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The Chimes Residential Home Requires improvement

Reports


Inspection carried out on 5 November 2019

During a routine inspection

About the service

The Chimes Residential Home provides accommodation with personal care for up to 44 people. People who

use the service had physical health and / or mental health needs, such as dementia. At the time of the inspection, 42 people used the service. The service had three separate dining rooms where people could eat.

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

People’s risks were not always managed safely. People’s risk assessments were not reviewed or completed to ensure they were kept up to date and reflected any changing needs. People’s care plans and risk assessments were reviewed monthly. However, not all actions relating to people’s care had been documented when there was a change in circumstances.

Where people were prescribed 'as required' (PRN) medication, the service did not always have protocols or guidance in place.

Personal protective equipment (PPE) was available for staff, such as disposable gloves to use to help prevent the spread of infection. However, we found during both days of inspection that staff were not always using the equipment provided when working with people.

We made a recommendation about staff use of PPE to help prevent the spread of infection.

We used the Short Observational Framework for Inspection (SOFI) during meal times that looked at people’s dining experience. We observed that there was limited interaction between staff and people.

The registered manager’s audit system had not been effective in finding the issues and risks that were found during our inspection.

There were effective systems in place to safeguard people from harm and abuse. The registered manager took the necessary action to implement the required learning identified from accidents and near misses.

People and their families, where appropriate, were involved in the planning of care and support needs. The registered manager had an effective system to ensure that staff received appropriate training.

People were involved in decisions about the décor of their rooms, which met their personal and cultural needs and preferences. People brought furnishings of their choosing that allowed personalisation of their rooms.

We observed staff supported people in a caring and compassionate manner. People’s care plans clearly evidenced the support they required and their personal preferences.

The service facilitated several theme days throughout the year to celebrate different events, which involved people, relatives and staff members.

People’s human rights were protected by staff who demonstrated a clear understanding of consent, mental capacity and Deprivation of Liberty Safeguards legislation and guidance

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.

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 this service was good (report published 19 May 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified two breaches. Regulation 12 the registered person failed to ensure risks relating to the safety, health and welfare of people using the service were assessed and managed safely and the registered person failed to ensure the proper and safe management of medicines. Regulation 17 The registered person had not established an effective system to enable them to assess, monitor and improve the quality and safety of the service provided.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as

Inspection carried out on 28 April 2017

During a routine inspection

This was an unannounced inspection carried out on the 28 April 2017.

The Chimes Residential Home provides accommodation with personal care for up to 44 people. People who use the service had physical health and / or mental health needs, such as dementia. At the time of the inspection, 33 people used the service.

There was a registered manager in place. 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 had individual risk assessments in place to keep them safe, which included assessments for mobility, nutrition and medicines. Measures taken to minimise risk of harm included the provision of mobility aids and sensor mats to alert staff.

Staff knew what action they would take if they had any concerns and showed a good understanding of the different types of abuse. We found that there were systems in place to protect people who lived at the home by ensuring appropriate referrals were made and action taken to keep people safe.

We found home had appropriate recruitment procedures in place, which ensured staff were suitable to support people who used the service.

There were sufficient numbers of staff on duty to support people.

People had the support they needed to take their medicines safely. Competency checks to ensure the staff had the relevant skills and knowledge for safe administration were in place

Staff had the necessary skills and knowledge to meet people’s needs.

The provider protected people’s right under the Mental Capacity Act 2005. Staff were able to demonstrate that they had knowledge of the principles of the MCA and confirmed they had received training in the MCA.

Staff promoted peoples independence, dignity and respect.

People were involved in making decisions about their care and were listened to by staff and management about their needs.

People's health needs were monitored and changes were made to people's care in response to any changes in their needs.

People were stimulated in both group and individual activities. The provider routinely and actively listened to people to address any concerns or complaints.

The registered manager and the provider were approachable and supportive. There was an open and inclusive culture within the home.

There were systems in place to gain people’s experiences and to continually monitor the quality of the service provided.

Inspection carried out on 24 July 2015

During a routine inspection

We inspected The Chimes Residential Home on 24 July 2015. This was an unannounced inspection. This was the first inspection since the provider registered with us on the 23 March 2015.

The Chimes Residential Home provides accommodation with personal care for up to 33 people. People who used the service had physical health and/or mental health needs, such as dementia. At the time of our inspection 31 people used the service.

The service did not have a registered manager in post, but there was a manager who had recently applied to become 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 and associated Regulations about how the service is run.

We found that some improvements were needed to ensure that there were enough suitably qualified staff available and deployed effectively to meet people’s needs in a timely way.

Systems were in place to monitor and assess the quality of the care provided, but some of these needed improvements to ensure that actions were identified and completed.

People received mixed experiences at mealtimes and we found that improvements were needed to ensure people’s nutritional needs were assessed and monitored.

People told us they felt safe and staff understood the procedures to follow to keep people safe.

People’s risks were assessed in a way that kept them safe and staff understood how to support people safely.

People who used the service received their medicines safely. Systems were in place that ensured people were protected from risks associated with medicines management.

People’s capacity had been assessed and staff knew how to support people in a way that was in their best interests. Staff had a good knowledge of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The MCA sets out the requirements that ensure, where appropriate, decisions are made in people’s best interests when they are unable to do this for themselves. We found that the provider and staff understood these requirements and had undertaken assessments that ensured people were supported in their best interests.

People told us that staff were kind and caring. We saw that staff treated people with respect, gave choices and listened to what people wanted.

People told us they were involved in hobbies and interests that were important to them. People were involved with the planning of their care and care was provided in a way that met their preferences.

The provider had a complaints procedure that was available and people knew how to complain if they needed to.

Staff told us that the manager and provider were approachable and improvements had been made to the way the service was managed. The provider promoted an open culture and recognised where improvements were needed.