Archived: Cheriton Care Home

Cheriton Care Home is registered to provide accommodation to a maximum of 45 people who require nursing or personal care, or treatment of disease, as a result of disorder or injury. At this inspection 27 people were living there, some of whom were living with dementia.

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

Risks to people were identified and managed safely by staff who understood their responsibilities to protect people from abuse and avoidable harm. People told us staff were mostly available when they needed them. Staff administered people's medicines safely. Accidents and incidents were reviewed by the registered manager to identify trends and to ensure necessary learning was shared with staff. Infection prevention and control was managed safely.

People had opportunities to take part in a variety of group activities. However, we received mixed feedback regarding activities provided to people who were unable to leave their rooms. People were supported to maintain contact with their relatives. Care plans included information needed to support people safely and in accordance with their wishes and preferences. These were reviewed regularly.

There were effective monitoring processes in place to help ensure a good standard of service. Quality assurance systems identified any areas that needed further development. The registered manager completed thorough investigations into any or concerns and acted to improve 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 (and update)

The last rating for this service was ‘requires improvement’ (published 2 July 2021) and there were two breaches of our regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced focused inspection of this service on 18 May 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when. This was to improve safe care and treatment.

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, responsive and well-led which contain those requirements.

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 COVID-19 and other infection outbreaks effectively.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. 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 Cheriton 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.

Cheriton Care Home is registered to provide accommodation to a maximum of 45 people who require nursing or personal care, or treatment of disease, as a result of disorder or injury. At this inspection 18 people were living there, some of whom were living with dementia.

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

Systems in place to monitor and improve the quality of the service had not always been effective. Records were not always available, or were not fully completed or accurate. These included medication records, recruitment files and records relating to people’s care. The provider failed to calibrate equipment used to administer medicines as per the manufacturer’s instructions. Staff did not always check expiry dates of equipment needed to administer medicines regularly.

Care plans and risk assessments for people included information about how to mitigate the risks they identified. However, we noticed that one person’s care plan did not provide staff with sufficient guidance on how to support them safely with catheter care. Not all staff received training by suitably qualified professionals in catheter care.

People told us they were safe and suitable arrangements were in place to protect them from abuse. Staff understood how to raise concerns and knew what to do to safeguard people.

Accidents and incidents were reported, and processes were in place to help identify trends and patterns to help prevent recurrence. People were protected by the service’s infection control and prevention practices.

Following our inspection, we requested further documentation from the provider to assure us that there were suitable systems in place to assess and monitor the quality of the services provided. The provider failed to provide the required information to us within the agreed timescales.

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 12 January 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We received concerns in relation to the management of medicines. 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, therefore we did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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

You can see what action we have asked the provider to take at the end of this full 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.

Cheriton Care Home is a residential care home providing personal and nursing care for up to 45 people aged 65 and over. At the time of the inspection there were 21 people using the service.

Cheriton Care Home supports people in one building and includes support for people living with dementia.

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

Risks to people were assessed and where risks were identified there were management plans in place. This included risks related to pressure damage.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 11 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 we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this targeted inspection to check the provider was now meeting Regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. 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 previous breaches of regulation. 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.

Cheriton Care Home is a residential care home providing personal and nursing care to 34 people aged 65 and over at the time of the inspection.

Cheriton Care Home accommodates up to 45 people across two floors. The service supports people living with dementia.

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

People and relatives felt people were safe at the service. However, we found risks were not always managed effectively to mitigate the risk of harm. Medicines were not always managed safely. Systems to monitor the quality and safety of the service were not always effective.

There were sufficient staff to meet people’s needs. People were supported by staff who understood their responsibilities to identify and report concerns of harm and abuse. There were effective systems in place to manage the risk of infection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There was a variety of meal choices and people’s dietary needs were met. Staff had the skills and knowledge to meet people’s needs. People were supported to access health services to enable them to live healthier lives.

People were treated with kindness and compassion. They were encouraged to maintain and improve their independence. Staff respected and valued people as individuals and ensured they were involved in all aspects of their care.

Staff knew people well and developed positive relationships with people. Whilst staff had a clear knowledge of people, care plans were not always person-centred. Relatives were made welcome at the service and staff understood the importance of supporting people to maintain and develop relationships. Complaints were resolved in line with the provider’s complaints policy.

The registered manager was open and approachable. There were systems in place to enable the provider to seek feedback from people, relatives and staff.

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 good (published 28 February 2018). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the lack of effective systems to ensure safe care and treatment and to monitor the quality of the service.

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.