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Chelmunds Court Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 25 December 2020

Chelmunds Court is a care home registered to provide nursing care and accommodation for a maximum of 73 people. Bedrooms are located across two floors. People with nursing needs lived on the first floor. Most people on the ground floor were living with dementia. There were 67 people living at the home at the time of our visit.

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

Some improvements to risk management had been made since the last inspection. Sufficient action had been taken in response to the issues identified in the warning notice we had served. However, further improvement was required to ensure people received safe, person centred, responsive care. Staff were recruited safely but staff told us there was not enough of them. This was despite the home being staffed in accordance with the provider’s dependency tool used to calculate the staff numbers required to care for people.

An ‘infection prevention control’ audit was carried out by CQC during the inspection. We found the provider was not following government guidelines to keep people as safe as possible and minimise infection control risks associated with Covid-19. Staff did not consistently follow PPE guidance and requirements for isolating people were not followed as required. Covid-19 testing for people was not completed in accordance with required timescales. Effective arrangements were in place to ensure visitors to the home were made aware of infection control requirements to keep themselves and others safe.

Arrangements to protect people from potential harm and abuse needed improvement. Staff knew how to recognise abuse but the provider’s arrangements to minimise and manage risks were not always clear or followed.

Governance systems to monitor the quality and safety of the service continued to be ineffective. When areas for improvement had been identified by audits and checks, timely action continued not to be taken to keep people safe and maintain their wellbeing. Staff spoke of the challenges they faced to follow procedures to ensure people received safe, person centred care.

People and their relatives spoke positively about the staff and the care they provided at Chelmunds Court. Relatives had maintained some contact with their family members during the national lockdown which included video and telephone calls.

Management changes had occurred since our last inspection. The new registered manager was supported by a management team. Regular staff meetings took place to inform staff of changes in practice and what was expected of them by the provider.

Rating at last inspection (and update)

The last rating for this service was Requires Improvement (published 27 March 2020) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider remains in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections although there has been evidence of some improvement at each of those inspections.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We needed to check whether the Warning Notice we previously served in relation to Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. We had identified concerns in relation to medicine management and completion of risk assessments related to peoples care. Care plans were not up-to-date and food and fluid charts lacked information to show people had consumed enough to maintain their health. Significant events that had resulted in injuries sustained by people had not been reported as required.

The inspection was also prompted in part due to concerns received about people falling, infection control

Inspection areas

Safe

Requires improvement

Updated 25 December 2020

The service was not always safe.

Effective

Requires improvement

Updated 25 December 2020

Caring

Requires improvement

Updated 25 December 2020

Responsive

Requires improvement

Updated 25 December 2020

Well-led

Requires improvement

Updated 25 December 2020

The service was not always well led.