Chapel Garth EMI Residential Home

We found the following examples of good practice.

The home looked and smelled clean, and was uncluttered. There were some narrow corridors where ventilation and social distancing posed a challenge. Staff were seen to be wearing masks and being careful to maintain as much distance as possible when passing each other, to minimise the resultant risks. We were assured because it was evident that staff were aware of and acting to minimise the risk posed by the building in order to keep people safe. We saw staff carried hand sanitiser and sanitised their hands frequently.

Some areas of the home and were designated to meet the needs of people who would not benefit from isolating in their rooms for long periods.

The regional support manager, who had been managing the day to day running of the service, had knowledge of current guidance. They ensured dissemination of information to staff, liaised with relevant agencies, and maintained communication with people and their family and friends. Staff also helped people to stay in touch with their family and friends by phone and on-line face to face chats.

The provider learned lessons and responded positively to address shortfalls and improve the service. We saw evidence that best practice feedback had recently been provided by a visiting infection control specialist nurse and, as a result, changes had been implemented quickly and effectively. We also found the regional support manager who supported us with the inspection to be receptive and responsive.

Chapel Garth provides residential care for up to 33 older people with dementia. People are accommodated on the ground floor and there is an upper floor used exclusively as office space and by staff. The communal areas of the home are accessible to people who use wheelchairs. The home is in Bentley on the outskirts of Doncaster. At the time of our inspection 31 people were using the service.

People’s experience of using this service:

At the last inspection, we rated the questions of is the service; safe, effective, caring, responsive and well-led as ‘good’. At this inspection, we found the question, is the service effective had deteriorated to ‘requires improvement.’ This was because although in practice care staff knew how to care for people in the right way, some of them had not received all the training that the registered person considered to be necessary. Also, staff had not received supervision and appraisal as per the providers policy.

The home needed refurbishment and redecoration to improve the environment. There was an action plan in place which included areas of the home such as communal dining and sitting areas, flooring and lights, which remained in need of decorating. The provider had given the ‘go ahead’ for work to commence

People and relatives told us they felt the service was safe and there were enough staff to support people. New staff members had completed their induction training and had shadowed experienced staff until they felt confident to work alone.

People received their medicines on time and systems used to manage and store medicines were safe. Suitable arrangements been made to promote good standards of hygiene. This included a staff member having the role of ‘infection control champion’.

The provider had introduced newly formatted care plans which the registered manager said would be fully completed for people within the next three months. Risk assessments and care plans seen were up to date and reflective of people's current support needs.

Systems in place ensured the needs of people were identified and respected. People, and those who were important to them, were at the heart of the service and were encouraged to be involved in decisions and developing their support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were provided with a varied diet that met their needs and preferences. They told us they liked the food offered at the home. We saw meals, drinks and snacks were provided throughout the day and these took into consideration people’s individual likes and dislikes.

There was access to medical services if needed and nursing care was delivered by visiting district nurses. Other health professionals provided services to the home and they gave us positive feedback about the standard of care provided by staff at the home.

There was generally a very kind and friendly atmosphere in the home between staff, people who used the service, relatives and visiting healthcare professionals. People told us, “They [staff] are very kind. I don’t have any problems, but I could talk to any of them. They are all so nice,” and “They [staff] are lovely people.”

People were able to choose how they spent their day and were supported to access the local community. Activities organised within the home were regularly reviewed to ensure the programme was what people wanted to do.

All complaints were treated seriously and were investigated by the registered manager. There were no open complaints and the home had received many compliments about the care they provided.

There was a registered manager who had established a positive culture in the service that was focused upon achieving good outcomes for people. Staff had been helped to understand their responsibilities to develop good team work and to speak out if they had any concerns. Furthermore, the registered manager and staff were actively working in partnership with other agencies to support the development of joined-up care.

Quality assurance systems were in place to monitor and continually improve the quality of the service provided.

Rating at last inspection: Good (report published on 13 December 2016).

Why we inspected: This was a planned comprehensive inspection based on the rating awarded at the last inspection.

Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Chapel Garth provides residential care for up to 33 older people living with dementia. People are accommodated on the ground floor and there is an upper floor used exclusively as office space and by staff. The communal areas of the home are accessible to people who use wheelchairs. The home is located in Bentley on the outskirts of Doncaster.

The service had a registered manager in post at the time of our 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.

We spoke with staff about safeguarding people from abuse and they were very knowledgeable about this. They told us they attended training and they had learned about the different types of abuse and how to recognise and report it. A safeguarding flowchart was available in the duty office to guide staff of what action to take if needed.

We looked at three recruitment files and found the provider had a safe and effective system in place for employing new staff.

We looked at systems in place to manage medicines and found that they were safe. Medicines were stored, administered and recorded correctly.

Care plans we looked at identified any risks associated with people’s care. For example, risk assessments were in place for falls, choking, pressure area care and nutritional needs.

Staff we spoke with told us they received appropriate training to do their job well. Training was provided via e-learning, however practical training courses were provided face to face.

We observed staff interacting with people and we spoke with staff and the registered manager and found the service to be meeting the requirements of the Mental Capacity Act. The registered manager told us that appropriate applications in relation to Deprivation of Liberty Safeguards were made to the supervisory body.

People received a healthy and nutritious diet based on their preferences and were given choices at meal times. We also saw a choice of drinks and snacks were offered at frequent intervals during the day.

People had support from health care professionals were required. This was sought in a timely and efficient way.

We observed staff interacting with people and saw they did this in very caring was. Staff had a calm and friendly manner and were focused on providing appropriate care and support to people who were using the service. Care plans we saw included information about people’s likes and dislikes.

The service had identified key staff to be dignity champions. Their role was to ensure dignity for people who used the service was upheld.

We looked at care records belonging to people and found they were informative and reflected the care and support being given. Care records included activities of daily living which explained how best to support the person.

The service employed an activity co-ordinator who was available 30 hours a week. We spoke with this person and they told us that they used this time to plan and support activities within the home.

The provider had a complaints procedure and people felt able to raise concerns if they needed to.

People told us the registered manager was supportive and there was a good leadership structure in place. People felt able to approach the manager and felt she listened to them and acted on what they told her.

We saw regular audits took place to check the quality of service provision. Action plans were devised to follow up any issues.

People were involved in the service and their views were sought. We saw evidence that people were involved in regular reviews and completed questionnaires, where they were able to comment about the service. The registered manager welcomed comments from people at all times.

Before people received care and treatment they were asked for their consent and the provider acted in accordance with their wishes. The appropriate procedure was followed where people were not able to give consent.

People who used the service had a care plan which was relevant to their individual needs. We spoke with people who used the service, five relatives and two care workers, two senior care workers, the cook and a domestic assistant as well as the registered manager and deputy manager. One person who used the service said, "It's really nice here." A relative said, "It's just like visiting my relative in their own home.'

People were supported to be able to eat and drink sufficient amounts to meet their needs. People we spoke with said that the food was homemade and good quality. One relative said, 'There is always plenty of food and drink available.'

People were cared for in a clean and hygienic environment. People we spoke with said their relative's room was always clean and tidy.

We found that the provider had an effective recruitment procedure in place. Appropriate checks were undertaken before staff began work.

The provider had an effective system in place to regularly assess and monitor the quality of service that people receive.

People we spoke with said they had no complaints but felt at ease to talk with staff.