9 February 2023
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
The inspection was undertaken by an inspector, a pharmacy inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Chester Court is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Chester Court is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
The inspection was unannounced.
What we did before the inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We sought feedback from the local authority and other professionals who work with the service. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with 4 people, 12 relatives, 1 visitor and 10 staff including the regional director, registered manager, care staff, nurses, head housekeeper, laundry assistant, head chef and maintenance man. We also received feedback from 6 health and social care professionals and the hairdresser who visited the home.
We reviewed a range of records. This included records relating to people’s care, medicines and staff recruitment. We also reviewed a range of records, including those relating to the management of the service which the registered manager sent us electronically.
9 February 2023
About the service
Chester Court is a care home providing personal and nursing care for up to 41 people. At the time of the inspection there were 37 people were living at the home.
People’s experience of using this service and what we found
There was a system in place to manage medicines; however improvements were needed to ensure records supported the safe use of medicines. Audits were carried out to monitor all aspects of the home. However, they had not identified the issues we found regarding medicines records. Following our visits; the registered manager took action to address the issues we identified.
The home was clean and safe infection control procedures were followed. Risks were assessed, managed and monitored. One relative told us; "They were in another care home and had a fall there. They have been fine here. I feel they are really safe there, no falls and no concerns about their care or safety. The staff always seem to be in attendance and keeping an eye on them. There are nursing staff as well as carers which is another level of safety I think.”
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
There was a cheerful atmosphere at the home. People and relatives spoke positively about the caring nature of staff. One relative told us, “Staff try and make it as happy and carefree as possible. They laugh and joke with mum and they will put her music on for her. She likes the staff which says a lot I think. The staff are all very nice and welcoming.”
There was a registered manager in place. The regional director explained they were advertising for a clinical deputy manager who would support the registered manager and have oversight of people’s nursing needs. In the interim; the home was supported by the provider’s team of clinical specialists.
People and relatives told us they thought the home was well managed. They spoke positively about the home. Comments included, “I would tell people that you could put your family member there and have peace of mind that they will be cared for properly and treated with respect" and "I would recommend the home. It is clean, warm, friendly and a good home. He would be unable to cope at home so he is in the best place."
Staff liaised with health and social care professionals to help ensure people’s needs were met. Several health and social care professionals considered that communication could be more effective at times to ensure people’s needs were met.
There were systems in place to involve people, relatives and staff in the running of the home. Meetings and surveys were carried out. We spoke with one person who devised a weekly quiz for people and staff. He also explained he was in the process of devising a newsletter for the home.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 3 February 2021). We carried out a focused inspection in November 2020 and found breaches of the regulations relating to medicines management, IPC and the governance of the service. The provider completed an action plan to show what they would do and by when to improve.
We carried out two targeted inspections in December 2020 and June 2021 to check that improvements had been taken in relation to IPC. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question. We found that action had been taken to improve in relation to IPC.
Why we inspected
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions of safe and well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make further improvements. Please see the safe and well-led sections of this full report.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Chester Court on our website at www.cqc.org.uk.
We have identified a breach of the regulations in relation to the maintenance of medicines records. Please see the action we have told the provider to take at the end of this report.
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.