26 January 2012
During an inspection looking at part of the service
During our visit we talked with two people and observed the support provided by the care staff to the other people living there. We also talked to the manager, deputy manager and one member of staff during the inspection visit. We looked at two care plan files, checked the medicines and administration records for two people, looked around the home, and looked at the recruitment files for two members of staff.
In 2011 the home was the subject of three separate safeguarding alerts. Details of these can been found in the inspection reports that were written following our inspections of the home on 6 September 2011 and 17 May 2011.
The purpose of this visit was to follow up on compliance actions and improvement actions made following our previous two inspections. We also checked to ensure that actions taken by the home following the safeguarding alerts were effective in reducing the risk of recurrence. We looked at the actions taken by the home to address compliance actions relating to outcome 9: Management of medicines, and outcome 10: safety and suitability of the premises. We also looked at the actions taken by the home to address improvement actions previously issued relating to outcomes 4, 5, 7, 8, and 24.
The providers sent us an action plan following our inspection in June 2011 However, our final report following our inspection in September 2011 did not reach the provider. This meant that they were unaware that we had asked them to send us an action plan for outcome 9: Management of medicines. We looked at the actions they said they would carry out, and checked to see if these had been completed.
Before this inspection we were contacted by a relative who raised concerns about the home since it had been in administration. The relative was concerned about the lack of action to address the poor physical state of the building, care planning and the training and skills of the staff who were supporting people with autism and complex care needs. Therefore we also looked at outcomes 12 and 14 during this visit.
We had also received concerns about the way the home had handled people's cash and savings and therefore we looked at the procedures in place to safeguard people from financial abuse. We found that the home had used one person's savings to purchase furniture and a television without seeking a best interest agreement with professionals, relatives or advocates. We also found that the home was regularly using people's money to purchase meals outside the home. There was no clear agreement with people, or with those who paid their fees, relating to whether all foods were included in the fees paid, or about the purchase of food using people's personal allowances.
We found that some progress had been made to develop care planning systems. However, further work was required to improve the communication methods used by the home in all systems. This included improving care planning to enable people to be fully consulted and involved in all aspects of daily life in the home, and in their individual care needs.
We found that action had not been taken to address the cleanliness and tidiness of the laundry. This meant that people living in the home were at risk of illness due to cross contamination and poor hygiene control methods.
Some improvements had been made to the way medicines were administered and recorded. However, we checked the balances of medicines supplied by the pharmacy in containers other than the monitored dosage packs. We found the balances were incorrect. This meant that there were inadequate accounting and checking systems in the home to ensure that all medicines had been correctly administered.
Very little action had taken place since our inspection in May 2011 to improve the decoration, floorings and furnishings in the home. A bathroom and a shower room remained in poor state of repair and people were discouraged from using them. The exterior of the building was in poor repair and in need of maintenance.
At our inspection of the home in May 2011 some staff had transferred to The Chantry a few weeks earlier from another employer under transfer of employment legislation. However, some recruitment and employment files had not been passed to The Chantry from the previous employer. This meant that The Chantry did not hold evidence that staff had undergone thorough recruitment checks, and they could not demonstrate their suitability for the job. There was no evidence to show the training or supervision this group of staff had received from their previous employer. The manger said she would contact the previous employer again to request their employment files.
We looked at the training provided by The Chantry to the whole staff team in 2011. We found that the staff had received training on all required health and safety related topics, and also topics relevant to the care needs of the people living in the home.
The manager was not registered with the Commission. However, an application had been received around the time of this inspection and will be processed in the near future.
When we arrived at The Chantry five people who lived in The Coach House were out for a minibus trip to Dawlish and we heard that outings were a regular occurrence. People told us how much they enjoyed their trip and the places they went to.