Chase House Limited

Chase House Limited is a care home providing personal and nursing care to 46 people who may be living with dementia, a physical disability or sensory impairment, at the time of the inspection. The service can support up to 50 people. The service is split across two floors, with bedrooms having ensuite toilets and sharing facilities including communal lounges, a conservatory and garden.

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

Quality assurance processes were in place, however required development to ensure they were robust. The registered manager told us the quality assurance system was being reviewed to ensure it drove change and improvement in the service.

People and relatives spoke positively about the service. One person told us, “They look after you quite well. I feel safe living here.” One relative told us, “[Relative] is definitely safe. I have never had any concerns or issues. The carers are very good, as they have an understanding of [relative's] condition and really try to help and put extra things in place." Another relative told us, "Despite limited access to the home over recent months we continue to have confidence the care provided is of a high standard. We are grateful to care staff in keeping [relative] safe."

People’s care and support needs and the associated risks had been assessed and guidance was recorded within peoples care plans.

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

Systems were in place to manage infection control. Staff were provided with adequate supply of face masks, gloves and aprons.

Staffing levels were adequate to meet people’s needs. People and relatives were familiar with the staff. One relative told us, “I know the staff well. It is nice because I have got to know staff and they know me now by my first name. They know [relative] well and what [relative] likes.” Another relative told us,” Always a lot going on and staff to support people."

Staff encouraged people to participate in activities available in the home. Activity co-ordinators were knowledgeable of peoples interests and hobbies and were passionate in providing a range of activities for all.

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 the service under the previous provider was good, published on 20 March 2019.

Why we inspected

The inspection was prompted in part due to concerns received relating to risk management. This risk related to an increase in medication errors and concerns related to staffing levels. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Chase House Limited on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Chase House Limited is a care home. It provides personal and nursing care for up to 50 younger adults and older people. Some of the people living at the service were living with dementia, long term health conditions and physical disabilities. At the time of the inspection, 49 people were living at the service.

People’s experience of using this service:

People's experiences of the service were quite positive. However, Well-led was rated 'requires improvement'. This was because the provider needed to improve their quality monitoring systems to show that actions were always taken to make sustained improvements.

Staff had been trained in how to protect people from harm, and they knew how to report concerns. Potential risks to people’s health and wellbeing were assessed and minimised. There were enough staff to meet people’s needs safely. People's medicines were managed safely. Staff followed effective processes to prevent the spread of infection.

Staff had been trained and had the right skills to meet people's needs effectively. Staff were well supported and had information they needed to meet people’s assessed needs. Staff supported people to have enough to eat and drink. Staff supported people to access healthcare services when required, to help maintain their health and well-being.

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 fully involved in making decisions about their care and support. People were involved in the planning and reviewing of their care plans. People told us staff were caring and friendly. Staff respected and promoted people’s privacy, dignity and independence.

Information in people's care plans supported staff to deliver person-centred care that met people’s needs. The registered manager sought feedback from people about the quality of the service provided. The registered manager worked in partnership with other professionals to ensure people received care that met their needs. There was a system to ensure people’s suggestions and complaints were recorded, investigated, and acted upon to reduce the risk of recurrence.

Rating at last inspection:

The service was rated 'good' when we last inspected it. That report was published in August 2016.

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor all information we receive about the service and schedule the next inspection accordingly.

The inspection was carried out by one inspector.

Chase House Residential and Nursing Home provides nursing and personal care for up to 50 older people. Most people who use the service are living with dementia. On the day of our inspection 48 people were using the service.

There was a registered manager in post.

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 felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and knew how to report any concerns. People had risk assessments in place, which had been reviewed, to enable them to be as independent as they could be.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs. Effective recruitment processes were in place and followed by the service to ensure appropriate staff were employed to provide care for people.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.

Staff received a comprehensive induction process and on-going training. They were well supported by the registered manager and senior staff and had regular one to one time for supervisions. Staff had attended a variety of training to ensure they were able to provide care based on current practice when supporting people.

Staff gained consent before supporting people. People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people.

People were able to make choices about the food and drink they had, and staff gave support when required. People were encouraged to have a healthy balanced diet. Special diets were catered for.

People were supported to access a variety of health professional when required, including opticians and doctors.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times.

People were supported to follow their interests and join in a variety of activities. Specific activity staff were employed who arranged a number of activities.

A complaints procedure was in place and accessible to all. People knew how to complain. Effective quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement where necessary.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints and other concerns. This reduced risks to people and helped the service to continually improve.

The provider had suitable procedures to manage emergencies and staff had the necessary training to do so.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. This meant that people’s human rights had been safeguarded as required.

There were adequate numbers of staff to meet people's needs at all times. Staff were suitably skilled and qualified to fulfil their roles and care staff received updates to their training on a regular basis.

Is the service effective?

People using the service experienced care that was planned and scheduled to meet their needs and mitigate any risks. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People using the service and their relatives were involved in the development of their care plans.

Care needs had been reviewed on a regular basis and any changes were reflected in their care plan. Records showed that the care delivered reflected the current care plan. We observed a high standard of care on the day of our visit.

Forms for consent to care and treatment were signed by people using the service or their representatives to indicate agreement to the care that they received. Staff were aware of the importance of consent and took steps to ensure that people gave consent at all times when providing care and support.

The provider had a range of measures to ensure that people using the service received adequate food and hydration and there were arrangements in place to plan and supply a varied and nutritious diet. Nutritional status was monitored by staff to ensure that weight and body mass index were maintained.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People requiring individual attention had their care and support scheduled to meet their needs.

People using the service and their relatives completed an annual satisfaction survey. The latest report showed a high level of satisfaction with the care provided.

People we spoke with were happy with the care and support they experienced. A family member of one resident told us, “They’re absolutely brilliant. They’ve really helped with nutrition, diet and overall care. I can’t say enough good things about them.” Another relative commented, “A cloud has lifted since she (family member) has been here. It’s perfect and the management and staff are absolutely fantastic.”

Is the service responsive?

There was a program of activities and entertainment organised by care coordinators to help to keep people involved in the daily life of the home and interact with others. People were supported to attend outside visits, outings and appointments and there were two dedicated mini buses to assist with transport.

People knew how to make a complaint if they were unhappy. We looked at how these complaints had been dealt with, and found that the responses had been open, thorough, and timely. People can therefore be assured that complaints are investigated and action is taken as necessary.

Is the service well-led?

The provider had a variety of systems to monitor the quality of service provided and audit their performance. People using the service and their relatives had regular opportunities to provide feedback on their care and express their views. There were appropriate procedures for dealing with complaints and reporting accidents and incidents.

At the time of our visit, 50 people were living in the home. We spoke with 11 of the 50 people, although due to some people's dementia needs, not everyone was able to tell us about their experiences. We therefore used a number of methods to help us understand the experiences of people using the service, including observation and talking with people's relatives and care staff.

One person's relative said they were generally happy with the care provided and the environment. People who spoke with us told us they felt cared for and well supported by staff. Two people said the care was "wonderful", and one person said, 'The staff are so lovely."

We observed staff providing respectful care and support to people, and saw this was delivered in line with the care records we reviewed to meet people's needs.

Clear processes were in place to ensure that the home remained clean and tidy. Staff had sufficient personal protective equipment to use when attending to personal care needs for people.

We saw that staff received regular on-going training which provided them with the appropriate skills to carry out their roles.