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Archived: Chesham House Requires improvement

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 19 March 2016

This inspection took place on 19 January 2016. The home was given one days’ notice of our intention to inspect to ensure staff we needed to speak with would be available. The home provides accommodation and personal care for up to 10 younger adults with mental health needs. There were eight people living at the home and two people on day transition as part of moving into the home when we visited.

The home 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.

Care plans and risk assessments did not all provide comprehensive information about how people should be cared for. Information was not always available about the outcome of health appointments or if these had occurred. Not all people received the support they required to ensure they had a varied and nutritious diet.

Information about how legislation designed to protect people’s legal rights should be applied for individual people was not always present. Staff were offering people choices and respecting their decisions appropriately.

The Deprivation of Liberty Safeguards (DoLS) were applied for appropriately but staff had not ensured they were aware of any specific requirements of one which had been approved. DoLS provides a process by which a person can be deprived of their liberty when they do not have the capacity to make certain decisions and there is no other way to look after the person safely.

Medicines were stored securely and administered safely. Individual ‘as required’ guidance were in use meaning there would be consistency in administration by different staff.

The recruitment process records showed all necessary pre-employment checks had been completed. There were enough staff to meet people’s needs and contingency arrangements were in place to ensure staffing levels remained safe. Staff received appropriate training and were supported through the use of one to one supervision and appraisal.

People felt safe and staff knew how to identify, prevent and report abuse. Plans were in place to deal with foreseeable emergencies. The home was well maintained with procedures in place to ensure this continued.

People were positive about the service they received. They praised the staff. A range of varied individual and small group mental and physical activities were offered with people able to choose to participate or not.

People were able to complain or raise issues on an informal basis with the registered manager and were confident these would be resolved. This contributed to an open culture within the home. Visitors were welcomed and staff worked well together which created a relaxed and happy atmosphere, which was reflected in people’s care.

The registered manager was aware of key strengths and areas for development of the service. Quality assurance systems were in place with regular contact by the provider’s senior management team and the registered manager with people and staff.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Inspection areas

Safe

Requires improvement

Updated 19 March 2016

The service was not always safe.

Individual risk assessments had not been completed or updated for all people.

People felt safe and staff knew how to identify, prevent and report abuse. Medicines were stored and administered safely and plans were in place to deal with foreseeable emergencies.

The recruitment process ensured all pre-employment checks had been completed. There were enough staff to meet people’s needs with arrangements in place to ensure staffing levels remained safe.

Effective

Requires improvement

Updated 19 March 2016

The service was not always effective.

Information about how legislation designed to protect people’s legal rights should be applied for individual people was not always present.

Not all people received care, treatment and support to meet their mental and physical health needs. People did not always receive the support they required to ensure they had suitably nutritious meals.

Staff were suitably trained and received appropriate support.

Caring

Good

Updated 19 March 2016

The service was caring.

People were cared for with kindness and treated with consideration. Their views and opinions were sought and staff acted upon these.

People’s privacy was protected and confidential information was kept securely.

Responsive

Requires improvement

Updated 19 March 2016

The service was not always responsive.

Care plans were disorganised and lacked some information to enable staff to respond consistently to people’s needs. Pre admission procedures had failed to ensure all needs and risks relating to one person were known by staff.

People were provided with appropriate mental and physical activities of their choosing.

People were able to complain or raise issues with the registered manager and were confident these would be resolved.

Well-led

Requires improvement

Updated 19 March 2016

The service was not always well-led.

Quality assurance systems were in place but had not identified all areas requiring improvement.

Staff and people were encouraged to raise questions and give opinions.