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The Chase Care Centre Requires improvement

Reports


Inspection carried out on 12 September 2018

During a routine inspection

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 carried out on 24 April 2018

During a routine inspection

We carried out a comprehensive unannounced inspection at The Chase Care Centre on 24 April and 3 May 2018.

At our last inspection on 6 June 2017 the service was rated Requires Improvement (RI). We found breaches of regulations 9 and 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was due to a lack of activities coupled with a lack of interaction, engagement and personhood for people which impacted on people’s wellbeing. We also found that people’s safety was not always sufficiently mitigated due to the unsafe management of medicines. At this inspection we found the service continued to be in breach of regulations 9 and 12 and we also found breaches with regulations 10, 11,13,14,17 and 18. We found that there were serious failings from both management and staff to ensure people received care and support in a safe and effective way.

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 86 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.

During our inspection, we were informed that the registered manager had tendered their resignation in April 2018 and therefore a temporary operations manager was providing the management support whilst recruitment takes place for a new manager. 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.

People who lived at the home gave mixed views about feeling safe. Five people and four relatives felt there were not enough staff to meet their needs in a timely way. We were told that agency staff working in the home were not always knowledgeable about their needs which had impacted on their dignity, care and general well-being. Staff were observed to be rushing from one task to another with little time to spend talking or engaging with people. This was particularly apparent during mealtimes.

Risks to people`s well-being and health were not always identified, assessed or mitigated in a way to reduce them. Where people were assessed as requiring a fortified diet to help reduce the risk of malnutrition they were not provided this by the kitchen staff who were not aware of people’s needs.

Where people had pressure relieving equipment in place to help prevent the development of pressure ulcers, checks carried out by staff did not effectively identify incorrect settings on air mattresses. There was a risk that this shortfall had contributed to people developing pressure ulcers.

People who lived with specific health conditions had no care plans in place to address this area of their needs and staff had no guidance on how to maximise and improve people`s health. People`s end of life care needs were not always assessed and people`s wishes, likes and dislikes were not always considered when staff developed or reviewed care plans.

People were not always protected from the risk of infections due to staff not adhering to safe infection control techniques.

People’s medicines were not managed or administered safely, which placed people at risk of harm.

People who had co

Inspection carried out on 6 June 2017

During a routine inspection

This inspection was carried out on 6 June 2017 and was unannounced. This was the first inspection since the provider registered with us in February 2016.

The Chase Care Centre provides accommodation for up to 110 older people, including people living with dementia and younger people with complex health need. The home is registered to provide nursing care. At the time of the inspection there were 105 people living there.

The service had a manager who was registered with the Care Quality Commission (CQC). 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.

People’s medicines were not managed safely and risks to people’s safety were not always sufficiently mitigated. Staff knew how to identify and respond to concerns of abuse. We also found that person centred care, engagement and activities was an area that was lacking on some of the units.

People were supported by sufficient numbers of staff who were safely recruited. The staff told us that they felt well trained and received a good level of support.

People’s capacity to make decisions was assessed and consent was sought. People were supported to eat and drink but the mealtime experience needed improving. People had access to health and social care professionals as and when it was needed.

People were not always treated with dignity and respect. We also found that confidentiality was not always promoted. Interactions between staff and people needed to be improved. However people told us that staff were kind.

People’s personal care needs were being met but their emotional wellbeing was not always promoted. Care plans were in place but not always followed. Activities provision required further development to ensure people had sufficient opportunity for engagement.

There was a quality assurance system in place. However, although these had identified issues, they were not all yet resolved. Some of the issues unresolved meant that there was a breach of regulations.

The registered manager was new to the service and was working through an action plan they had developed to address the issues they had found. People and staff were positive about the registered manager. We found that formal complaints were responded to.