Background to this inspection
Updated
4 May 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 Health and Social Care Act 2008.
Inspection team
The inspection was carried out by one inspector 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
Chypons is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.
Registered manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there were two managers registered with the CQC..
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We also reviewed information that we held about the service such as notifications. We used information sent to us by the provider in their PIR. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
We used all of this information to plan our inspection.
During the inspection
We reviewed 3 people's care plans and risk assessments. We reviewed staff training and supervision. We also reviewed other records relating to the management of the service. We spoke with 3 people who lived at Chypons residential home, 9 staff, the deputy manager and the administrator and finance officer. The registered manager was on leave at the time of this inspection visit. We spoke with them on the phone throughout the inspection. We spoke with 2 relatives during the inspection and 7 on the phone to gather their views.
Updated
4 May 2023
About the service
Chypons Residential care home is a residential care home providing personal care to up to 27 people. The service provides support to older people and people living with poor mental health and dementia. At the time of our inspection there were 25 people using the service.
People’s experience of using this service and what we found
The staff used an electronic medicines management and recording system. Medicines were stored in lockable cupboards in people’s rooms. People received their medicines as prescribed. The recording of medicines that required stricter controls was not always effective. We found errors in these records. There was no regular audit of these medicines.
There were enough staff to meet people's needs and ensure their safety. Two new staff had been recently recruited which had improved the pressure recently felt by the staff team. However, new staff had not always been safely recruited.
Personal money was held at the service on behalf of some people living at Chypons residential care home. The money was held securely however, records for this money did not always tally with what was held in cash.
Identified risks were assessed and recorded. However, they were not always regularly reviewed and updated when changes had taken place in people’s needs. Care plans did not always contain guidance and direction for staff on how to meet people’s current needs. However, staff were meeting people’s needs and there was no impact on people as a result of the lack of written guidance.
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. However, the registered manager did not have an overview of applications made for restrictive care plans to be authorised. Information provided regarding which people had an authorisation in place for restrictions placed upon them was not accurate.
The registered manager did not always have effective oversight of the service. There was not an effective audit programme in place to help identify any areas of the service that may require improvement. Accidents and incidents had not been audited since June 2022. The concerns found at this inspection had not been identified by the registered manager or the provider prior to our inspection.
Experienced kitchen staff had good knowledge of people’s dietary requirements. Food looked appetising and people told us they enjoyed it. Staff recorded people’s intake when required and were available to support people where needed.
We toured the premises and found them to be in good condition and free from malodours. People’s rooms were comfortable and filled with personal items to give them a familiar feel for people.
The service had notice boards which displayed information for people and staff on how to report any safeguarding concerns.
Staff sought people's consent before providing personal care and assistance. Staff were kind and caring and sought people’s consent before care and support was provided.
People and families were asked for their views and experiences through surveys. Relatives told us, “(Person’s name) is happier and has put on weight since being here,” “I visit regularly and never tell them I am coming. It is always welcoming, clean and lovely here. They always call me if anything changes with (Person’s name)” and “(Person’s name) is thriving living there and is much happier and healthier.”
The registered manager understood their responsibilities under the duty of candour. CQC was advised of any notifiable event which may have taken place as is required. Relatives were kept informed of any changes in people’s needs or incidents that occurred.
The registered manager and staff worked closely with local health and social care professionals to meet people’s needs.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection:
The last rating for this service was good (published 7 March 2018).
Why we inspected
Prior to this inspection CQC had received concerns from a member of the public in relation to staffing levels, monitoring records, nutritional support and the management of medicines. As a result, 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. This is based on the findings at this inspection.
We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, effective and well led sections 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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Chypons on our website at www.cqc.org.uk
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.