Archived: Chapel View Care Home

We considered all the evidence against the outcomes we inspected to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe. Safeguarding procedures were robust and staff understood their role in safeguarding the people they supported. People who lived in the home said, 'I feel safe and happy here' and 'Everybody is kind and nice.'

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted, relevant policies and procedures were in place. Appropriate staff had been trained to understand when an application should be made, and how to submit one. This meant that people would be safeguarded as required.

We found there was an effective recruitment procedure in place to ensure people employed were of good character and had the skills and experience necessary for the work they performed. All staff had completed Disclosure and Barring Service (DBS) checks which helped to safeguard people who lived in the home.

Is the service effective?

Care files we checked confirmed that initial assessments had been carried out by the staff before people moved into the home. This was to ensure the home was able to effectively meet the needs of the people who were to live there. People's health and care needs were assessed with them, and their family and friends were involved in the formulation of their plans of care. Specialist mobility and equipment needs had been identified in care plans where required.

We found people were provided with nutritious food. Some people required specialised diets for health or personal reasons and these were provided. During our observation at lunch time we found people were not given a choice of drink, main meal or dessert. An alternative choice had been prepared but when we asked why people were not given a choice the staff said they had 'forgotten to ask people.' One person told us, 'I like lemonade so they get it me and I can have a drink whenever I want.'

Is the service caring?

We found people were treated with respect and dignity by the staff. During our inspection we observed staff speaking with people who used the service in a friendly and caring way. We observed care and support was provided to people when requested.

Two care workers we spoke with demonstrated a good understanding of people's needs and were able to give examples of how they promoted people's independence. Staff were skilled and confident in recognising the diversity, values and human rights of people who used the service.

We spoke with eight people to ask about their views of living at the home. Comments included, "It is really nice here," 'They are sometimes short of staff but they're not a bad bunch and will do their best to help you if you ask them, 'It's alright here and there are some choices,' 'It's lovely here and they really look after you' and 'I got to like it here very quick, the carers are lovely and I feel I might be getting back to my old self.'

Is the service responsive?

Staff told us the care and support provided was flexible to the person's needs and adjustments could be made where required. Staff said they informed the manager if they felt any change in needs was required and the support was reviewed.

We spoke with four relatives. One relative said, 'We looked around plenty of places before we brought [family member] here. I am impressed by the staff and the feel of the place. Recently when [family member] had an episode of extreme distress the staff were brilliant and came straight away. They [staff] responded swiftly and appropriately.'

People were able to join in with a limited range of activities. Two care workers were covering the activity worker post until a permanent activity worker was recruited. On the day of the inspection there was no activities provided for people. People we spoke with said, 'We had a concert the other day which was really good."

People knew how to make a complaint if they were unhappy. Relatives spoken with said they had no worries or concerns about the home but if they did they could talk to any of the staff and they would listen and sort it out."

Is the service well-led?

The service worked in partnership with key organisations, including the local authority and safeguarding teams, to support care provision. We saw evidence the service had taken advice provided by other healthcare professionals so that the quality of the service would be improved.

There was a system in place to make sure the manager and staff learnt from events such as incidents, complaints, concerns and investigations. This helped to protect people from the risk of harm and helped to ensure that lessons were learned from mistakes.

The service had a quality assurance system. Records seen by us showed that shortfalls identified in the manager's audits had been addressed. For example, an audit of health and safety was completed each month. We found areas of concern which were identified in April 2014 had been actioned.

People who used the service, their relatives, friends and other healthcare professionals involved with the service had completed a satisfaction survey in 2013. We saw the majority of areas people were asked about had scored below the national average for other services of this provider. The home manager said surveys had recently been sent out again so they would be able to assess if people thought the service had improved since the last quality assurance audit.

At our previous inspection we also found care planning records were not accurately maintained. We found there was conflicting information recorded about the care and support that people required, which could result in people being provided with inappropriate or unsafe care and support.

To check compliance, we spoke with six people who used the service, five members of staff, the home manager and the regional manager.

People that we were able to communicate with told us that they were happy living at the home. Their comments included, "It's ok here and it's getting better," "I'm alright and have nothing to grumble about" and "Everything is fine, the staff treat me well and I can please myself what I do."

We reviewed the care records of four people. We found that the standard of records throughout Chapel View had improved. We found that care records had been regularly audited by the home manager and the regional manager. Care plans had been reviewed and updated so that there was a full and accurate record of the care and support provided to people.

At this inspection we found, during our SOFI observation that staff had positive interactions with people, they spoke patiently and kindly whilst offering choices and involving people. People also had positive interactions and communication with each other.

People that we were able to communicate with told us that they were happy living at the home. Their comments included, "They look after me," "I'm ok here" and "Things are better."

We found that people were asked for their consent to care and treatment and the staff acted in accordance with their wishes.

We spoke with one relative who was visiting the home and they said they were satisfied with the care provided.

We found people's care and treatment was planned but was not always delivered in a way that ensured their safety and well being.

Our conversations with people, relatives and staff, together with observations on the day of our inspection evidenced that there were enough staff on duty and staff working in the home were appropriately qualified to do their jobs.

We found people were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained.

We spoke with eight people who used the service. They told us that overall they were happy living at the home, but there were things they thought should be improved. Their comments included, "This place is pretty disorganised. The new manager seems extremely good and the other staff have a very caring attitude," and "They just need someone to get organised so it's not such a mish-mash."

We found that each person had a care plan which explained that consideration needed to be given to capacity and deprivation of liberty legislation to ensure people's rights were protected. There was no evidence to demonstrate that this had been followed when it was indicated that a person lacked capacity.

Our conversations with people, relatives and staff, evidenced that on most days there were enough staff on duty to meet people's needs.

The provider had an appropriate system in place for gathering and evaluating information about the quality of care the service provided.

People were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained.