Chaseley Care Home

Chaseley Care Home is a residential care home providing personal care to 18 people aged 65 and over at the time of the inspection. The service can support up to 24 people.

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

People were happy with the measures in place to minimise the risks related to Covid-19. The registered manager was following national guidance to keep people and staff safe. However, the environment was not properly maintained in all areas. The provider had failed to effectively operate systems and processes to assess, monitor and improve the quality of the service.

Care plans and risk assessments were reviewed regularly to ensure they were up to date. Safeguarding procedures were in place to protect people from the risk of abuse by staff who understood and were trained on how to recognise and respond to concerns. Medicines were managed and administered safely. The registered manager and staff were clear about their roles and provided care which resulted in good outcomes for people. They worked in partnership with a variety of agencies to ensure people's health and social needs were met.

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 requires improvement (published 28 February 2018).

Why we inspected

We received concerns in relation to infection control. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence the provider needs to make improvement. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Chaseley Care Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to the cleanliness of the environment and the governance of the service to meet health and social care regulations.

Please see the action we have told the provider to take at the end of this 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 per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last inspection in March 2017, we found the provider was not meeting legal requirements in relation to Safe care and treatment, Staffing and Good governance. At that inspection, we rated the service ‘Requires Improvement’.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to make improvements for people who used the service.

During this inspection, we checked the improvements the provider had made and found they were meeting legal requirements.

Chaseley Care Home 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.

Chaseley Care Home is registered to provide accommodation for up to 24 people who require 24-hour care. At the time of our inspection, 18 people were living at the home. The premises are an adapted hotel on the promenade. Accommodation in provided over three floors, with a passenger lift for access between floors.

The service had a 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 2008 and associated Regulations about how the service is run.

Electrical and gas installations had been tested and certified as safe. A full re-wire of the home had taken place in August 2017. The water supply had also been checked for safety.

The provider had refurbished some bedrooms which were pleasantly decorated. However, some other areas of the home required refurbishment. There were areas of the home which required maintenance. We have made a recommendation about this.

We found the service had safe practices with regard to managing medicines. Staff who administered medicines had all been trained to do so safely.

Staffing levels had been assessed in line with the needs of people who lived at the home. This helped to ensure there were always enough staff deployed to meet people’s needs.

People’s needs were met by a well-established and trained staff team. Staff received a good level of support from the management team.

People we spoke with told us staff were kind and caring. Staff respected people’s privacy and dignity. People were treated as individuals and enabled to maintain as much independence and control as possible.

People told us they felt safe living at the home. The provider had systems to protect people against the risks of abuse or unsafe treatment. Staff we spoke with were aware of procedures to follow in order to help people to keep safe.

People were offered a choice of food and drinks and spoke positively about the meals provided to them.

The service sought guidance and advice from external professionals when necessary, in order to ensure people’s ongoing health needs were met.

Staff understood the requirements of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards. The service worked within the law to support people who may lack capacity to make decisions for themselves.

Written plans of care and assessments of people’s needs were kept under review. These were personalised and showed people or, where appropriate, others acting on their behalf had been involved in the care planning process.

The provider had a complaints policy. People knew how to make a complaint or raise concerns and felt they would be listened to. People told us they felt any concerns would be dealt with appropriately.

The registered manager carried out audits and encouraged people to share their views on their experiences of the service. This helped to ensure the quality of the service was assessed and monitored regularly.

People we spoke with and staff told us they felt the home was well-led. They told us the registered manager was approachable and willing to make time to listen to people.

Chaseley Care Home provides residential accommodation for up to 24 people whose needs are associated with the ageing process and long term conditions. The home offers short to long term care. Accommodation is over three floors with full lift access. The sun lounge offers promenade and sea views, with parking to the front of the building. There is a separate lounge and dining room.

Chaseley Care Home was registered with The Care Quality Commission (CQC) as a different limited company until September 2016 when the new company was registered with CQC. This is the first inspection as the new company. The director of the previous company is a director of the new company. The registered manager has continued to manage the home. This has meant the director and manager of the new service have continued knowledge of the home and people who live there.

At this inspection we found a number of breaches of the Health and Social Care Act 2008

(Regulated Activities) Regulations 2014. Breaches were found for safe care and treatment, management of medicines and staffing.

At the time of the inspection visit 19 people lived at the home.

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.

We checked the safety of the premises. We looked at the electrical installation certificate that had been issued in October 2013. These certificates are valid for five years. However the certificate stated there were immediate and urgent actions required, which had not been carried out.

This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because the provider had not ensured that the premises and equipment were safe for service users, staff and visitors.

Several bedrooms had been refurbished and looked smart and welcoming. However other areas needed attention. A number of windows had broken locks and could not be opened. Some communal areas and bedrooms although clean, were ‘tired and worn’. On the first day of inspection we saw lots of bin bags full of used continence products stored in the back garden. These were unsightly and restricted people’s access to the garden. These had been moved when we returned to the home on day two of the inspection.

Staff did not always manage medicines safely. We observed a member of staff leave the medicines trolley opened and unattended. This meant people had access to medicines not intended for them.

This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because the provider had not ensured medicines were managed safely.

There was a low staff turnover and no new staff had been appointed since the home was re-registered with CQC. Staff had been trained in care and had the skills and knowledge to provide support to the people they cared for. However staffing levels left people unsupervised, with little attention for long periods of time. This was of concern where people had dementia or high care needs.

This was breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because the provider had failed to ensure sufficient staff were deployed to support people.

Although we found the registered manager and staff team provided good care and the registered manager supported and encouraged the staff team, the home was not always well led. Audit systems were in place however they were not robust or effective as they did not highlight the concerns CQC noted during the inspection. The audits did not effectively evaluate the service or identify staffing, safety or environmental issues and provide safe governance and oversight.

This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because systems were not in place to provide good governance and ensure the safety and wellbeing of people.

People we spoke with told us staff were caring and supportive and cheerful even when they were busy. They said their health needs were met promptly and care records reflected this.

People we spoke with said staff supported them to remain as independent as they could be. They told us staff were caring and respectful, listened to them and assisted them as quickly as they could. They said staff were familiar with their care needs and preferences.

Staff recognised the importance of social contact, companionship and activities. They engaged in conversations with people and supported them on activities, outings and holidays, whenever they could, often in their own time. However more dependent people, particularly those cared for in bed had less interaction and stimulation. The registered manager told us people in bed had radio, TV and a light box to occupy them but our observations were that staff interaction was limited.

We have made a recommendation about staff offering more frequent social interaction and activities.

People told us they felt safe and contented at Chaseley Care Home. The service had procedures to protect people from abuse and unsafe care. Staff were familiar with these and had received training in safeguarding adults. They told us they would take prompt action to ensure people’s safety where they became aware of or suspected a safeguarding concern. We observed staff provided safe, patient and sensitive care during the inspection.

People told us they were offered a choice of meals and were complimentary about the food provided. Drinks were offered to people throughout the day and their dietary and fluid intake was sufficient for good nutrition.

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS). This enabled staff to work within the law to support people who may lack capacity to make their own decisions.

Care plans were personalised, involved people and where appropriate their relatives and were regularly reviewed.

People told us they knew how to raise a concern or to make a complaint if they were unhappy with something. They said staff were approachable and listened if they had a concern.

There were procedures to monitor the quality of the service. The registered manager sought people’s views in a variety of ways. People said staff were willing to listen which encouraged them to express their views.

You can see what action we have asked the provider to take at the back of the main body of the report.