Archived: Chesapeake House

Updated 28 February 2020

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.

Inspection team

This 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

Chesapeake House consists of two services types in two houses which have been adapted, to provide residential care. The main building 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.

This service also provides care and support to people living in four ‘supported living’ apartments, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. The apartments were located at the rear of the care home, accessed via the patio area.

The service had a manager registered with the Care Quality Commission. 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.

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. This included details about incidents the provider must notify us about. We sought feedback from the local authority, who raised concerns about the governance systems. 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.

During the inspection we spent time observing care and support in the communal areas. We observed how staff interacted with people who used the service. We spoke with seven people and one relative during the inspection site visit. This was to gain people's views about the care and to check that standards of care were being met. We spent time with the registered manager during the inspection site visit and spoke with the administrator and two support workers. We looked at the care records for two people. We checked that the care they received matched the information in their records. We looked at two staff files in relation to recruitment and staff training. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data. We sought the views of three support workers who we emailed on 15 January 2020.

Updated 28 February 2020

About the service

Chesapeake House is a residential care home, registered to support 11 adults, in an adapted building over two floors. The property is two houses converted which was registered before the

Registering the Right Principles were adopted. Chesapeake House is registered to provide accommodation for persons who require nursing or personal care, for adults with learning disabilities. Personal care was also provided for up to four people who were supported to live more independently in individual flats in supported living settings, which were located on the same site.

At the time of our inspection, 11 people were receiving residential care which included one person living in the individual flats on the same site. A further three people were living in the flats, not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. One person was in receipt of personal care when we visited.

The service had not fully been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people. However, the size of the service having a negative impact on people was not fully mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were was an identifying sign and industrial bin outside to indicate it was a care home.

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

The providers quality monitoring systems were not effective to monitor the quality of care provided and to drive improvement. The provider lacked oversight in reporting all incidents. Risk guidance to keep people safe was not always detailed to ensure staff knew what action to take should a person become unwell. Window restrictors were still not fitted to the windows on the second floor, to prevent accidents. People's safety was not protected by the provider's recruitment practices, as not all pre-employment checks were carried out. Support plans and risk assessments were not always in place to ensure people’s needs could be consistently met.

We recommend the provider assesses the environment both internally and externally to ensure there are no hazards for people with limited mobility.

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.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff received an induction, ongoing training and support to discuss their work and developmental needs. However, staff had not received training relevant to the needs of the people at the service.

People told us they felt safe at Chesapeake House. Staff understood their responsibility to safeguard people from harm and knew how to report concerns.

People were supported to maintain relationships with people important to them. Staff were caring in their approach and had good relationships with people. Staff treated people with respect and their dignity and privacy was respected. People were supported by staff to maintain their independence.

People were supported to maintain their health and well-being and had access to healthcare professionals such as GP's when required. People were supported to eat and drink enough to maintain a balanced diet.

Refreshments were available to people throughout the day. People and their representatives were involved in their care to enable them to receive support in their preferred way. People were supported to access local community facilities to enhance their well-being.

The provider's complaints policy and procedure was accessible to people who used the service and their representatives. Peoples representatives knew how to make a complaint. Relatives and staff felt they could approach the registered manager if they had any concerns.

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 11 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

During this inspection, we identified one breach of the Health and Social Care (Regulated Activities) 2014. This was in relation to the governance of the service. A breach of the Care Quality Commission (CQC) (Registration) Regulations 2009 was also identified relating to notifying CQC of incidents.

Please see the action we have told the provider to take at the end of this report.

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.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least Good. We will work with the 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.