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Inspection carried out on 17 September 2018

During a routine inspection

This comprehensive inspection took place on 17 and 18 September 2018. The first day was unannounced.

Canford Chase 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.

Canford Chase accommodates up to 55 older people in purpose-built premises. Nursing care is provided. There were 46 people living or staying there when we inspected.

The registered manager had been in post for several years. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was committed to excellence in end of life care, working closely with health professionals so that when the time came people had a comfortable, dignified and pain-free death. Staff were particularly skilled and confident in caring for people who were dying and their loved ones. The service collaborated with a local hospice for staff development and to obtain specialist advice on symptom control when needed.

There was a vibrant activity programme based on people’s hobbies, interests and wishes and tailored to their individual needs. There were regular trips out for those who wished and were well enough. The service had established links with the local community and continued to develop these.

There was a strong emphasis on the importance of eating and drinking well. Positive relationships with staff encouraged people to eat and drink, particularly those who might be reluctant. Waiters and waitresses were employed to ensure that people who spent most of their time in their room had the same service as people who came to the dining room. The chef met people regularly to obtain their feedback and gather up-to-date information about dietary needs and preferences. The chef also spoke regularly with clinical staff to review people’s weights and individual nutritional needs. The provider had produced a comprehensive nutrition resource folder for care and catering staff.

People were supported to live healthily and obtain the care and support they needed from other health professionals. Where people had complex health needs, staff sought to optimise care by identifying and implementing best practice. Staff ‘champions’ actively supported colleagues to make sure people experienced the best possible health and wellbeing in view of their conditions.

The service worked in partnership with other organisations to keep up to date with new research and make sure staff were trained to follow best practice. Care was planned and delivered in line with current good practice and standards. Standards of nursing care were very high. People and where appropriate their families were meaningfully involved in planning care. Their choices were reflected in detailed, comprehensive care plans and staff understood their needs and preferences well.

People were protected against abuse and avoidable harm. Staff understood their responsibility to report concerns about abuse and knew how to do so. Medicines were stored and managed safely. We have made a recommendation about the scope of medicines audits.

Risks to people were regularly assessed and they were helped to stay safe in the least restrictive way possible. The premises and equipment were in good condition and there was regular maintenance. The building smelt pleasant throughout. Effective processes were in place to control and prevent infection.

There were sufficient skilled and competent staff on duty to provide the care people needed. Appropriate recruitment checks were made before staff started working at the service, such as criminal records checks and taking up references fro

Inspection carried out on 22 June 2017

During an inspection looking at part of the service

Canford Chase is a purpose built care home which is registered to accommodate a maximum of 52 people who require nursing or personal care. There were 45 people living in the home are the time of our inspection.

This was an unannounced inspection that took place on 22 June 2017. At the last inspection in January 2016, the service was rated good overall, but the question 'Is the service safe?', was rated requires improvement.

The purpose of this inspection was to follow up on the actions taken by the service to address the breach of regulation in relation to the provision of safe care and treatment. This was because at the last inspection we found that; people had not always been protected against the risks associated with the unsafe management and use of medicines and the risks to people's health and safety had not been properly assessed and action had not been taken to mitigate any such risks.

At this inspection there were significant improvements. The provider had given the registered manager clinical and management support. Systems had been reviewed, assessed and improved. All actions included in the registered manager and provider’s action plan had been met.

The people living at the home told us that they felt safe and well cared for. A relative told us that they were confident about the care and support that was provided and never felt that had to worry when they were not there.

Staff in the home were also positive about the home and the service they provided. They were all aware of the shortfalls from the last inspection and had worked hard with the registered manager to rectify the issues.

At this inspection we changed the rating for the key question ‘Is the service safe?’ from Requires Improvement to Good. The overall rating for the service remained Good.

Further information about this inspection is in the detailed findings below. Our previous comprehensive inspection from January 2016 provides information about the other areas that have previously been inspected.

Inspection carried out on 18 January 2016

During a routine inspection

This was an unannounced inspection that took place on18,19 & 20 January 2016. The aim of the inspection was to carry out a comprehensive review of the service. At our last inspection in July 2013 there were no breaches of legal requirements.

Canford Chase is a purpose built home and is registered to accommodate a maximum of 52 people who require either nursing or personal care. There were 49 people living there at the time of our inspection. The home is well equipped and has good communal facilities which include a café and hairdressing salon.

The home was led by a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

All of the people living at the home and visitors told us that they felt safe and well cared for. We received only positive comments about Canford Chase throughout our inspection. Staff in the home were also positive about the home and the service they provided. They told us they felt well supported by the management team that was in place.

People were not always protected against the risks of unsafe management of medicines and risks to their health and safety were not always properly assessed and managed.

People received care and support that was person-centred and respectful. There were appropriate numbers of staff on duty to meet people’s needs. People’s needs were assessed and plans were in place to ensure that their needs were met. People’s choices and decisions were respected and staff enabled people to retain their independence.

Staff received regular training and supervision and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience to help people with their care and support needs.

Observations and feedback from staff, relatives and professionals showed us that the home had an open and positive culture.

There were systems in place to monitor the safety and quality of the service. This included the use of audits and surveying the people who used the service and their representatives.

You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 12, 15 July 2013

During a routine inspection

We undertook this unannounced inspection as part of our scheduled programme of inspections. We also followed up on a compliance action set at our inspection in February 2013, related to records not being accurate and maintained.

We spoke with people that lived in the home, three relatives and four staff. We reviewed records related to care planning, medications, maintenance of the home and the quality assurance systems used.

People's needs were assessed and a plan of care was drawn up. Plans reflected people�s identified needs and gave guidance on how support should be provided. When necessary risk assessments had been undertaken and risk management plans were in place to reduce the risk of harm to people. For example, records showed the home had used pressure releiving equipment to minimise the risk of skin breakdown.

Medications were stored and administered correctly. On our first visit we noted there were errors in the amount of tablets held and the amount recorded as given. The home immediately undertook an audit of all medicines and identified shortfalls in recording the number of tablets held. On our second visit amounts held tallied with the charts.

The premises were well maintained and had communal areas for people to use.

The provider had systems in place for monitoring the quality of the service provision that protected people's health and well-being.

Records were kept securely and were up to date and accurate. Where people's needs had changed this was clearly documented.

Inspection carried out on 1 February 2013

During a routine inspection

People living in the home were addressed by their preferred name and were able to make choices about how they spent their time.

People�s care plans evidenced how and when they needed support and the manner in which it should be given. Care records were reviewed on a regular basis and updated if needed. However, on occasion information had not been updated to reflect the current needs of an individual.

People were supported to maintain their nutritional intake and support with meals and drinking was given discreetly and at a pace that suited the individual. People were able to choose their meals from a choice of three dishes and snacks and drinks were offered at regular intervals throughout the day.

People we spoke with considered staff were kind and caring. The duty roster evidenced that there were adequate numbers of staff available to provide support.

Staff were recruited in a safe manner and received opportunities for professional development.

Records required for the purpose of running the service were securely stored.