Chalkwell Grange

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last inspection we rated this key question inadequate. At this inspection the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The manager shared learning with staff from incidents, accidents, complaints and safeguarding so that the service could continually improve and develop positive outcomes for people. Information was shared with staff through handovers, daily flash meetings, memos and staff meetings.

The manager completed daily walkarounds of the service. This enabled them to maintain oversight of the quality and safety of care being provided, identify any issues promptly and engage with people and staff throughout the day. These walkarounds provided additional opportunities to monitor practice, address concerns and ensure any actions required were followed up in a timely manner.

The manager had introduced daily reflective practice meetings for staff as a structured approach to learning and continuous improvement. This included individual and group reflection on incidents, events, or ideas, supporting staff to consider different perspectives, identify learning and recognise areas for improvement. Outcomes from reflection were documented and used to inform decision-making and embed improvements in practice.
 

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Before people came to live at the service the manager completed a full assessment of their needs to ensure they could be met by the service. People and their relatives had an opportunity to visit the service before they moved in to see if it was a place they would like to live. The manager liaised with other healthcare professionals to ensure people’s healthcare needs continued to be supported.

However, we identified some gaps in the care records for a person who had recently moved into the service. Not all identified risks and needs were fully reflected in their care plans, including information relating to medicines, mobility, skin integrity and continence. Following the inspection, the manager reviewed and updated the person’s care plans to address the gaps identified.

A relative told us, “We had an assessment completed before [relative] moved into the home. They asked us questions to get to know [relative]. We are fully involved in the care plan and any reviews.”
 

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.

Staff understood how to recognise the signs of abuse and could describe the actions they would take to safeguard people. This action included informing other agencies if they were concerned about action being taken. A staff member told us, “If I felt someone was at the risk of abuse, I would immediately notify the manager but if I needed to escalate further, I would do so.”
The manager reported that organisational safeguarding visits had recognised noticeable improvements within the service.

People told us they felt safe living at the service. One person told us, “I feel safe here because staff are always around and they are very kind.” Another person told us, “I feel very safe here and have been here for 2 years now.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found staff practice reflected the principles of the MCA. People were encouraged to make their own decisions, while still minimising risk. Staff understood their roles and responsibilities in relation to the MCA 2005 framework.
 

The service worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risks to people had been assessed and risk assessments had been put in place to help mitigate these. Risks included areas such as supporting people with physical healthcare needs, use of mobility equipment and with personal care. Staff knew the risks to people well and told us they were kept up to date if there had been any changes to risk assessments.

People were encouraged to take positive risks to pursue activities that mattered to them. For example, one person was participating in a charity bike ride. This meant risks were managed proportionately, balancing people’s safety with their rights to choice and independence and enabling them to participate in activities that were meaningful to them. A person told us, “I am lucky I can go out when I want to, because I am very independent.”

There was also clear guidance in place for staff to support people with specific health needs such as, diabetes. This included actions to take in the event of out-of-range high or low blood glucose levels, enabling staff to recognise changes in people’s conditions and respond appropriately to ensure safe and effective care.

Personal emergency evacuation plans (PEEPS) contained all the information staff, and the fire service may need to evacuate people safely in the event of a fire.
 

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The environment was adapted to meet the needs of people living there. There were spacious living areas offering people plenty of room to relax and engage in activities comfortably. Additionally, people had access to outdoor spaces, providing an opportunity to enjoy fresh air and relax in the gardens. People had their own rooms and specialist equipment was provided as needed. Maintenance staff were employed to ensure the premises were well-maintained and safe. There were systems in place to ensure any maintenance needed was recorded and responded to promptly.

The provider had invested in improving the environment at the service. Recent refurbishment works had been completed, including the installation of new carpets, enhancements to the bistro area and improvements to the downstairs dining room. These changes helped to create a more comfortable and welcoming environment for people, visitors and staff.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff worked together well to provide safe care that met people’s individual needs. The manager had processes in place to ensure all staff received an extensive induction and staff we spoke with confirmed this. Appropriate checks were in place before staff started work, including obtaining full employment histories, references and a Disclosure and Barring Service (DBS) check. DBS checks provide information about convictions and cautions held on the Police National Computer and help employers make safer recruitment decisions. People living at the service were also involved in the recruitment process and took part in staff interviews. We saw evidence of this during the inspection, demonstrating that people had opportunities to contribute to decisions about the staff employed to support them.

The manager completed staff file audits which ensured that all employee records were regularly reviewed, up to date and contained all the necessary information. All staff files had been checked, and gaps in information identified had been addressed.

Supervision arrangements were consistent, and staff received regular support through formal supervision. The service had recently introduced a new supervision template which supported more meaningful and structured conversations with staff. Supervision records reflected the discussions held and included clear actions, objectives and follow-up arrangements. This provided staff with opportunities to reflect on their practice, discuss their development and identify any support they required.

During our inspection we did not identify any concerns regarding staffing levels. People received support in a timely way, call bells were responded to promptly, and staff were available throughout the home to meet people's needs.

A health professional told us, "Staff training has improved, staff receive regular supervision, attend staff meeting and staff reflection has been introduced. This allows the team and management to discuss areas of improvement, empowers the staff to present ideas or initiatives, learn lessons and discuss ways in which further incidents can be mitigated. There is now a culture of teamwork, staff feel valued and can approach management at any time "
 

The manager assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff had received training in infection and prevention control, and the provider had policies in place for staff to follow, should there be any outbreaks of infectious diseases. The service had regular cleaning schedules in place and staff had personal protective equipment (PPE) available for their use. Both the manager and deputy manager carried out regular checks and audits to monitor the cleanliness of the service.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Staff did not support people with medicines until they had completed the required training, and medicine competency assessments were completed. People had care plans and risk assessments in place which detailed what medicines they were prescribed and how they liked to be supported. Protocols were in place for medicines prescribed on an as required (PRN) basis. The manager and deputy manager carried out regular audits and where discrepancies were noted these were investigated to identify the cause and any actions needed.

A health professional told us, "There has been significant improvement in the safe handling of medications including external audits regularly undertaken by a pharmacist, this has identified areas of weakness in administering medication and allowed them to strengthen their practice with minimal errors now occurring. Medication is robustly audited."