Archived: Chalkmead Resource Centre

Chalkmead Resource Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is located in Merstham Village in Surrey.

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 and associated Regulations about how the service is run.

At the last inspection in January 2017 we looked at the five key questions. The rating for safe, effective, caring and responsive was good with well-led requires improvement. The overall rating was good. We asked the provider to take action to make improvements regarding the registered manager ensuring that all person-centred records followed best practice guidance and the provider reviewed their incident and accident analysis in line with best practice guidance. Both recommendations were followed up and found to be met.

People told us that the home provided a pleasant, friendly and relaxed atmosphere that was created by the staff and they were satisfied with the care and support they received. They also thought there were enough staff who met people’s needs in a kind and thoughtful way.

The home’s recording, auditing and quality assurance systems were comprehensive and kept up to date. They consistently monitored and assessed the quality of the service provided and information was regularly reviewed and recorded in a clear and easy to understand way.

People had access to community based health professionals when required, staff discussed their health needs with them and they were provided with balanced diets that also met their likes, dislikes and preferences and protected them from nutrition and hydration associated risks.

People told us good quality meals were provided and there was a good variety of choices. Staff supported people to eat their meals and drink as required whilst enabling them to eat at their own pace and enjoy the experience.

The home was a safe environment for people to live and staff to work in. It was clean, well-furnished and maintained.

Staff knew the people they supported and were appropriately skilled and trained to meet people’s needs. They also understood their responsibility to treat people equally and respect their diversity and human rights. They treated everyone equally and fairly whilst recognizing and respecting people’s differences.

Staff thought the registered manager and organisation provided good support and there were opportunities for career advancement.

People said they found the registered manager and staff were approachable, responded to them and encouraged feedback from them.

The inspection took place on the 15 November and was unannounced.

A registered manager was 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.

People said that the home was well-led and that management was good. Although the registered manager had started to take action to drive improvements at the home, the management of records still required improvements.

Formal systems were not being used consistently to support people to express their views and to be involved in making decisions about their care and support. There had been no residents or relatives meetings since the manager had been in post.

People said that they were happy with the care and attention they received. However there were inconsistencies with up to date information in care plans. Other people had assessments and care plans that were personalised and reflected their individual needs.

The registered manager had completed some audits of the service such as people’s weight and activities but not for other aspects of the service and as a result actions were not always implemented to improve the quality of service they received. The registered manager acknowledged further work was required in this area and explained that since being in post she had prioritised areas such as ensuring staffing levels were maintained. We have made a recommendation about this in our report.

People said that there were enough staff on duty to meet their needs and to provide assistance at the times they wanted. Staff recruitment processes were robust and helped ensure the provider only employed suitable staff to care for people.

People said that they were treated with kindness and respect. In the main people were treated with dignity and respect and their privacy was promoted.

People said that they were happy with choice of activities available to them. The home employed dedicated activity staff and an activity programme was in place.

People received their medicines when they needed them and medicines were managed safely. There were systems in place to ensure that medicines had been stored, administered, and reviewed appropriately. Risks to people’s safety were assessed and actions taken to reduce reoccurrence where possible.

People said that they would speak to staff if they were worried or unhappy about anything. Staff had received safeguarding training and were aware of their responsibilities in relation to safeguarding.

People said that the food at the home was good. Staff assisted people when required and offered encouragement and support. People were provided with a choice of freshly cooked meals each day and facilities were available for staff to make or offer people snacks at any time during the day or night. Specialist diets to meet medical, religious, or cultural needs were provided where necessary

Staff were sufficiently skilled and experienced to care and support people to have a good quality of life. A training programme was in place that included courses that were relevant to the needs of people. Staff received support to understand their roles and responsibilities and said that the manager was approachable.

Chalkmead Resource Centre was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). These safeguards protect the rights of people by ensuring if there are any restrictions to their freedom and liberty these have been authorised by the local authority as being required to protect the person from harm. Staff understood their responsibilities in relation to capacity and decision making. This was in line with the Mental Capacity Act (2005) Code of Practice which guided staff to ensure practice and decisions were made in people’s best interests.

We spoke with several people who used the service during our visit and they told us they were generally happy living in the home. They said the staff were kind and caring and that some were nicer than others. A person who had recently been admitted said "I can relax now as I am well cared for", another person told us "I love the company and can choose what I want to do".

The home was busy and people were looking forward to Christmas. The activity coordinator was arranging a carol service with the local school, and Christmas parties were also being planned.

We spoke with relatives and visitors who all spoke highly of the home. One relative told us "I visit every day and I am always made very welcome". Another visitor told us "I am so much more at ease since my family member moved here as he is well cared for and happy".

We noted that people were not always protected from abuse because an incident of poor practice was not raised as a safeguarding referral to the local authority.

We found the provider had effective systems in place to monitor and regularly assess the quality of service that people received.

We found a lack of leadership in the home regarding effective use of resources and allocation of staff.

We were told that staff were kind and caring and treated people with dignity and respect. Some people told us that there were always enough staff on duty to help them with personal care. Some people told us that that often had to wait for care in the morning as there were insufficient staff to help them when they liked.

We had good feedback regarding the food and people were seen to enjoy their lunch in nice surroundings.

The home was clean and well decorated and people were able to personalise their rooms according to incivil choice.

Quality assurance was monitored and any suggestions or comments were acted upon.