The Chimneys Residential Care Home

At the last inspection, the service was rated Good. At this inspection we found the service remained Good in all five questions and Good overall.

There was a registered manager 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.

Since our previous inspection in January 2016 we have reviewed and refined our assessment framework, which was published in October 2017. Under the new framework certain key areas have moved, such as support for people when behaviour challenges, which has moved from Effective to Safe. Therefore, for this inspection, we have inspected all key questions under the new framework, and also reviewed the previous key questions to make sure all areas were inspected to validate the ratings.

People were protected from the risks of abuse because staff were trained in recognising and reporting any safeguarding concerns. The registered manager checked staff were suitable for their role before they started working at the home and made sure there were enough staff to support people safely. Medicines were stored, administered and managed safely. The housekeeping staff followed best practice guidance to keep the home clean.

Risks to people’s individual health and wellbeing were identified with the person and their representative and care was planned to minimise the identified risks. The provider and registered manager regularly checked that the premises, essential supplies and equipment were safe for people to use.

People were cared for and supported by staff who had the skills and training to meet their needs effectively. People were supported to eat and drink enough to maintain a balanced diet that met their preferences. People were referred to other healthcare services when their health needs changed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People, relatives and staff felt well cared for. The registered manager and staff understood people’s diverse needs and interests and encouraged them to maintain their independence according to their wishes and abilities. Staff were happy working at the home. People were supported and encouraged to maintain their interests and to socialise in the home and in the local community. Staff respected people’s right to privacy and supported people to maintain their dignity.

People and relatives knew the manager well and were confident any concerns or issues they raised would be dealt with promptly. People and their relatives were encouraged to share their opinions about the quality of the service. Staff were inspired by the registered manager’s leadership, skills and experience to provide a quality service. The service people received was in accordance with the fundamental standards of care.

Further information is in the detailed findings below.

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There was a registered manager 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 service provides accommodation and personal care for up to 26 older people, some of whom are living with dementia. Twenty-five people were living at the home on the day of our inspection.

Staff understood their responsibilities to protect people from harm and were encouraged and supported to raise concerns under the provider’s safeguarding and whistleblowing policies. The registered manager assessed risks to people’s health and welfare and wrote care plans that minimised the identified risks.

There were enough staff on duty to meet people’s health and social care needs. The registered manager checked staff’s suitability to deliver personal care during the recruitment process. The registered manager regularly checked that the premises and equipment were suitable and properly maintained to minimise risks to people’s safety .People’s medicines were managed, stored and administered safely.

People’s needs were met effectively because staff received appropriate training and support. Staff read the care plans and new staff shadowed experienced staff until they knew people well and understood their needs and abilities. Staff were encouraged to reflect on their practice and to develop their skills and knowledge, which improved people’s experience of care.

The manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The manager had applied to deprive one person of their liberty in accordance with the Act. They were awaiting the Supervisory Bodies decision to grant the authority at the time of our inspection.

People were offered meals that were suitable for their individual dietary needs and met their preferences. People were supported to eat and drink according to their needs and staff understood the importance of helping people to maintain a balanced diet.

People were cared for by kind and compassionate staff who knew them well. Staff knew about people’s individual preferences for care and their likes and dislikes. Staff supported people to maintain their health by seeking advice and support from other health professionals. The registered manager made appropriate arrangements to support people until the end of their life.

People and their representatives were involved in discussing their care needs and in developing a care plan. Care was planned to meet people’s individual needs, abilities and preferences and care plans were regularly reviewed.

The provider’s vision and values were understood and shared by the staff. The management team demonstrated the skills and quality of leadership to inspire and support staff effectively.

The provider’s quality monitoring system included consulting with people, their relatives and other health professionals to ensure planned improvements were focussed on people’s experience.

The registered manager made regular quality checks of people’s care and health, medicines management, meals and suitability and management of the premises. Accidents and incidents were investigated and actions taken to minimise the risks of a re-occurrence.

In the four care plans we looked at, we saw the manager assessed people's needs and abilities before they moved into the home. The manager had identified risks to people's health and well-being and written detailed instructions for staff to minimise risks. We saw that people's care plans were regularly reviewed and updated to match people's changing needs.

The provider's policy, procedures and guidance for staff ensured that people received the medicines they needed, when they needed them. We saw that medicines were stored and administered safely.

Care staff told us they liked working at the home. One member of care staff told us, "The staff and manager are lovely and helpful." They said they had regularly opportunities to discuss their practice and their own professional development.

We found that the manager dealt with complaints and comments in an open and straightforward way, in accordance with provider's policy and procedures. The records we looked at explained the actions the manager had taken to resolve issues that people had raised.

We found that people's written care plans were centred on their individual needs and preferences and were regularly reviewed. Care staff we spoke with knew people well and understood their preferred habits and routines. During our visit we saw care staff anticipated people's needs effectively by the way that people responded to them.

The provider had created an effective infection control policy and procedures. Care staff explained how their infection control training and the written procedures guided their practice in various aspects of their work.

Care staff told us they felt supported to deliver the care people needed because of their training and regular opportunities to talk about their practice with their line managers. A member of care staff told us, 'I do like working here, it's a nice atmosphere and nice staff.'

We found that the care plans and daily records of care and support given were detailed and agreed by people who lived at the home. People's confidential, personal information was kept securely but was accessible enough for staff to deliver care and support effectively.