Archived: Chapel House

Updated 11 February 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 Care Act 2014.

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 two inspectors.

Service and service type

Chapel House 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.

The service did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with three people about their experience of the care provided. We spoke with seven members of staff including the provider, the manager and care workers.

We reviewed a range of records. This included two people’s care records and multiple medication records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

We had a meeting with the provider on 20 July 2021 to discuss the findings of the inspection so far and to inform the provider of actions we would be taking.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 11 February 2022

About the service

Chapel House is a residential care home providing accommodation and personal care for up to three children and young people with high levels of support needs linked to mental health conditions. At the time of the inspection three young people lived at the service.

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

Risks associated with people's behaviours were not managed safely. People who used the service and staff were placed at risk of harm. Opportunities to learn from incidents had been missed. People were subject to restrictive interventions that did not respect their rights. Not all staff had training in the safe management and administration of medicines

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support. The provider was not following proactive best practice models to reduce the need for restrictive interventions. We have made a recommendation that the provider refers to national and best practice guidance to reduce the use of restrictions and restraint.

There was a risk people may receive care and support from staff who did not have the necessary skills and competency to support them effectively. Staff did not always receive support and supervision. Further work was needed to ensure the environment met people's needs. People had enough to eat and drink and their physical health needs were met.

Peoples choices were not always respected. Changes in the staff team had a negative impact on the development of trusting relationships. People's right to privacy was not always respected. The approach to building people's independence was inconsistent.

We found systems and processes used to ensure the service was running safely were not effective. We observed a lack of leadership, direction and oversight.

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

Rating at last inspection

This service was registered with us on 11 September 2020 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about the care people were receiving. A decision was made for us to inspect and examine those risks. As a result, we undertook a comprehensive inspection.

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, effective, caring, responsive and well-led sections of this full report. We took immediate action to inform stakeholders and commissioner of the severity of our concerns and continue to work closely with them to evaluate and monitor the location.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant 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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment, safeguarding, staffing, need for consent, fit and proper persons and good governance at this inspection.

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

Special Measures

The overall rating for this service is ‘inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe, and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions 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.