1 September 2022
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.
This was a focused inspection to check whether the provider had met the requirements of the Conditions we have placed on the provider’s registration in relation to Regulation 11 (Need for consent), Regulation 12 (Safe care and treatment), Regulation 13 (Safeguarding service users from abuse and improper treatment), Regulation 17 (Good governance) and Regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
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.
The inspection was carried out by three inspectors.
Service and service type
Chimnies Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Chimnies Residential Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
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 was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
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.
During the inspection
We spent time observing the interactions between people and staff in communal areas of the home, in order to help us understand people's experiences.
We spoke with 11 people who used the service and one relative. We spent time observing care and reviewing care records to help us understand the experience of people who could not talk with us. We spoke with six members of staff including the registered manager and care staff as well as the consultant who has been working with the service to make improvements. We spoke with two visiting healthcare professionals.
We reviewed a range of records which included seven peoples care plans. We looked at medication records and four staff files in relation to recruitment. We reviewed accident, incident and safeguarding processes, nutrition and meetings, and a variety of records relating to the management of the service, including provider improvement plans. Following the inspection, we received further information from the registered manager that we had requested. This included training records, audits, equipment servicing records and accident and incident analysis records.
1 September 2022
About the service
Chimnies Residential Care Home (Chimnies) is a care home providing accommodation and personal care for up to 29 people, some of whom may be living with dementia. People live in an adapted house over two floors, with a lift connecting the floors. The service sits in a small village with views across open fields. At the time of our inspection 19 people were living at Chimnies.
People’s experience of using this service and what we found
Since our last inspection, management had worked hard to improve the service and as such the care people received. We found big improvements during this visit and work was continuing to embed the positive changes into daily working practice. Staff were positive about the effect the changes had had on the service.
The registered manager acted promptly to address a couple of areas that we identified needing further work. This included following the requirements of safe recruitment and identifying and recording all risks to people. We have made a recommendation to the registered manager in these areas.
People were happy living at Chimnies. They told us staff were kind and caring and they did not have to wait long to receive staff input if they rang their bell.
People felt safe and staff were aware of how to recognise abuse and report it correctly. Where people had accidents and incidents these were recorded and action taken to address them.
Risks to people had been identified and staff followed guidance to help keep people free from harm. People were supported with their medicines and provided with sufficient food and drink. Staff involved health care professionals where needed to help people maintain a good level of health.
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 lived in an environment which was clean and safe and people said they could choose how and where they spent their time. People were cared for by a staff team who were trained in their role, worked well together and enjoying working at Chimnies. Friendships had formed between people and staff and people got on well together.
The registered manager gave people the opportunity to be involved in the service and retain their independence where they could. The registered manager supported staff and worked with external agencies and professionals to support people’s care needs. The registered manager had plans on how to further improve 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 and update
The last rating for this service was Inadequate (published 18 March 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since 18 November 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 18 November 2021. Breaches of legal requirements were found that related to safe care and treatment, staffing, good governance, and safeguarding service users from abuse and improper treatment. The provider completed an action plan after the last inspection to show what they would do and by when to improve
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Effective and Well-led which contain those requirements.
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 Inadequate to Requires Improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Chimnies Residential Care Home on our website at www.cqc.org.uk.
We have made a recommendation to the registered provider in relation to risks for people and recruitment processes.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.