Archived: Chelmsford Nursing Home

The registered manager had left the service prior to our inspection. There was an acting manager managing the service. They had not, as at the time of our inspection, applied to the Care Quality Commission to be registered as the manager.

We spoke with two people who used the service, a visiting relative, and three staff, the acting manager and the deputy manager. We looked at six people's care records. Other records viewed including health and safety and quality checks.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

The service had made referrals to the local authority regarding the Deprivation of Liberty Safeguards (DoLs) and these had been made appropriately. Mental capacity assessments had been carried out.

People's care records showed that care and treatment was not always planned and delivered in a way that was intended to ensure people's safety and welfare. Records contained omissions and people had not always been involved in their care planning.

There were not always sufficient qualified staff on duty.

Is the service effective?

Audits were carried out of the premises and care plans. However, actions were not always taken to remedy deficiencies.

Records we saw did not show that people were protected from the risk of social isolation.

Is the service caring?

We observed staff spending time engaged in activities with people but we also saw staff providing support in a disengaged manner. For example we saw a member of staff sitting with a person for 45 minutes. This person had been assessed as needing one to one support. The member of staff did not make any attempt to engage the person in conversation or interact with them during this time.

We saw staff supporting people to use a computer and read the newspaper. This was done in an appropriate and supportive way. For example the person being supported to read the newspaper was asked which articles they wanted to read and the member of staff discussed the article with them when they had read it.

Is the service responsive?

People or their relatives were not always involved in developing their own care and support plan.

We observed staff offering people choices but this was not always done in a way which promoted dignity.

Is the service well-led?

Governance systems such as audits were in place however these were not applied effectively.

Some people had complex needs which meant they were not able to talk with us about their experiences of the service, but from our observations people looked relaxed and comfortable. We spoke with five people who used the service and they were all positive about the care they received, the staff and the manager.

One person told us they were: ”Very satisfied with the home.” They said they were very able to raise issues but, on the whole, they didn’t really need to. They added: “Initially I found the food wasn’t very good. There were a lot of dried pasta meals but this has now changed. I have no complaints now. The food is fresh and well cooked and there is plenty of choice.” They also told us that they were treated with respect by staff who maintained their dignity when carrying out personal care. However, they said: "Occasionally agency staff do not always provide care to the same standard as the regular staff and at nights when agency staff are working the response time is not so prompt.”

Another person told us they were: ”Very happy living at the home” and “A home is as good as the staff who work in it and there are some darlings here and there are some who are not so gentle, but that is because they do not realise this.”

Everyone we spoke with praised the manager of the service stating they were approachable, caring and effective.”

One person said:” The staff are perfect; dinners are perfect, the manager is gorgeous and I have no complaints at all.” Another person told us that they were quite happy with the care provided, but wished there was more choice in daily life. A relative told us:” I couldn’t fault this home in any way, they are wonderful to my X it gives me peace of mind when I’m not here. I visit every other day but on the days I don’t come in I know X is in safe hands. I know the staff well now and I feel incredibly fortunate to know they will look after X for me.”

People told us that in the main staff were very kind and caring however there was a small group of staff that did not treat them with kindness, consideration or respect. Staff received training in mandatory core subjects but were not properly supported to ensure they were competent in their role.

The premises were suitable, clean, hygienic and free from offensive odours.

Arrangements were not in place to ensure that people using the service were supported to express their views and experiences and be involved as much as they are able. Audits were carried out to check safety and check that processes and systems were followed correctly by staff. However there were no systems in place to monitor and review any actions required to address shortfalls found and to complete the quality monitoring process.