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Reports


Inspection carried out on 26 September 2018

During a routine inspection

This comprehensive inspection took place on 26 September 2018 and was unannounced.

Cheverells is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection.

Cheverells is registered with CQC to provide care for 38 older people, some of whom may be living with dementia. Cheverells accommodates people in one spacious, adapted building in a residential area of Northam, Bideford. Access to the three floors of the building is via a platform lift, stair lifts and staircases throughout the home.

Cheverells was run as a family business with both the providers working in partnership with each other. One of them was the registered manager and the other was the ‘matron’ at the home.

At our last inspection in May 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since out last inspection.

Why the service is rated good.

People were happy and enjoyed living at Cheverells. They told us staff were caring, kind and respectful to them. Relatives were also positive about the service and the care given; one said “They (providers and staff) welcomed us whole-heartedly and made (my relative) feel so at home straight away. And that’s how it’s been ever since.”

There had been a recent change in the running of the home with the introduction of a team leader role. This meant there was always a team leader on duty to support and guide staff. People said staff worked well together. Staff knew people well and had built positive relationships with them. People received care that was assessed, planned and delivered in an individualised way. Each person had a personalised care plan in place which documented how they would like their care to be given. Risks to people were identified and minimised as much as possible.

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.

Staff supported people to stay safe by understanding how to recognise abuse and the correct procedure to take if they had any concerns. Staff were trained, knowledgeable and skilled in their roles. There was enough staff on duty to meet people’s needs fully. Staff received regular supervision and felt involved in the running of the home. They were motivated and enjoyed their jobs.

People received a balanced and nutritious diet and people were very complimentary of the food served. One person commented, “I can’t praise the home highly enough and the food is definitely included in that.”

The service provided an extremely clean, tidy and well-maintained home for people to live in. There was a large private garden for people to sit and relax in. People could access all areas of the home. People benefitted from continuous monitoring and improvements made in the home to make it better for people to live in.

The providers were visible in the home and worked alongside staff. People and staff spoke highly of them and their caring nature. They respected and valued the staff that worked for them. One person said, “It’s like a big family” and “The owners go to endless trouble over every aspect.”

Further information is in the detailed findings below.

Inspection carried out on 5 May 2016

During a routine inspection

This inspection took place on 5 and 10 May 2016 and was unannounced. The inspection took place over two days. The team consisted of one adult social care inspector.

Cheverells Care Home is registered to provide accommodation for 38 older people who require personal care. At the time of our inspection, there were 37 people living there.

The service is owned by two providers; one of whom is the registered manager and the other is the matron.

At the last inspection on 21 and 22 April 2015, four breaches of regulation were found. These were because:

• assessments and care plans were not in place;

• risk assessments were not in place;

• people’s rights under the Mental Capacity Act 2005 had not been adhered to and the correct procedures to deprive people of their liberty had not been taken;

• systems to ensure the safe management of the service were not in place.

The providers wrote to us with an action plan to say what they would do to meet the breaches of regulation by 30 June 2015. At this inspection, we found they had followed their action plan and met the legal requirements.

One of the providers was also the registered manager. 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 lived in a home where they were relaxed and comfortable. The service was consistently described as homely, friendly and lovely. People said, “I’m happy and I’m looked after”, “It’s always been very good here … love it” and “I couldn’t do their (care staff) job … they are all kind and understanding … you can’t get a better place.”

People received care suitable for their needs with enough staff on duty. Staff knew people well and cared for them as individuals. Two people said, “You can’t find fault with this place … it’s A one … it’s a very good place” and “If you need any help, they (care staff) are always there.”

Care staff were safely recruited. They were trained, motivated and enjoyed their work. They received supervision and felt listened to and supported by the registered manager and provider. Care staff had a good understanding of safeguarding and knew how to recognise the different types of abuse. They knew the correct action to take and who to report any concerns to.

Each person had a care plan with suitable risk assessments in place. Care plans were clear and up to date. Health and social care professionals were involved in people’s care and their advice acted upon. Mental capacity assessments had been carried out and applications made to the local authority if people were deprived of their liberty.

People received their medicines in a safe way. People enjoyed a varied and nutritious diet with a choice of food offered. People enjoyed a range of activities and outings which suited their individual interests and hobbies.

Staff recognised the importance of family and friends who were welcomed at all times. Two relatives said, “Excellent … go above and beyond to meet individual needs … you (providers) provide a caring home where nothing is too much trouble” and “The welcome is wonderful.”

People lived in a home which was well maintained. There were large gardens for people to sit and relax in. People, relatives and health care professionals were very complimentary of Cheverells, the providers and care staff. Two health care professionals said, “I plan to book myself in when the time comes … would be very happy for any of my relatives to live at Cheverells” and “Good care in a friendly well-kept environment.”

There was a complaints policy and procedure in place with information about how to raise concerns or complaint. Systems were in place to assess the quality of the service and make improvements.

Inspection carried out on 21 and 22 April, 2015

During a routine inspection

This inspection took place on 21 and 22 April 2015 and was unannounced.

At the last inspection 22 June 2013 we found the service was meeting all the legal requirements and regulations associated with the Health and Social Care Act (2008).

Cheverells Care Home is registered to provide accommodation for 38 older people who require personal care. 38 people were living at the home at the time of inspection.

The service had a registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated regulations about how the service is run. At this service, the registered manager is also one of the registered providers.

This was the first inspection carried out since the service was re-registered on 14 January 2015.

Management and staff had limited understanding of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards. Where people lacked capacity, staff did not understand the law which underpinned people’s right and the appropriate action had not been taken. People had some assessments of risk and plans of care in place. However, these were not accurate and up to date; they did not fully reflect the care and support the person was receiving.

Adequate systems for regularly monitoring the quality of the service were not in place and did not pick up any shortfalls in record keeping. The premises, services and equipment were well maintained and serviced in accordance with the relevant legislation.

A plan of regular events at the home was in place, but these events were limited and did not always reflect people’s individual abilities, hobbies or interests.

There was a homely and friendly atmosphere at Cheverells Care Home during our visits.

People told us they were happy and enjoyed living at the home. Comments included “It’s like home”, “I am really, really happy here”, and “Everything is perfect, like a home.”

People, their relatives and professionals all spoke highly about the care and support provided. Relatives felt welcomed by staff and had developed good relationships with them.

People felt safe and told us staff were kind and caring to them. Staff treated people with dignity and respect. Enough care staff were on duty and they received training and support to do their jobs properly. Ancillary staff such as cooks, housekeepers, maintenance and gardeners were employed.

People had their medicines managed safely. People received nutritious meals and told us they enjoyed the food, but would like more choice.

Views were sought from people and their relatives from a quality assurance survey sent out yearly but regular residents meetings were not held.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of this report.