s individual support needs.

People had access to health care professionals, which included the community mental health team, the GP, district nurse, optician and dentist. People were supported to maintain a healthy diet and if people lost weight or their appetite there were systems in place to support them. The menus were based on people’s preferences, they chose what they wanted to eat and said they food was very good.

There was an open and relaxed atmosphere in the home, people were encouraged to be involved in developing the support provided and were able to talk to the registered manager and provider at any time. People did not have any concerns, they said there were enough staff working in the home to look after them and they had the skills and knowledge they needed to provide the right support to meet their needs.

Inspection carried out on 23 July 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service. We spoke to people living in the home who told us "It’s good here, really brilliant” and “I am able to go out, and I get support.”

During our inspection we found that people had been involved in decisions about their care and chose how they spent their time. Care plans documented the needs of people and their preferences.

Safeguarding measures were in place to protect people living in the home. The provider had systems in place to ensure staff recruitment measures were followed.

A copy of the complaints procedure was displayed in the main reception, and included in the homes statement of purpose. A complaints policy was available for people to access if required. Evidence was seen that comments and complaints were documented, listened and responded to in a timely and appropriate manner.

Inspection carried out on 16 October 2012

During an inspection to make sure that the improvements required had been made

We spoke with two people who lived in the home and a visitor. People who lived in the home told us they were happy with the care they received. One person told us “I have never had any problems, it’s very nice here”. A visitor spoken with told us “I have visited regularly over the last eight weeks, I did not think we would ever find anywhere we would be happy with, but things are so settled here, the staff look after her very well”.

We found that care plans clearly documented the needs of people. Generally care was provided to meet individual needs and the provider had appropriate systems in place to monitor and improve the service.

Inspection carried out on 12 June 2012

During a routine inspection

We spoke to a number of people living in the home, everyone told us they were happy with the care provided. One relative told us “staff are attentive and do all they can”. Another told us they felt the home was lacking organised activities.

Reports under our old system of regulation (including those from before CQC was created)