We carried out a review of the data available to us about The Chase Care Centre on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Chase Care Centre, you can give feedback on this service.
The Chase Care Centre is registered to provide accommodation, 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, 109 people were living at 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 include supporting young people with acquired brain injuries, people with mental health needs, physical needs and people who are living with dementia.
People’s experience of using this service and what we found
People and their relative told us they felt safe. People were safeguarded from the risk of abuse by trained, knowledgeable staff and received safe care and treatment.
Risks to people’s health, safety and wellbeing had been identified, assessed and reviewed regularly. Staff were provided with guidance to support people safely.
Any incidents and accidents at the service were analysed and action taken in response to the findings.
Medicines were managed safely, and strong infection prevention and control procedures were followed. This included the safe facilitation of visits for relatives and friends.
Staff were recruited safely to the service with all relevant pre-employment checks completed. Staffing levels were consistent at the service and reviewed regularly.
Quality assurance processes were robust. The registered manager used a wide variety of methods to monitor the safety and quality of the service and make improvements where needed. Staff and relatives told us that the registered manager was approachable, and staff were confident that action would be taken if they raised concerns.
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 (published 31 October 2019).
Why we inspected
This was a planned inspection based on our ongoing monitoring of the service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
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 include supporting young people with acquired brain injuries, people with mental health needs, physical needs and people who are living with dementia.
We found the following examples of good practice.
¿ The service was receiving professional visitors to the service with robust infection control procedures in place. Visitors were received into the reception area on arrival where health screening was completed. Each visitor was provided with guidance, personal protective equipment (PPE) and had their temperature checked by staff.
¿ The service had purchased a visitors’ pod for people and their relatives, which was situated in the courtyard. The pod was a separate outbuilding that could facilitate screened visits. Visitors were able to enter the courtyard via an external gate with no access to any other areas of the building. At the time of our inspection, visits had been suspended due to an outbreak of COVID-19 at the service. The registered manager told us that once visits are resumed, they will be limited and by appointment only, with times allocated to avoid potential infection transmission with other visitors and to allow for the visiting area to be thoroughly cleaned between visits.
¿ People and staff had engaged with the routine testing scheme. The registered manager maintained a comprehensive log of all tests and results for people and staff. Risks to people and staff in relation to their health, safety and wellbeing had been thoroughly assessed.
¿ The provider had developed policies and procedures in response to the COVID-19 pandemic. The registered manager and senior staff completed daily checks and ‘walkarounds’ of the service, alongside regular infection prevention and control audits and PPE competency checks for staff.
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, 93 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 include 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.
People's experience of using this service
We received positive feedback about the service and the care people received. People and professionals commented positively about the effectiveness and responsiveness of the support people received. There was evidence that people received good care outcomes and their comments about the service supported these findings.
Systems to ensure people were safeguarded from harm were effective and robust. People were supported by staff who had been trained to identify and report concerns. People were safe because potential risks to their health and wellbeing had been mitigated and were being managed effectively. Staffing levels were appropriate to meet people’s needs. People were supported to take their medicines. Lessons were learnt from incidents to prevent recurrence. Staff followed effective processes to prevent the spread of infections.
The registered manager and staff worked hard to ensure people received effective care to meet their needs. People were supported by staff who had completed the provider's mandatory training and additional specialist training in relevant areas. Staff practice was supported by recognised good practice guidelines.
Staff had respectful, caring and friendly relationships with people they supported. Staff upheld people's dignity and privacy, and they promoted their independence.
People received personalised care and support which met their needs and reflected their
preferences.
There was a positive and open culture. Staff roles and responsibilities were clear, and staff were supported through regular supervision from the registered manager.
The provider’s quality monitoring processes had improved and now evidenced how they continually worked to further improve the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was Requires Improvement (published 8 November 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found enough improvement had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
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 external safeguarding authorities. Referrals to local safeguarding authorities and CQC were done in a timely manner.
Where people were assessed as requiring a fortified diet to help reduce the risk of malnutrition we found that staff were knowledgeable and the kitchen staff who were aware of people’s individual dietary needs. However, we found that records relating to the amount of fluids people had consumed were not accurately recorded.
Where people had pressure relieving equipment in place to help prevent the development of pressure ulcers, we found that all the necessary checks and records were up to date and accurate.
Infection control measures were in place. Staff were observed to use personal protective equipment, including the use of gloves and aprons while supporting people with personal care. People’s medicines were managed safely. Medicines were stored safely and administered by trained staff.
People who had complex health care needs had been assessed and care plans developed to provide guidance to staff but we found that these were not always implemented to ensure people`s health and welfare was maintained at all times.
People had mixed views with regard to being involved with developing their care. Some care plans contained inaccurate and out of date information which required updating to reflect people`s current needs.
People were asked for their consent to the day to day care and support they received from staff. We observed staff assisting people and communicating with them and asking for their involvement in the task.
We found that staff failed to respect and maintain people's dignity and privacy.
The principles of the Mental Capacity Act 2005 (MCA) were followed by staff and where Deprivation of Liberty Safeguards (DoLS) authorisations were in place, with conditions listed on the restrictions to people`s freedom, plans were in place to meet these and keep people safe.
Staff received support through induction and a training programme with a mixture of distance learning and face to face training. We found the training provided had improved since the last inspection was carried out in relation to both specialist training and mandatory training had also been updated.
Recruitment processes were robust and ensured that the staff employed were suitable to work in this type of care setting.
We found the standard and choices of meals provided had improved and where necessary staff had referred people to specialist support in cases where they were at risk of malnutrition.
The atmosphere at The Chase Care Centre had improved since the last inspection and felt more welcoming and calm. However, on the day of this inspection there was only one activity staff member to provide activities to 67 people. People who spent time in their bedrooms were at risk of social isolation. This is an area that requires improvement.
People told us that they felt more confident in raising any concerns they may have since the new manager started at the home.
We found the systems now in place to provide an overview of the service and monitor the quality of care and support provided had improved.
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 complex health care needs had not been properly assessed and care plans had not been developed regarding their health needs to offer guidance to staff on how to maximise people`s health and keep them safe.
People told us they did not know about their care plans. Care plans we reviewed were not up to date and did not reflect people`s current needs.
People were not always asked for their consent to the day-to-day care and support they received from staff. We observed staff assisting people without communicating with them and walking into people’s bedrooms without knocking. Staff did not follow the principles of the Mental Capacity Act 2005 (MCA). Staff were not aware if people had Deprivation of Liberty Safeguards (DoLS) authorisations or Do Not Resuscitate (DNR’s) in place which could restrict their freedom unlawfully and place people at risk of harm.
Staff received support through induction and a training programme with a mixture of distance learning and face to face training. However training was not consistently effective in providing staff with the appropriate skills and knowledge to help them meet the needs of the people who lived at the service. We could not be assured that staff were competent following the completion of their training, especially for people whom English was their second language. Staff were unable to explain the procedure to follow in relation to how they safeguarded people from harm and the correct fire evacuation procedures for the home.
Recruitment processes were robust and ensured that the staff employed were suitable to work in this type of care setting.
People had mixed views on the food provided to them. People who had to maintain a healthy diet and lose weight were appropriately supported by staff; however the needs of the people at risk of malnutrition or requiring special diets were not always met effectively.
The atmosphere at The Chase Care Centre was subdued and unreceptive, with several people left for long periods of time without any stimulation or engagement from staff. Over both days of the inspection there were only two activity staff providing activities to 86 people. People who spent time in their bedrooms were at risk of social isolation.
Some staff and people who lived at The Chase Care Centre told us they did not know who the registered manager was. They gave us mixed views about if they felt confident to raise concerns or complaints to the managers. Relatives told us that they did not always feel listened to.
Although there were systems in place to provide an overview of the service we found that these audits were not consistent and at times only provided limited information about the issues found.
The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months.
The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.
This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.
For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.
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.