South Chowdene

We found the following examples of good practice.

¿ The home was clean and there was regular cleaning of all surfaces. The environment had been refurbished and furniture was used to support with social distancing.

¿ The management team had worked with staff to keep the environment as homely as possible but still adhering to social distancing guidelines.

¿ Professional visitors completed health declarations and were tested for COVID-19 at the service. Risk assessments were completed prior to each visit.

¿ Staff wore appropriate PPE and had access to this throughout the home. Staff had received additional training during the pandemic about correct PPE usage and infection prevention and control.

¿ The provider had created a team responsible for updating each service with updates to government guidelines and they had created easy to follow process for use by staff.

South Chowdene is a residential care home providing nursing and personal care to up to 42 people aged 65 and over. Accommodation is provided in a purpose-built building over two floors. At the time of the inspection 35 people were living at the service.

People’s experience of using this service and what we found

People were at the heart of the service and their views were valued and listened to. One relative said, “All the residents are treated as a person, not a commodity. [Staff] have time to sit and talk and have a bit chat. The level of care is outstanding, not just good. It's like a true family here.”

The registered manager was enthusiastic and committed to foster an open and transparent culture. The provider and registered manger had developed especially strong links with the local community and went above and beyond to ensure the home was as accessible as possible. Quality assurance was robust, involved people living at the home and used to learn lessons and drive improvement.

Staff were kind and treated people with dignity and respect. The registered manager and staff regularly went above and beyond to meet people’s needs and preferences. People could participate in a diverse programme of meaningful activities, including regular opportunities to integrate with the local community. People received especially compassionate and dignified end of life care.

People, relatives and staff confirmed the home and service were safe. Staff felt confident to use the safeguarding and whistle blowing procedures, if needed. The registered manager ensured staffing levels were sufficient to meet people’s needs. The provider followed safe recruitment practices when employing new staff. The home was clean and well maintained. Incidents and accidents were reviewed to identify learning and keep people safe.

Staff received good support and completed the training they needed. Staff supported people to have enough to eat and drink and to access healthcare services.

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.

People's needs were assessed and the information used to develop personalised care plans. People could participate in a wide range of activities. Complaints were thoroughly investigated.

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 good (published 20 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

South Chowdene is registered to accommodate up to 42 older people who require nursing care. There were 35 people living at the home at the time of the inspection.

The home had a registered manager. 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.

People, relatives and staff consistently told us people were safe living at South Chowdene.

Staff had a good understanding of safeguarding and the provider’s whistle blowing procedure. They told us they had not needed to use the whistle blowing procedure but would not hesitate to do so if needed. Safeguarding concerns had been fully investigated in line with the local authority’s safeguarding procedures.

There were sufficient staff on duty to meet people’s needs. People and staff confirmed this was the case and we saw that staff answered call bells quickly. Staffing levels were monitored on a regular basis.

Staff supported people to mobilise in line with their assessed needs and using the correct equipment.

Medicines were managed appropriately. Staff were trained to administer people’s medicines and accurate records were provided to confirm medicines were administered safely. Only trained staff whose competency had been assessed administered people’s medicines.

Regular health and safety checks were carried out including checks of fire, gas and electrical safety. Where potential risks had been identified, a risk assessment was in place to minimise the risk. Procedures were in place to deal with emergency situations.

The provider had effective recruitment checks in place to help ensure new staff were suitable to work at the home. For example, requesting and receiving references and checks with the disclosure and barring service (DBS).

Incidents and accidents were logged, investigated and monitored. Records showed action had been taken to prevent the situation from happening again.

People, relatives and staff gave us positive feedback about the registered manager. They told us she was supportive, approachable and making improvements to the home.

The provider has a range of quality assurance checks to help maintain people’s safety and wellbeing.

The registered manager had been proactive in submitting the required statutory notifications.

There were opportunities for staff to give feedback about the home through attending staff meetings or speaking to the registered manager directly.

South Chowdene is a nursing home situated in a residential area of Low Fell in Gateshead. It is registered to accommodate up to 42 older people who require nursing care. There were 28 people living at the home at the time of the inspection.

The service had not had a permanent registered manager since November 2015; there was a new manager in post who was intending to register with us. 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. It is a legal requirement of the provider’s registration to have a registered manager in post.

Staff knew how to keep people safe and prevent harm from occurring. The staff were confident they could raise any concerns about poor practice in the service and these would be addressed to ensure people were protected from harm. People in the service felt safe and able to raise any concerns they might have.

Staffing was organised to ensure people received adequate support to meet their needs throughout the day and night. Recruitment records demonstrated there were systems in place to employ staff who were suitable to work with vulnerable people.

People’s medicines were managed by nursing staff who were trained and monitored to make sure people received their medicines safely. The medicines storage area was organised and effective ordering and supply procedures were in place with a local pharmacy. The service had plan in place for senior staff to assist with medicines and suitable training and preparation were in place to support this.

Staff received support from senior staff to ensure they carried out their roles effectively through mentoring and support. Supervision and appraisal processes were now in place to enable staff to receive feedback on their performance and identify further training needs.

People could make choices about their food and drinks and alternatives were offered if requested. People were given support to eat and drink where required. We observed a mealtime where senior staff and the manager assisted.

Arrangements were in place to request external health and social care services to help keep people well. External professionals’ advice was sought when needed and incorporated into care plans. External healthcare professionals spoke of effective joint work with the staff and manager.

Staff demonstrated they had an awareness and knowledge of the Mental Capacity Act 2005. The service had made applications for people who may be deprived of their liberty and there was a robust review and renewal process in place.

Staff provided care with kindness and compassion; we saw smiles and interaction between people and staff. People could make choices about how they wanted to be supported and staff listened to what they had to say.

People were treated with respect. Staff understood how to provide care in a dignified manner and respected people’s right to privacy and to make choices. The staff team knew the care and support needs of people well and took an interest in people and their families to provide individualised care.

People had their needs assessed and staff knew how to support people according to their preferences and choices. Care records showed that changes were made as people’s needs changed and in response to requests from people using the service, relatives and external professionals.

Staff knew people as individuals and respected their choices. People were supported to enjoy activities although this was limited at the time of inspection due to the absence of the co-ordinator. The new manager told us they had plans to improve activities further. People could raise any concerns and felt confident these would be addressed promptly by the manager and senior staff.

The home had a new manager who was visible and hands on. There were systems in place to make sure the service learnt from events such as accidents and incidents, complaints and investigations. The provider had notified us of all incidents that occurred as required.

People and relatives views were sought by the service through surveys and day to day contact. People, relatives and staff spoken with all felt the manager was caring and responsive. External professionals commented on the positive impact the new manager had on the service since starting.

We undertook this focused inspection to check if the provider was now meeting the legal requirements. This report only covers our findings in relation to these requirements. You can read the report from our last comprehensive inspection by selecting the 'all reports' link for South Chowdene on our website at www.cqc.org.uk.

South Chowdene is a nursing home situated in a residential area of Low Fell in Gateshead. It is registered to accommodate up to 42 older people who require nursing care. There were 26 people living at the home at the time of the inspection.

The service had not had a registered manager since November 2015; there was an acting 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.

Staffing numbers were assessed using the provider’s dependency rating tool and there were sufficient staff to meet people’s needs. Staff and people told us they had more time to spend with people and were less tasks focussed in their work.

Some medicine care plans and records could not demonstrate that people received all their medicines as prescribed. Care plans and records around creams and ointments did not demonstrate these were being used as prescribed. Action was not always taken when issues about medicines management were identified by audits.

Staff had not received appropriate supervision and appraisal. We found that little progress had been in made since our last inspection on providing staff with supervision. Staff had not received an annual appraisal of their performance.

People were supported to eat and drink to maintain their wellbeing. Systems and processes were now in place to ensure that people ate and drank enough to maintain their wellbeing. We observed a positive mealtime experience where staff had time to support people in a dignified manner.

We saw that care plans were personalised and were subject to regular review. These plans contained personalised details about peoples likes and dislikes, detailing how best to support them.

The service had a process to respond to and learn from complaints; we saw that actions had been taken to learn from complaints.

The service had not had a registered manager in post for six months. Staff and relatives told us this had a negative impact on the service.

The processes in place to complete agreed actions was not robust. We saw that actions had not been completed in agreed timescales and the process used to manage these was not robust. Feedback from people and relatives had been sought and acted upon to improve the service offered.

People had their needs assessed and the assessments were used to develop personalised care plans. One person commented, 'The care is fine.' A family member told us 'Staff are approachable and do what is needed.' Another family member commented, 'So brilliant, it's untrue the care in here', and, 'Such a nice place.'

The provider had systems in place to ensure people received their medication appropriately and in a timely manner. Medication was only administered by qualified nurses who had had their competency assessed.

People who used the service told us they had no concerns about the ability of the staff who cared for them. One person commented, 'The carers without exception are excellent.'

People we spoke with said they were happy with their care and told us they knew how to complain if they needed to.

We found some care records we looked at were incomplete and inaccurate.

During our observation we saw people were treated with consideration and respect. People and their relatives told us they were happy with the care which was provided. One person said, "It's good here, all of the staff are polite. If I need anything I pull the cord and the staff come to me." A relative told us, "It's a good home. They keep me informed. They answer any questions I have straight away. They respect my mam's wishes. They'll always put her to bed whenever she asks to go, and get her anything she wants."

We reviewed four care records and saw that people's preferences and care needs had been documented. We spoke with four members of staff. Staff were knowledgeable about people's care needs and what they should do to support them.

Staff training was kept up to date so that staff could care for people safely and to an appropriate standard.

The provider had made suitable arrangements to protect vulnerable people from the risk of abuse.

We found there was an effective system in place to monitor and assess the quality of the service provided.