Chaston House Care Home

Updated 28 June 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Chaston House Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Chaston House Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information and information gathered as part of monitoring activity that took place on 18 February 2022 to help plan the inspection and inform our judgements.

During the inspection

We spoke with three people who used the service and a visitor about their experience of the care provided. We spoke with two members of staff including the registered manager.

We reviewed a range of records. This included four people’s care records and all the medicines records. We looked at three staff files in relation to recruitment and staff supervision and a variety of records relating to the management of the service, including audits and safety checks were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at the staff rota, care plans and risk assessments, meeting minutes and quality assurance records. We received feedback by email from four care workers.

Updated 28 June 2022

About the service

Chaston House Care Home is a residential care home providing personal care for up to 11 people aged 65 and over. At the time of our inspection, there were six people using the service.

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

Although there were risk assessments and support plans in place, not all risks to people’s safety and wellbeing had been identified and mitigated. People told us they felt safe; however, the systems in place did not always protect people from avoidable harm.

Health and safety checks were irregular, and some had not been carried out for several months. There were discarded items piled up in two areas of the garden which posed a safety risk to people.

People’s medicines were not always managed safely and we found discrepancies which had not been identified by the provider’s audits.

People’s needs were assessed but records of assessments were basic and lacked information. Care plans did not always indicate people were consulted in relation to how they wanted their care and support and some people could not remember if they had participated in the planning of their care.

We saw people taking part in activities on the day of our inspection. However, there was no activity board or individual activity plans for people who used the service, so we could not be sure their needs in this area were being met.

The provider’s quality monitoring systems were not always effective as they had failed to identify the shortfalls we found during our inspection and had not always ensured people were safe.

People using the service were happy with the care they received. They told us staff were kind and listened to them. Feedback from external professionals was positive and indicated people’s needs were met. People had access to healthcare services when needed and the staff communicated well with healthcare professionals to meet people’s needs.

The home was clean and some improvements to the décor had taken place. Further improvements were planned. There were robust procedures for preventing and controlling infection, and the staff followed these.

There was enough suitable staff who were trained and supported so they knew how to care for people. The registered manager regularly assessed staff competencies and skills. Staff received regular supervision.

There were systems for identifying, investigating and responding to complaints, accidents, incidents and safeguarding alerts.

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.

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 inadequate (published 18 April 2020) and there were multiple breaches of regulation. The provider completed an action plan after that inspection to show what they would do and by when to improve. We undertook a focused inspection on 4 November 2020 and found improvements had been made and the provider was no longer in breach of regulation 12 but remained in breach of regulation 17. At that inspection, we did not inspect the key questions effective, caring and responsive so we were unable to check if the provider has met the breaches of regulations 9 and 10. The service has been rated requires improvement or inadequate for the last three consecutive inspections.

At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive 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.

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

Enforcement and Recommendations

We took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.