Chacombe Park

Chacombe Park is a care home. They are registered to provide accommodation, nursing and personal care for up to 77 people. At the time of the inspection there were 77 people living there.

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

The provider’s policy for visiting arrangements in the home was not always in line with government guidance. However, the registered manager had used innovative ways to ensure regular meaningful visits still happened during the pandemic. After our inspection, the provider changed their policy to ensure it was in line with government guidance.

People were supported by staff who understood what actions to take to keep people safe. Staff had received training around safeguarding and understood how to recognise and escalate safeguarding concerns. Staff

were safely recruited and systems had been developed to determine safe staffing levels.

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 were supported by staff who had the right skills and knowledge to meet their needs. Staff were responsive to changes in people's needs and liaised with healthcare professionals to support people's health and well-being.

People were supported to receive meals of their choosing and to access the healthcare they needed.

People were supported with care that was kind and caring. Staff knew the people living at the home and what was important to them. People were treated with dignity and respect and were encouraged to retain their independence.

People received care that was responsive to their needs. People had access to activities based on their interests and felt an integrated part of their local community. There were systems in place that enabled concerns or complaints to be raised and responded to.

People received a service that was well-led. There were a number of effective monitoring systems in place that measured the quality and safety of the service.

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 12 January 2018).

Why we inspected

The inspection was prompted in part due to concerns received about visiting arrangements and whistleblowing concerns in relation to the management of the service. A decision was made for us to inspect and examine those risks.

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 COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the last inspection the service was rated ‘Good’ when we published our report on 25 November 2015. At this inspection we found the service remained overall ‘Good’, with ‘well-led’ requiring improvement.

A registered manager was in not in post when we inspected although we had received an application to register a manager and their application was being processed. The new manager was subsequently registered on 20 November 2017.

There had not been a registered manager in post since the last registered manager voluntarily cancelled their registration on the 18 April 2016. Their successor left without submitting an application to register as manager and this sequence of events resulted in the provider having to appoint another manager. Although the provider had made timely arrangements for Chacombe Park to be managed until a new manager was registered it remained a legal requirement that a registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 were safe. There were sufficient numbers of experienced and trained staff to safely meet people’s assessed needs. There were appropriate recruitment procedures in place to protect people from receiving care from staff that were unsuited to the job.

People’s needs had been assessed prior to admission and they each had an agreed care plan that was regularly reviewed to ensure they continued to receive the care and support they needed. People were safeguarded from abuse and poor practice by staff that knew what action they needed to take if they suspected this was happening. Risks to people’s safety were reviewed as their needs and dependencies changed.

People were treated equally and shown respect as individuals with a range of needs that came together from diverse backgrounds. They received care and support from staff that knew what was expected of them and they carried out their duties effectively and with compassion. Care plans were personalised and reflected each person’s individual needs and provided staff with the information and guidance they needed to manage risk and keep people safe.

People’s capacity to make informed choices had been assessed and the provider and staff were aware of the Mental Capacity Act 2005 and the importance of seeking people’s consent when receiving care and support. People were encouraged and enabled to do things for themselves by friendly staff that were responsive and attentive. Their individual preferences for the way they liked to receive their care and support were respected. Staff had insight into people’s capabilities and aspirations.

There were appropriate arrangements in place for people to have regular healthcare check-ups. People had access to community healthcare professionals and received timely medical attention when this was needed.

People who needed encouragement and support with eating a healthy diet received the help they required. They had enough to eat and drink, the menu choices were appetising and the people we spoke with said they enjoyed their meals.

Medicines were appropriately and safely managed and staff had received the training they needed in the safe administration of medicines. Medicines were securely stored and there were suitable arrangements in place for their timely administration.

People, and where appropriate, their family or other representatives were assured that if they were unhappy with the care provided they would be listened to and that appropriate action would be taken to resolve matters.

We found that staff received regular supervision and annual appraisals of their performance and they were provided with the necessary training to ensure they could do their work safely and effectively.

We saw that risk assessments were completed for identified risks to people's health and wellbeing. For example, falls, nutrition, continence management, medicines administration and challenging behaviour. This meant that people's care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

We spent time observing how staff related to people who used the service and how people with dementia were supported to engage with other people around them and their environment. We saw that people were positively engaged in one to one and group activities.

We saw that the dementia care environment provided people with access to books, magazines, soft furnishings, rummage boxes, board games and other activity materials for people to engage with. We saw that people's bedrooms had been personalised with their own photographs, ornaments and items of furniture that were meaningful to them.

We saw that staff worked at a relaxed pace and their interactions with people demonstrated that they valued and promoted the involvement of all people who used the service regardless of their mental or physical abilities.

People we spoke with said the staff were 'happy, cheerful and friendly'. We spoke with one visitor who told us they were extremely pleased with the care their mother received, that the staff were very supportive to both them and their mother. They also express their satisfaction with the cleanliness of Chacombe Park.