Archived: Churchill House Residential Home

The service provides accommodation and personal care for up to 11 older people. On the day of this inspection there were 11 people living there. The service was last inspected on 5 August 2014. No concerns were identified with the care being provided to people at that inspection.

There was a recently appointed manager who was not yet registered. They had submitted an application to register a few days prior to this inspection. 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.

People told us they felt safe living at Churchill House. Comments included “Yes, I feel safe. I could speak out if I had any concerns.” Staff had received training in all aspects of safeguarding people and they knew how to identify and report any concerns.

Safe procedures had been followed when recruiting new staff. Checks and references had been carried out before new staff began working with people. This meant they were confident new staff were suitable for the job they had applied for.

People held their own medicines in a secure locked cabinet in their room. Staff had received training in safe administration and we observed a member of staff following safe practice when administering medicines. People told us they were satisfied with the way their medicines were stored and administered.

There were enough staff to meet people’s support needs and to care for them safely. There had been a high turnover of staff in the last year and this had resulted in 10 new staff being recruited. People told us the staffing levels had improved following the recruitment of the new staff. For example, we asked one person if there were enough staff and they told us “Now, yes. Last year was not so good.”

Staff were kind, cheerful and understanding of each person’s individual needs. People were treated with dignity and respect. A person who lived in the home said “The staff are all very, very kind. They are all marvellous.” A visitor told us “They are very kind here.”

Staff had an understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards. DoLS applications had been submitted where relevant. Staff understood the importance of seeking consent before carrying out care tasks. We observed staff seeking consent from people before carrying out any tasks for people.

People had been involved and consulted in drawing up and agreeing a plan of their support needs. Their care plans were comprehensive, well laid out and easy to read. The care plans explained each person’s daily routines and how they wanted staff to support them. The plans were regularly reviewed and updated. The care plans and daily notes provided evidence to show that people were supported to maintain good health.

Staff had received training, supervision and support to enable them to effectively support each person’s mental and physical health needs. New staff received thorough induction training before they began working with people. All staff received ongoing training on topics covering all aspects of their jobs. One member of staff told us they had received “very good training – Guinness have covered every corner.” Another member of staff said “Guinness training is excellent.”

The home was well maintained, clean, warm and comfortable. The lounge had been redecorated and refurbished in the previous year. Although the decoration of the home was generally good, some areas had not been redecorated for a number of years. A ‘Customer Champion’ who had recently visited the home reported that some areas of the home “Need a bit of TLC”.

People participated in a variety of social activities within the home and in the community. During our inspection we saw people going out shopping, for walks, or to meet with friends. An activities co-ordinator was employed for 10 hours a week.

The provider had a range of monitoring systems in place to ensure the home ran smoothly and to identify where improvements were needed. People were encouraged to speak out and raise concerns, complaints or suggestions in a variety of ways including questionnaires, resident’s meetings, and through visits to the home by customer champions and senior managers employed by the provider.

Before our inspection we reviewed all the information we held about the home. We examined previous inspection reports and notifications received by the Care Quality Commission.

On the day of our visit there were 10 people living at Churchill House. We looked at the care files of three people living there. We met with seven people, two relatives, the manager and three staff to find out if they the care and services they received met people's needs.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

The service was safe because people's health and care needs were understood by a trained and supported staff. Risks to people's health and welfare were understood and managed in line with their agreement. A person told us 'I feel safe here'.

There was monitoring of events and incidents and measures were put in place to minimise a repeat of any issues. This included, changes to health care needs and some medication incidents. People's medicines were being managed on their behalf in a competent way.

People told us they were confident there were sufficient staff to meet their needs. This was also confirmed by the staff we spoke with.

Care plans included considerations of the Mental Capacity Act (2005) and staff demonstrated an understanding of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) and how they applied to their practice. We found the location to be meeting the requirements of the Mental Capacity Act (2005). People's human rights were therefore properly recognised, respected and promoted.

Is the service effective?

The service was effective because people's health and well-being was promoted. Care plans provided instructions to staff about the care each person wanted and needed. We saw evidence of multi-professional visits and appointments, for example GP, speech and language therapist, and community nurses.

Is the service caring?

The service was caring because we saw staff communicating in a warm and caring manner. For example, in the afternoon we saw a member of staff sitting with a person helping them with a crossword. We saw other people sitting in a group and staff chatting with them in a cheerful and supportive manner. Comments included 'The staff attitude is very good'

Is the service responsive?

The service was responsive because people's likes and dislikes were taken into account. For example, a person told us they were able to lead their life as they wished, 'I can do what I want ' I can get up when I want and go to bed when I want. I can have my meal in my room or I can go to the dining room'.

The staff we spoke with understood each person's needs. They were able to describe people's preferences and showed sensitivity to each person's needs.

Care files were regularly updated and provided staff with sufficient information about each person's needs to ensure their health and welfare needs were met safely.

Is the service well-led?

A new registered manager had been appointed in recent months. They also managed another home nearby and their working week was shared between the two homes. The manager showed us monitoring forms which provided evidence of regular checks carried out to ensure all aspects of the service were safe and ran smoothly.

Staff told us they were confident the management arrangements worked well and that the service was well-led and their views were listened to. There were regular group and individual meetings with people who lived in the home. Staff meetings and staff supervision sessions were held monthly. All meetings were minuted and this showed that people and staff could raise matters about the service and know their views were valued.

The people we spoke with were complimentary about the way the home was managed and about the staff who supported them. One person we spoke with said, “The staff are lovely and look after me very well”; whilst another said, “I can choose how I spend my day and often go to the shops or for a walk”. This showed people were happy in the environment they lived in with support they received.

The inspection we carried out was a “follow up” inspection to look at how the service had improved since our last inspection on 27 September 2013. We had highlighted minor concerns with the way people’s records were kept secure. We found that improvements had been made to the security of people’s records however other aspects of record keeping required improvement.

Churchill House was undergoing a period of management change. Staff, and the people who lived at the home, had been told that the future management of the home was to be shared with another home just across the road. Some people expressed their concerns and the feeling of uncertainty that this had created. One person said “It is unsettling at the moment.” Another told us “(The old manager) has left and a lady is coming, but she’s on holiday now and we’ve not met her.”

Despite the uncertainty people expressed their satisfaction with the home saying “The home is very good, otherwise I would not stay here.” "One person told us that they had researched all the homes in Exeter, and Churchill House was the best."

In general we found the home to be compliant. However we saw that at the time of our visit people's files were not stored securely. We were told that there was a plan in place to rectify this matter.

At the time of our visit 10 people were living at the home and there was one vacancy.

People’s privacy, dignity and independence were respected. Their views and experiences were taken into account in the way the service was provided in relation to their care. One person commented “You’ve only got to ask if you want anything.”

People received care that met their needs and protected their rights. For example, someone who needed medication for pain said they received it promptly. One person said “The carers really do look after you”.

There were enough qualified, skilled and experienced staff to meet people’s needs. One person said of the staff, “They are good people.” People confirmed that they felt safe at the home. They were protected from the risk of abuse because the provider had taken reasonable steps to prevent abuse from happening. There were also systems to manage risks to the safety and welfare of people who used the service and others at the home, such as visitors and staff.

The provider had effective systems to monitor the quality of service that people received. One person described the registered manager as “very helpful” with regard to dealing with any problems. Another said “It’s an excellent service – it’s all good.”