Archived: Chasedale Care Home

Updated 9 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Act.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by an inspector, a specialist advisor and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Chasedale is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

We spoke with 4 people, 2 relatives and 10 staff, including the registered manager, regional manager, area manager, quality manager, dementia lead, deputy manager, administration officer and care staff. We contacted 4 external professionals via telephone and email and 3 further care staff via telephone. We spoke with 10 more relatives via telephone.

We observed interactions between staff and people. We reviewed a range of records. This included 8 people's care records and medicines records. We reviewed a variety of records relating to the management of the service, including policies and procedures, training records and meeting minutes.

Updated 9 June 2023

About the service

Chasedale Care Home is registered to provide accommodation, nursing and personal care to a maximum of 60 older people, including people who live with dementia. At the time of the inspection there were 58 people living at the home.

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

Systems and processes for identifying patterns and trends were in place. These had not always been utilised effectively, meaning patterns and trends had not always been analysed or identified to reduce the risk of incidents happening again.

Care planning was person-centred initially but then not reviewed meaningfully. Some daily records were not person-centred and some external advice to support risk assessments was not always easily accessible. The provider had plans in place to improve records.

People were not always supported to have maximum choice and control of their lives and to live in the least restrictive way possible and in their best interests; policies and systems in the service supported this practice but staff actions did not always follow those policies. The provider had identified these concerns prior to our inspection visit but further retraining and awareness was required. We have made a recommendation about this.

The provider had recognised the majority of the areas for improvement required, prior to our inspection visit, and had begun to implement changes and improvements.

People felt safe and supported. Staff helped people promptly and regularly checked on their wellbeing. Relatives told us they had confidence in the ability of staff to look after their loved ones in a safe way.

People’s care plans were up to date but needed more person-centred detail to improve them. The provider had plans in place to improve records.

The environment was clean. Areas of the home were in need of refurbishment to ensure it was more welcoming and dementia-friendly. The mealtime experiences were at times task-focussed and the provider needed to do more to ensure dementia-friendly best practice enabled people to have a more enjoyable mealtime. We have made a recommendation about this.

Medicines administration was safe. Staff were trained, supervised and had their competence regularly assessed. Records were clear and stock checks and audits ensured the risks of errors were reduced.

There were sufficient staff to keep people safe. The provider had reduced reliance on agency staff. People and relatives were happy with the levels of staff support.

People were kept safe from the risk of abuse. The provider had relevant policies and procedures in place. Staff reacted promptly to individual incidents and concerns, but there was a lack of meaningful oversight.

Staff were recruited safely. The registered manager had held regular individual supervisions with staff and team meetings. Staff felt they could raise concerns where they had them.

Staff demonstrated a good understanding of people who used the service and a desire for them to receive good quality care.

Utilities and equipment were regularly checked and well maintained.

The provider worked well with external professionals.

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 10 January 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Chasedale Care Home on our website at www.cqc.org.uk.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this report.

You can see what action we have asked the provider to take at the end 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 COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We have made recommendations that the provider reviews understanding and implementation of Mental Capacity Act guidelines, reviews and improves the environment and experience for people living with dementia, and reviews and improves the person-centred nature of care plans.

Follow up

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