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Archived: Chiltern Court Care Home Inadequate

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Inadequate

Updated 13 January 2018

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.

This unannounced inspection took place on the 13, 14 and 16 November 2017. During our last inspection in February 2017 we found breaches of Regulations 9, 10,12, 13,14 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 ( HSCA RA Regulations 2014) and Regulation 18 of the Care Quality Commission (Registration) Regulations 2009 ( Registration Regulations 2009)

As a result we imposed conditions on the provider’s registration. This meant we asked the provider to supply us with information on a monthly basis to evidence improvements in these areas. They were legally required to do so and complied with these conditions. During this inspection we found improvements in regulations 13 and 14 HSCA RA Regulations 2014 and Regulation 18(Registration Regulations 2009).

However we found continued breaches in regulation 9, 10, 12 and 17 of the HSCA RA Regulations 2014 with additional breaches in regulation 19, 15 and 18 HSCA RA Regulations 2014.

The home had not had a registered manager in post since April 2017. Since the last registered manager left their post there have been three further managers covering the position, none of whom have remained in employment or applied to be registered with us.

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.

Chiltern Court Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single packages under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Chiltern Court Care Home is a nursing and residential home for older people. The home is registered to accommodate up to 53 people, at the time of our inspection 23 people were living in the home. The accommodation is spread over three floors. The bottom two floors have lounges and dining areas. Only one person was living on the third floor.

We found improvements had been made in some areas of the safe handling of medicines. However, records were not always up to date or used appropriately to pre

Inspection areas

Safe

Inadequate

Updated 13 January 2018

The service was not always safe.

Records related to medicines had not always been completed accurately. Some medicines had not been administered when needed which meant one person was experiencing pain.

Recruitment practices were not safe, as previous employment checks were not always carried out, and gaps were not always interrogated. This did not ensure staff were always suitable to work with people.

Standards of hygiene and infection control were not up to standard. Health and safety checks had not consistently been completed. This placed people�s at risk of harm or illness.

Effective

Requires improvement

Updated 13 January 2018

The service was not always effective.

Staff were not always suitably trained or supported to carry out their role effectively. People were therefore at risk of receiving inappropriate or unsafe care.

Records related to food and fluids had not been completed accurately or consistently. This meant the provider could not accurately gauge people�s intake. This placed people at risk of dehydration or malnutrition.

People�s ability to make decisions for themselves was considered by the provider. Records showed where people�s liberty was deprived to ensure their safety; appropriate applications had been made to the supervisory body.

Caring

Requires improvement

Updated 13 January 2018

The service was not always caring.

The provider failed to ensure the care provided in the home was suitable and safe. This did not demonstrate a caring approach.

People did not always experience dignified care and were not always shown respect by staff. This did not protect their self-esteem or self-worth.

Care plans did not always reflect people�s mental health needs and did not focus on supporting people to remain independent. People did not always experience person centred care.

Responsive

Requires improvement

Updated 13 January 2018

The service was not always responsive.

Where people needed aspects of their care recorded by staff, these records were not always consistently or accurately maintained. This meant the provider could not effectively monitor the care provided to ensure it met people�s needs.

People were at risk of social isolation and boredom as activities and stimulation were not always available to people when they needed or wanted it. This did not protect people�s mental health needs or encourage social interaction to prevent loneliness.

People did not always know how to raise a complaint. This meant the provider could not drive forward improvements, without considering the experience of people living in the home.

Well-led

Inadequate

Updated 13 January 2018

The service was not always well led.

The provider had failed to ensure a registered manager had been in place to provide suitable guidance for staff and to effectively manage the service people received.

The provider had failed to ensure that where improvements were required to the practices and care being provided this had taken place in a timely manner. This meant people were not consistently receiving good quality care.

Quality audits had not identified the areas of concern we found during the inspection. There was a lack of accountability and poor monitoring by the provider of the experiences of people and staff in the service.