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The Chase Care Centre Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 8 November 2018

We carried out a comprehensive, unannounced inspection at The Chase Care Centre on 12 September 2018.

At the last inspection, on 24 April and 3 May 2018, we asked the provider to make immediate improvements in some areas of the care and support people received. These areas were in relation to risk management for people, safeguarding systems and processes, training, consent to care, personalised care, dignity and governance systems.

The inspection was carried out to follow up the breaches of regulations 9,10,11,12,13,14, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 found at the last inspection and to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2012, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.We found the provider had worked hard to improve the service to people living at the home, with significant improvements to staff training, staff supervision, safeguarding people from harm, staff knowledge and practices in relation to DoLS (Deprivation of Liberty safeguards) and DNACPR (Do Not attempt cardio pulmonary resuscitation) and the standard of meals provided.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

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

The Chase Care Centre is registered to provide personal and nursing care for up to 110 people aged 18 and over with a range of complex health and care needs. At the time of our inspection, 67 people were using the service.

The Chase Care Centre is divided over three floors and accommodates people within six separate units, some of which have adapted facilities. The service supports people with complex nursing and residential needs which included supporting young people with brain acquired injuries, people with mental health needs, physical needs and people who are living with dementia. At the time of this inspection one unit (Churchill) was closed for renovation work to be completed.

A new manager had been appointed since the last inspection took place in April 2018 and was in the process of applying to become registered with the Commission. A registered manager is a person who has registered with the CQC 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.

At this inspection we found that improvements had been made, however we found some areas were still developing and required improving to ensure people safety was maintained and protected from the risk of harm.

Risks to people`s well-being and health were identified and assessed but not always mitigated in a way that maintained their safety.

People's end of life care needs and people`s wishes, likes and dislikes had not always been assessed or considered when staff developed or reviewed care plans.

We have made a recommendation about an adjustment to the current care plans in place.

Staff demonstrated they had the knowledge to identify potential abuse and the process for reporting concerns. Notices and information was displayed throughout the service informing people, staff and visitors how to report concerns and relevant contact numbers for e

Inspection areas

Safe

Requires improvement

Updated 8 November 2018

The service was not always safe.

Although people`s specific health conditions were assessed and guidance was in place, staff did not always implement these in order to maintain their health and well-being.

People were protected from the risk of harm by staff who had a good knowledge about safeguarding procedures.

There were sufficient staff deployed to meet people`s needs in a timely way.

Incidents identified and reported to managers were analysed, escalated and reported to external safeguarding authorities.

People were protected from the risk of infections by staff who followed infection control measures and used personal protective clothing when needed.

People received their medicines safely.

Effective

Requires improvement

Updated 8 November 2018

The service was not always effective.

Although there are plans to improve the environment, the home remained stark and uninspired especially for people who live with dementia.

People`s dietary needs were monitored but their fluid intake was not always monitored or recorded.

Training and supervision provided to staff had improved

Staff ensured they obtained people’s consent before providing care and support.

The principles of MCA, DoLS and DNAR’s were known to staff. Where DoLS authorisations were in place with conditions attached these were met.

People were supported to access health care professionals as needed to help ensure that their health and well-being was maintained.

Caring

Requires improvement

Updated 8 November 2018

The service was not always caring.

People mostly received care and support from staff in a kind way however people’s dignity and privacy was not always respected or maintained.

Staff were not always aware of people`s likes, dislikes, preferences.

People had mixed views about being involved in their care planning and review meetings.

Confidentiality was maintained.

People`s records were kept locked and secure.

Responsive

Requires improvement

Updated 8 November 2018

The service was not always responsive.

Care plans did not always reflect people`s likes and dislikes

Some care and support was still delivered to people, in a task orientated way.

People`s care plans did not always provide detailed guidance in order to give staff sufficient information to meet their needs effectively.

The current activity programme continues to fail to provide opportunities for people to engage in their social interests, hobbies and pastimes.

People who lived with life limiting conditions had a plan in place for staff to know their wishes and preferences but it did not always record the care they should receive nearing the end of their life.

People told us they were now confident that their complaints would be dealt with appropriately and everyone knew who the manager was.

Well-led

Requires improvement

Updated 8 November 2018

The service was not always well led

Auditing systems require further development to ensure people`s care records are monitored, kept updated and provide sufficient details in order for staff to know how to deliver care and support to people in a safe way.

People and staff told us the manager was responsive to their needs.

The providers governance systems had improved and were more effectively used by the manager to constantly review ways to improve the service people received.

Staff were aware of their roles and responsibilities and felt listened to and valued by the manager and provider.

Staff were supported through regular supervision and staff meetings.

People told us their views were obtained through satisfaction questionnaire's.