Background to this inspection
Updated
13 August 2021
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
This inspection was completed by two inspectors.
Service and service type
The Chimes Residential Home 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 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. However, we gave short notice of the inspection from outside the home. This was because we needed to know of the COVID-19 status in the home and discuss the infection, prevention and control measures in place prior to us entering.
What we did before inspection
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 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 and from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.
During the inspection
We spoke with four people who used the service and one relative about their experience of the care provided. We also spoke with one visiting health professional. We spoke with nine members of staff including care and domestic staff, the deputy manager, the registered manager and one of the directors.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at four staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found and requested further governance information from the provider.
Updated
13 August 2021
About the service
The Chimes Residential Home is a residential care home providing personal and nursing care to up to 44 people aged 65 and over. The home supports people living with dementia, mental health conditions, physical disability and sensory impairment.
People’s experience of using this service and what we found
We have identified areas where the provider needs to make improvements to ensure people are in receipt of good quality care.
People had not always been supported by staff who had been safely recruited. Staff recruitment checks were not always completed in a timely way and gaps in employment history were not always explored and documented. We have made a recommendation about recruitment processes.
The provider was not following current government guidance relating to infection, prevention and control for COVID-19. Staff and managers did not always follow current best practice to ensure cross infection was minimised at all times.
Improvement was needed in the provider’s governance systems to ensure they kept up to date with national government guidance. Records relating to the home’s environment needed to be organised so they were easily available and audit trails made clearer.
Visits had commenced following the changes in government guidelines and relatives were screened for symptoms of COVID-19 before visiting their family members. People and staff had access to COVID-19 testing.
The provider had made improvements since our previous inspection to ensure the monitoring of when people were repositioned was recorded. Risks to people were identified and plans were in place to help staff manage and help reduce the risks. Staff knew how to support people safely and were attentive to their needs. People received their medicine when they needed them. People were supported by sufficient numbers of staff and staff knew how to raise concerns in relation to people’s safety or abuse.
People and staff told us the registered manager was approachable and they were supported in their roles. The registered manager was aware of their duty of candour and worked in partnership with other organisations for the benefit of the people who lived at The Chimes Residential Home.
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 13 January 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.
Why we inspected
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 had received concerns in relation to the management of medicines, the cleanliness of the home and how the home was being managed. 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. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
We found no evidence during this inspection that people were at risk of harm from these concerns. However, we have found evidence the provider needs to make improvement in other areas. 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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Chimes Residential Home on our website at www.cqc.org.uk.
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 two breaches in relation to the provider’s governance of the home and infection control practices.
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.