Chase House Limited

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people’s needs were not always met.

At our last assessment, the provider was in breach of the legal regulation relating to person-centred care. Improvements were found at this assessment; however, these were not consistently embedded and the provider remained in breach of this regulation. Care plans were not always sufficiently personalised and people were not always meaningfully involved in decisions about their care and support.
 

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

At our previous inspection, we identified concerns in relation to person-centred care. During this inspection, while some improvements had been made, these were not consistently embedded.
Care was not always planned in a way that reflected people’s individual preferences, needs and choices. Care plans contained generic information about people’s preferences, communication and interests, and were not always individualised. For example, one care plan recorded that a person enjoyed television and music but did not include specific preferences.

This was reflected in care delivery. During inspection, care was at times task-led, particularly during mealtimes and in communal areas. A person told us, “It can be a bit boring at times.” Systems to support choice, such as easy read menus and show plates, were not always used in a person-centred way. As a result, people were not always meaningfully involved in decisions about their care.

The provider told us they planned to introduce further person-centred approaches, including enhanced keyworker systems and tools such as memory boxes; however, these were not yet embedded at the time of inspection.
 

The provider demonstrated an understanding of the diverse health and care needs of people and their local community, and care was generally joined-up and coordinated. People were supported by a consistent core staff team, which promoted familiarity and continuity of care. The provider told us they had removed reliance on agency staff. Staff demonstrated knowledge of people’s needs, and records showed that care was coordinated with input from healthcare professionals where required.

The provider did not always supply information in formats tailored to individual needs.

During observation, staff did not consistently use communication aids, such as visual prompts or show plates, to support people to understand choices, particularly during mealtimes. This reduced people’s ability to engage fully in decisions about their care. We also observed a near-miss incident where a person requiring a modified texture diet to reduce choking risk was shown show plates of unmodified food. This resulted in the person reaching out to take food that could have caused harm before staff intervened. Improvements were also needed in relation to signage to support an accessible environment, particularly for people living with dementia.

However, we also found positive communication methods and good practice, including information clearly displayed about how to raise complaints, safeguarding concerns and whistleblowing.
 

Although systems were in place to gather feedback from people and key stakeholders, people did not always feel involved in decisions about their care. Feedback indicated some people were not regularly asked for their views or involved in care planning. One person told us, “I have never been asked to look at my care plan,” and a relative said, “Residents need to be informed more,” although another relative said, “They want to listen to us about concerns.”

This showed people's experiences of involvement were variable. While some people and relatives felt their views were listened to, others did not feel consistently informed or involved in decisions about their care and support.
 

The provider ensured people could access the care, support and treatment they needed when required. People had access to healthcare services and external support, and referrals were made appropriately. Staff worked with healthcare professionals to ensure people’s needs were met, and there was no evidence that people experienced barriers to accessing care or support.

At our previous inspection, we identified concerns in how the provider reviewed information to ensure people experienced equitable outcomes. During this inspection, while some improvements had been made, these were not consistently embedded.

Systems were not always used effectively to review information about people. Records relating to people’s care and wellbeing were not always complete or used to inform care. Care plans were not always clear or sufficiently detailed, which increased the risk of people receiving care that was not fully tailored to their needs. A person told us, “I have never been asked to look at my care plan.” This meant the provider could not be assured that people consistently received equitable outcomes.
 

At our previous inspection, we identified concerns in relation to end-of-life care planning. During this inspection, while end-of-life care plans were now in place, these were not always sufficiently developed. End-of-life care plans often contained limited or generic information and did not consistently reflect people’s individual wishes, including cultural, religious or personal preferences.
This meant there was a risk that people would not receive care at the end of their lives that reflected what was important to them.