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The Chase Requires improvement

Reports


Inspection carried out on 29 January 2020

During a routine inspection

The Chase is a residential care home providing accommodation and personal care to nine people with a learning disability, aged 18 and over at the time of the inspection.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to nine people. Nine people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

We found care was not always delivered in line with guidance for managing behaviours that challenged the service and staff training in this area was either out of date or had yet to be completed. We found out of date food stored in the refrigerator. Records related to daily care did not include details of the personal care provided by staff. Consent to take pictures was not always obtained from relatives or people. We found ineffective audits and notifications of incidents and authorised deprivation of liberty safeguards (DoLS) had not been submitted to the CQC as required to do so by law.

People and relatives told us they felt safe. Staff checks were carried out to ensure they were safe to work with people who used the service. Risks to people were assessed and manged to reduce the risk of avoidable harm. People were supported to take their medicines safely. Staffing levels were based on people’s level of need. Systems to manage the risk of the spread of infection were in place, however, out of date food was not disposed of.

People and relatives were mostly asked their consent before care was provided. 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. However, we have made a recommendation in relation to consent to obtain photographs.

People’s needs were assessed and used to develop their plan of care. Daily records required further details in relation to personal care provided by staff. We have made a recommendation in relation to good practice in record keeping.

People received sufficient amounts to eat and drink to maintain their health. Staff received training relevant to their role and understood people’s individual needs. We noted a number of repairs and improvements were required to the kitchen and communal bathrooms. We made a recommendation in relation to developing an action plan with timescales for completing these.

Relatives told us people were treated well by staff who were caring and knew them well. People were supported to maintain their independence where possible. People were encouraged to make daily living decisions about their care and were supported by staff to make choices.

People were supported by staff who knew them well and understood their needs and preferences. Relatives told us they felt their relative was well cared for by staff who understood them well.

Relative

Inspection carried out on 6 July 2017

During a routine inspection

The Chase provides care for up to nine people with a learning disability or autistic spectrum disorder. At the time of the inspection, there were nine people using the service.

At the last inspection of 7 and 8 August 2014, the service was rated Good. We carried out this unannounced inspection of the service on 6 July 2017. At this inspection, we found that the service had maintained its ‘Good’ rating.

People remained safe at the service because staff assessed and managed the risks to each person’s welfare. Staff mitigated risks of abuse to people and their training in safeguarding adults enabled them to identity and report any concerns.

A sufficient number of suitably qualified staff were deployed at the service and provided safe care. Safe recruitment procedures ensured only suitable staff worked at the service. People received their medicines safely in line with current good practice guidelines.

Staff received adequate training and had the skills and knowledge to carry out their roles effectively. Appropriate support provided through induction, regular supervisions and an annual appraisal ensured staff reflected on their performance and improved the quality of care provided.

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

People were encouraged to make choices and involved in decisions about their day to day lives. Best interests meetings ensured people who did not have the capacity to make decisions about their care received the support they required to do so. People received care from staff who understood and applied the principles of the Mental Capacity Act 2005 and the requirements of the Deprivation of Liberty Safeguards.

People received sufficient food and drink and the support they required to have a healthy and balanced diet. People had access to healthcare professionals when required to maintain their health and well-being. Staff delivered people’s care as planned and were responsive to their individual needs. People using the service, their relatives where appropriate and health and social care professionals were involved in designing and reviewing care plans to ensure they were person centred.

Staff continued to treat people with respect and deliver their care with dignity and compassion. People received personalised care that met their individual needs. Staff had clear information about how people wanted their care delivered, things that mattered to them and how they wished to spend the day. People enjoyed taking part in a wide range of activities at the service and in the community. People lived in suitably designed and adapted premises.

A culture focused on people prevailed at the service. People using the service, their relatives and health and social care professionals made positive comments about the registered manager and the service. The registered manager continually improved the quality of care people received through regular monitoring and auditing of the service. People’s quality of care was in line with current practice because of the close working relationships between the service and other agencies.

Inspection carried out on 7 and 8 October 2014

During a routine inspection

The inspection took place on the 7 and 8 October 2014. The inspection was unannounced.

At our last inspection on 30 July 2013 the service was meeting their legal requirements against the regulations.

The Chase is a residential home for up to eight adults both male and female who have a learning disability or autistic spectrum disorder. Care was also provided to people with hearing and visual impairments. At the time of our inspection eight people were using the service.

There was a registered manager at the service. 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.

The service kept people safe and people told us they felt safe as did their relatives. Care staff had been trained in safeguarding and whistle blowing and these procedures and were up to date. The service was accessible by a key pad and all visitors were required to sign at arrival. Medicines were managed safely and people received their medicines on time.

Care staff received regular training to keep their skills up to date and commented that they were pleased they were given a lot of training. The manager had requested and received authorisation for Deprivation of Liberty Safeguards (DoLS) for all people in the service. These had been requested promptly and in response to changes to the law. Care staff had received training in the Mental Capacity Act 2005 and DoLS but some of the staff we spoke to did not know people had DoLS authorisations.

People liked the care staff and the manager and said everyone was kind and caring. Relatives had commented that care staff were good but when some agency staff were used there was sometimes a language barrier and compassion was not always there.

People were treated with dignity and respect and the service provided a separate area for the only two females in the service to live with their own living room. This provided them with added privacy from the main house.

People’s needs were met and the care staff met with people regularly to discuss how their care was. People attended activities outside of the service and relatives were actively involved in facilitating some of external clubs that people attended. The manager reviewed people’s care and risk assessments every three months or sooner if required.

There were good quality assurance procedures in place so that staff knew how they were performing through supervisions and team meetings. The service sent surveys to relatives and staff to obtain feedback, which was positive towards the service. People using the service participated in meetings which also provided the service with an opportunity to gain feedback on what they could improve for people’s benefit.

Inspection carried out on 30 July 2013

During a routine inspection

People at the service had structured days and were very active. On the day of the inspection we found that people had gone out or were getting ready to go out for the day. People happily told us what they were going to do that afternoon. One person said "I'm going to get a magazine".

We looked at four care plans and they detailed very clearly what support people should receive. People were developing independence skills and we found that one person was now able to tell staff how they wanted a cup of tea by clicking the kettle switch. People who were not able to communicate were engaged in the service as staff had the relevant skills to do so, for example they used sign language.

We observed lunchtime at the service and found that the food given was a healthy portion. Two people we spoke to in the morning told us what they had eaten for breakfast which was cereal. Staff who prepared food had completed food hygiene training.

Staff knew how to protect people from abuse and management discussed safeguarding at all their supervision meetings with staff every month.

Inspection carried out on 14 February 2013

During a routine inspection

There were eight people living at the home at the time of our inspection. When we arrived some of them were out and some were relaxing in the lounge. There were three members of staff on duty and others arrived for the late shift as the inspection progressed. We spoke with the manager and the deputy throughout the inspection and also interviewed two members of staff individually. We spoke to all of the people who lived at the home who were present but due to their limited communication abilities it was not possible to conduct in depth interviews. We did observe people relaxing in their home, interacting with staff and going out for various activities.

All of the views expressed by the people who live at the home were positive about the service they receive, as were the staff about the provider and the training and support they had received.

We observed processes for decision-making as well as care plans, policies and procedures and risk assessments. Records were complete and up to date. We saw a complaints procedure displayed on a notice board and safeguarding and whistle-blowing policies.

Inspection carried out on 5 October 2011

During a routine inspection

People that could verbally express their views told us that The Chase was a good place to live. Other people expressed their views through their families, and through our own observations. People presented as being relaxed and at home, and we saw a good rapport between people living in the home, care staff and the manager.

Reports under our old system of regulation (including those from before CQC was created)