Chalkwell Grange

Updated 14 September 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.

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.

Inspection team

The inspection was carried out by 2 inspectors 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

Chalkwell Grange 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. Chalkwell Grange is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for 2 months and had applied to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

Inspection activity started on14 August 2023 and ended on 25 August 2023. We visited the service on 14 and 15 August 2023.

What we did before inspection

We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. 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 this information to plan our inspection.

During the inspection

We spoke with 12 people who used the service about their experience of the care provided and 7 relatives. We also spoke with 10 members of staff including regional director and the manager. We observed the care provided and also 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, including 11 people's care records. A variety of records relating to the management of the service, including 2 staff recruitment files, audits, staff rotas and medicine records.

Updated 14 September 2023

About the service

Chalkwell Grange is a residential care home providing accommodation and personal care to up to 48 people. The service provides support to older people some of whom are living with dementia. At the time of our inspection, there were 41 people living in the service.

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

Medicines were not always managed safely. People did not always receive their medicines as prescribed as reconciliation of stock was inaccurate.

There was not always enough staff to meet the needs of people particularly on the first floor. This meant communal areas were not monitored effectively by staff.

Risk management was not always effective. Risks were identified, however controls in place were not followed effectively. Infection control processes were effective.

Governance systems and processes were in place. However, these did not always identify shortfalls effectively.

There were appropriate policies and systems in place to protect people from the risk of abuse. Safe recruitment systems were in place to ensure staff were suitable to work with people.

Staff were positive about the new manager at 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.

The last rating for this service was good (published 3 March 2023).

At our last inspection we recommended the provider seek independent advice and guidance to improve the service's medication practices. At this inspection we found the provider had not fully met this recommendation.

Why we inspected

We received concerns in relation to the management of medicines and risk management. As a result, we undertook a focused inspection to review the key questions of safe 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 based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

Enforcement and Recommendations

We have identified breaches in relation to medicines management, staffing and governance processes at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.