Chiswell Residential Home

Updated 7 December 2019

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 Care Act 2014.

Inspection team

The inspection was undertaken by one inspector.

Service and service type

Chiswell Residential Home 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 service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and relatives of two people about their experience of the care provided. We spoke with four members of staff including the provider and care workers. We spoke with a visiting health care professional to gain their feedback about the quality of the service provided for people. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.

Updated 7 December 2019

About the service

Chiswell Residential Home provides accommodation and personal care for up to six people with mental health needs in one adapted building. On the day of our inspection, there were six people using the service.

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

People felt safe living at the service, relatives and healthcare professionals confirmed the care and support provided maintained people’s safety. Training had been provided to give staff the skills to safeguard people from potential abuse. Risks to people’s safety and well-being were assessed and mitigated as much as possible. The provider ensured pre-employment checks were completed before new staff were employed. People, staff and external professionals confirmed staffing levels were appropriate to meet people’s needs.

People’s medicines were managed safely. The provider undertook assessments of staff practice to satisfy themselves that staff were competent to safely administer medicines. The home was clean with no malodours. Staff had received infection control training and protective clothing including gloves and aprons was available to them. There was a process in place for reporting, recording and investigating any accidents and incidents.

People’s needs and preferences had been individually assessed and were kept under constant review. People’s relatives and external professionals told us the care and support provided met people’s complex needs. The staff team were very experienced in providing care for this group of people. Some training had not been refreshed in a timely way which meant the staff team may not all be fully up to date with current practice in some areas. However, there was no evidence this had an impact on the quality of care provided to people. Staff felt fully supported by the provider and often worked alongside them providing care and support to people.

People enjoyed the home cooked food provided for them. People accessed healthcare services as needed. Specialist services were available to help guide staff on making positive changes in people’s lives, including their mental health needs. 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 were supported by an established staff team who knew them well. Staff treated people with respect and dignity. People were fully involved in their care as much as they could be. The service operated as a family home and people's wishes were central to the provider’s ethos. People’s right to privacy and confidentiality was respected and integral to the ethos of the home.

People received care and support that was entirely flexible and responsive to their individual needs. People were encouraged and supported to be part of the local community they lived in. Opportunities for engagement were routinely brought into the home for people to enjoy. Relatives and other visitors were welcomed into the home at any time. The provider had a policy and procedure to support people to raise complaints. The provider and staff team were very clear that Chiswell Residential Home was people’s own home and they would be supported to stay in their own home should their health deteriorate.

The provider and staff team demonstrated a clear culture of ensuring people and their needs were a priority. Staff greatly enjoyed working at the home, they felt supported and involved. The provider was in day to day contact with the service and always available for staff should they need advice. Quality assurance processes were in place to help ensure the provider’s standards were upheld. People, their relatives and external professionals were encouraged to give feedback about the way the service operated. The provider maintained their skills and knowledge and kept themselves up to date with changes in legislation and practice.

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 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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