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.