Chilton Meadows Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.At our last inspection we rated this key question good. At this inspection the rating has changed to requires improvement. This meant people’s needs were not always met.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not consistently make sure people were at the centre of their care and treatment choices. There was not always a holistic approach to providing person-centred care across all units. People’s need for social stimulation was not consistently assessed and considered in a personalised way. People and their relatives had mixed opinions on whether there were enough activities to keep people stimulated and meaningfully occupied.

Across all units, but particularly Beech and Munnings units, where people were living with dementia, many people were spending the majority of their time sitting in the lounge area either at a dining table, where some remained for several hours following a meal, or in an armchair.

Activities staff were stretched, trying to cover across the whole site and staffing levels did not permit care staff to fulfil or support this role in meaningful way. This meant social interactions were not recurrent and there were risks of social isolation which were not consistently identified, assessed and managed.For example, during the first day of our inspection we saw 2 people remained in their bedrooms for over 7 hours, laid on their bed, within a sparce room with no activities and limited interaction.

People were not consistently offered the opportunity to take part in activities. We received a lot of feedback, as part of this inspection, about a lack of activities to promote people’s social cognitive and physical well-being. Many people were not able to provide us with feedback, due to them living with advanced dementia, however many relatives and staff raised concerns. One person’s relative told us, “There isn’t much entertainment mostly just the TV.” Another relative said, “Staffing levels also limit activities beyond basic care. There are many [people] who have no visitors and suffer from loneliness. There are very few activities, no film afternoons, and minimal physical activity. Many [people] clearly love the musical events, but they don’t even seem to think about putting on the radio or having a nostalgic music session.”

Some staff also raised concerns about the options for people to participate in activities. One staff member said, “I think the activities could be a lot better as they always seem to do the same things and the [people] who stay in bed don't get included.” Another staff member said, “I feel we need more activities on site, and they are needed 7 days a week to keep the people’s minds active.” A third staff member commented, “I feel there are some [people] that are not always having the opportunity for 1 to 1 as there is not enough staff for the chats or for them to take time to participate in an activity that they enjoy. I’d like more time to do 1 to 1 with [people] in bedrooms too.”

Staff also told us where people were receiving 1:1 care, often from an agency member of staff, activities staff could not get involved resulting in those people not receiving stimulation. Our observations during inspection also supported this. Where activities staff had the time and opportunity to spend with people, we found them to be warm and friendly towards people who clearly benefited from their input.

On both days of our inspection, we saw on Beech Unit people trying to open the door to the secure garden so they could go outside. Staff either failed to notice or refused to permit people to go outside despite it being a warm and sunny day, encouraging them to come away from the door and sit down. We heard a member of staff say, “If we open the door, everyone escapes,” this was despite it being a secure space. We also observed a person walked around tidying tablecloths who was told by a staff member to sit down, this clearly frustrated the person who was wanting to be active and then proceeded to sit in a lounge chair stamping their feet.

We found 2 people who laid in bed all day in a sparce room with no stimulation and nothing to do or listen to. The only engagement was when staff brought a meal to their room.

We found a variance across the units and more than one person’s care plan was not always accurate and up to date and this had the potential to impact on their ability to be at the centre of their care.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Whilst the registered manager held residents’ and relatives’ meetings, they had not ensured all people were aware of these. For example, some relatives told us they were not aware of meetings being held of surveys requesting their feedback on the care their family member received. One relative told us, “I have not attended relatives meeting, I am not aware of them. There are no newsletters or phone calls.” Another relative said, “I have not attended any meetings or received any questionnaires, newsletters or emails but I am aware of a [social media] page.” A third relative commented, “I’ve not received any questionnaires to complete, any newsletters or emails.” This meant not all people’s relatives were given the opportunity to take part.We suggested the registered manager check the distribution list for communications from the service.

People and their relatives told us they would know how to make a complaint if they needed to. We saw the management team kept a log of all complaints received, however, the log did not include any actions to make improvements and prevent a re-occurrence.‘Following our inspection the provider told us that actions taken to address the complaint and prevent a reoccurrence are contained within their complaint response letters.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. People and their relatives were supported to discuss their wishes regarding end-of-life care, and these were documented in their care records. A member of staff told us, “People like different things as a result their needs differ... we tried to make [person] comfortable by providing the things they liked and care according to their care plan and choices that day.” Another member of staff said, “[People] are given good end of life care in my experience. Pain relief is given as soon as deemed necessary, family are accommodated when they come to visit and often offered a drink. If the family want to, they can stay overnight, and we try to make them as comfortable as possible in the circumstances.”