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Chaseview Care Home Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 30 October 2020

During an inspection looking at part of the service

About the service

Chaseview Care Home is a residential care home providing personal and nursing care to 85 people at the time of the inspection. Most people living at the service were older people some of whom had dementia. The service can support up to 120 people across four units in an adapted building.

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

Since our last inspection, improvements had been made with risk assessments for people at risk of skin complications. This included control measures, referral to professionals and monitoring the risks. People’s nutrition and hydration risks were recorded appropriately, and staff followed care plans and health professional’s advice. However, risk assessments were not completed for people that had breathing problems to minimise associated with breathing. The management team told us that these risk assessments would be completed.

Infection control procedures had been enhanced due to the risk of COVID19 and we observed the service was clean and a cleaning schedule was in place. Systems were in place to ensure visits were made safely. Personal protective equipment [PPE] was readily available and people and staff were tested regularly.

There was sufficient staff available to support people safely. Staffing levels were reviewed regularly and call bells were answered promptly.

Quality assurance processes at the service monitored the safety and wellbeing of people at the service. These processes were completed regularly and when actions were identified to improve elements of care, these were followed up on.

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 24 October 2019) and was a focused inspection to follow up on the warning notice we served for staffing and requirement notice for good governance at our last comprehensive inspection on 18 March 2019.

Why we inspected

We undertook this targeted inspection to follow up on recommendations we made at the last inspection on call bell monitoring and good governance and to check if improvements had been made on skin integrity risk assessments. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

CQC have introduced targeted inspections to follow up on specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

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 coronavirus and other infection outbreaks effectively.

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

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.

Inspection carried out on 7 October 2019

During an inspection looking at part of the service

About the service

Chaseview Care Home is a residential care home for up to 120 older people, primarily with dementia. At the time of the inspection, the home was supporting 87 people with personal and nursing care.

People’s experience of using this service

Improvements had been made with staffing. Staff rotas showed that there were enough staff across units to support people safely. Call bells were being answered promptly. However, we found instances whereby call bells were not within easy reach of people. We made a recommendation in this area.

There were inconsistencies with risk assessments. Some assessments included mitigation to minimise risks, which were not being carried out. Unexplained bruising was not being analysed to identify cause to minimise risk of skin complications.

Audits had identified shortfalls with risk assessments and an action plan was in place. However, prompt action was required to ensure people received safe high-quality care.

Pre-employment checks were carried out to ensure staff were suitable to care for people safely. Safeguarding procedures were in place and staff were aware of these procedures. Medicines were being managed safely.

Systems were in place for quality monitoring to ensure people’s feedback was sought to improve the service. Staff were positive about the management of 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

The last rating for this home was requires improvement (published 26 April 2019) and there were breaches of regulation in relation to staffing and good governance.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 18 March 2019. Breaches of legal requirements were found. As a result, we served a warning notice to ensure the home was compliant with staffing. The provider also completed an action plan after the last inspection to show what they would do and by when, to improve with Good Governance and Staffing.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions, Safe and Well-led, which contain those requirements.

The ratings from the previous comprehensive inspection for those Key Questions were looked at on this occasion and were used in calculating the overall rating at this inspection. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

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

Follow up:

We will speak with the management team prior to this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Inspection carried out on 18 March 2019

During a routine inspection

About the service:

Chaseview Care Home is a residential care home providing accommodation and personal care to 97 people, at the time of the inspection.

People’s experience of using this service:

• Some people, relatives and staff raised concerns with staffing levels. We found a number of issues with staffing, which included delay in call bell response and ineffective staff deployment in units.

• Some staff raised concerns with lack of support given by the management team. Supervisions were not regular to ensure staff were supported at all times. This was being addressed. We made a recommendation in this area.

• Care plans were inconsistent especially in the area of skin integrity to ensure people were in the best of health and received person centred care. We made a recommendation in this area.

• Audits had not identified the shortfalls we found during the inspection especially with staffing.

• People received their medicines as prescribed and medicines records were completed accurately. However, there was lack of robust systems in place to review people’s medicine’s annually. We made a recommendation in this area.

• Risks associated with people’s needs had been assessed.

• Staff had completed essential training to perform their roles effectively.

• People were supported with their nutritional needs and had choices with meals. However, people and relatives expressed concerns with meals and the timing of meals. We made a recommendation in this area.

• The staff worked well with external health care professionals and people were supported with their needs and accessed health services when required.

• People continued to receive care from staff who were kind and compassionate. Staff treated people with dignity and respected their privacy.

• Staff had developed positive relationships with the people they supported. They understood people’s needs, preferences, and what was important to them.

• People’s independence was promoted.

• We identified two breaches of Regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

• Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.

• For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

• At the last inspection on 5 and 6 February 2019 the service was rated ‘Requires Improvement’. At this inspection, the rating for the service continuous to be ‘Requires Improvement’.

• At our last inspection, the service was in breach of three Regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to staffing, risk management and restricting people’s liberty lawfully. At this inspection, breaches relating to risk management and restricting people’s liberty lawfully had been addressed. However, concerns remained with staffing.

Why we inspected:

• This was a planned inspection based on the rating of the last inspection.

Follow up:

• We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

Inspection carried out on 5 February 2018

During a routine inspection

We carried out an unannounced inspection of Chaseview Care Home on 5 and 6 February 2018. Chaseview Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Chaseview Care Home is a care home for up to 120 older adults. This included people with dementia and people who were at the home for a short stay. The home was split across four units and each unit was managed by a unit manager. There were 100 people living at the home on 5 February 2018, which had reduced to 99 people on the second day of the inspection.

The home had recently changed providers and this was the first inspection since the new provider took over.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

Risk assessments for most people who lived in the home included information on how to mitigate identified risks. However, risks were not always robustly managed for some people to ensure they were safe at all times.

Some people, relatives and staff raised concerns about staffing levels. The way staff were deployed across the home meant there were sometimes delays in providing support to people who required it.

Some people who lived at the home were deprived of their liberty under the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Deprivation of Liberty applications had not been made for four people when their initial DoLS authorisation had expired. Staff were aware of the principles of the MCA and assessments had been carried out to determine people’s ability to make decisions in certain areas.

Quality assurance systems were in place but were not always effective. The audits which the home carried out had not identified the shortfalls we found during the inspection to ensure people were safe at all times. Accurate and complete records had not been kept to ensure people received high quality care and support.

Medicines were managed safely. In general, we found that people’s Medicine Administration Records (MAR) had been completed accurately. Medicines was being administered as instructed on people’s MAR, or in accordance with the provider’s policy.

Pre-employment checks had been carried out for new staff to ensure they were suitable to provide care and support to people safely. Staff we spoke to were aware of how to identify abuse and knew who to report abuse to, both within the organisation and externally.

Incident records were reviewed and these showed the provider took appropriate action following incidents that had been recorded. Systems were in place to analyse incidents for patterns and trends to ensure lessons were learnt and incidents were minimised.

Systems were in place to reduce the risk and spread of infection. Staff had access to personal protective equipment and used this when needed.

Staff had the skill and knowledge to provide support effectively. Records showed that some staff needed refresher training in some areas. This was being addressed by the management team. Staff were knowledgeable on how to support people. Supervisions were carried out regularly and staff told us that they were supported by the manager.

People had access to healthcare services and staff knew what to do if people felt unwell.

People in general told us that they enjoyed the food at the home and were given choices. However, people in one unit raised concerns with meals. People’s weight and food intake was monitored when required and if there were concerns, action was taken, which resulted in people’s health improving.

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