Archived: Chaseview Care Home

We last inspected the home on 11, 12, 14 and 15 May 2015. We carried out this unannounced focussed inspection on 9 February 2016 due to concerns raised by the local authority around the safety and effectiveness of the service provided. This inspection was carried out to check there were adequate numbers of nurses employed, appropriate building maintenance systems were in place, people were offered adequate amounts of food and drink to meet nutritional and hydration needs and the provider was working with the legal requirements of the Mental Capacity Act (2005).

There was a registered manager at this home. 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.

At this inspection, we found there was enough nursing staff employed and the provider was in the process of recruiting a nurse to fill the vacancy they had. The home had systems in place to maintain the environment and there were plans to carry out a full refurbishment of the bathrooms this year. People had risk assessments carried out to minimise risks associated with their care. There were enough staff to care for people safely. The registered manager had a daily meeting with staff in the home to ensure they were kept up-to-date with any concerns.

We found that staff had received relevant training and provided the service to people within the legal requirements of the Mental Capacity Act (2005). There were systems in place to ensure people who were at risk of malnutrition or dehydration were monitored and staff had received training in nutrition and hydration. Records showed that people had access to healthcare professionals as required.

We considered our inspection findings to answer 5 key questions we always ask:

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Is the service safe?

Staff were up to date with their health and safety training including fire safety and food hygiene. We found that some staff needed refresher training in moving and handling and were booked onto courses for this during August 2014. However we found there were a number of issues with medicines management which included unclear administration guidelines. We found from an audit check conducted by the contractor on 27/09/2013 and by the home on 28/07/2014 that some bed rail bumpers posed a health and safety risk because they were not using the correct types.

Is the service effective?

People's needs were assessed and reviewed every month. Staff we spoke with understood what people's care needs were. Staff had received training in nutrition and hydration which meant they were qualified to support people at risk of malnutrition or dehydration and this training was up to date. Records were kept of fluid and food intake for people who were at risk of dehydration and malnutrition. People were given choices of food to eat and could choose an alternative not listed on the menu, if they preferred. A family member told us that her relative 'was receiving excellent care here.'

Is the service caring?

Staff were observed to speak to people in a kind and caring way. For example, we observed one member of staff serving a person a meal and asking if they would like their fish cut up today or if they felt able to manage. We spoke with people and family members who generally thought staff were caring. Their comments included, 'staff are caring and kind', 'staff are good, they care for me' and 'very good care.' We observed staff chatting to people and being attentive to their needs.

Is the service responsive?

One family member told us their relative was 'settled and happy, well looked after' and 'when she was poorly they sent her to hospital.' We spoke with the GP who told us he thought the service was responsive and he 'felt confident that anything that arose would be addressed.' One person told us 'If I'm not happy about something I tell the staff and they reply quickly.' Staff we spoke with were able to tell us what they would do if they found a piece of equipment was faulty or not working.

Is the service well-led?

There were several quality assurance systems in place including staff meetings and head of department meetings. The provider had a system to collect the views of people who use the service and the views of family members through a quality assurance survey. We saw evidence that the provider collated the responses and used these to improve the service.

We found that people were supported to have adequate nutrition and hydration. They were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and reduce the risk of abuse from happening. Adequate systems were in place to assess and monitor the quality of service provision.

We found that medications were stored securely, and we observed them been administered in line with the services procedures. We had some concerns with the recording of as required (PRN) medications. People told us there were enough staff to meet their needs. One person said 'there's always someone here when you need them.' We observed staff to have time to carry out their duties, and to be ale to meet people's needs. People told us they knew how to make a complaint, and we found the service had a complaints procedure in place.