Archived: Chesham House

Updated 19 March 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 19 January 2016 and was unannounced. The inspection was conducted by one inspector and a specialist advisor in the care of people with mental health needs.

Before the inspection we reviewed information we held about the home including previous inspection reports and notifications. A notification is information about important events which the service is required to send us by law.

We spoke with five people living at the home. We also spoke with the two regional support managers, registered manager and six care staff.

We looked at care plans and associated records for five people, additional records of care people had received, staff duty records, one recruitment file, accidents and incidents reports, policies and procedures and quality assurance records. We observed care and support being delivered in communal areas.

We previously inspected this service in January 2014 where no concerns were identified.

Updated 19 March 2016

This inspection took place on 19 January 2016. The home was given one days’ notice of our intention to inspect to ensure staff we needed to speak with would be available. The home provides accommodation and personal care for up to 10 younger adults with mental health needs. There were eight people living at the home and two people on day transition as part of moving into the home when we visited.

The home had a registered manager. 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.

Care plans and risk assessments did not all provide comprehensive information about how people should be cared for. Information was not always available about the outcome of health appointments or if these had occurred. Not all people received the support they required to ensure they had a varied and nutritious diet.

Information about how legislation designed to protect people’s legal rights should be applied for individual people was not always present. Staff were offering people choices and respecting their decisions appropriately.

The Deprivation of Liberty Safeguards (DoLS) were applied for appropriately but staff had not ensured they were aware of any specific requirements of one which had been approved. DoLS provides a process by which a person can be deprived of their liberty when they do not have the capacity to make certain decisions and there is no other way to look after the person safely.

Medicines were stored securely and administered safely. Individual ‘as required’ guidance were in use meaning there would be consistency in administration by different staff.

The recruitment process records showed all necessary pre-employment checks had been completed. There were enough staff to meet people’s needs and contingency arrangements were in place to ensure staffing levels remained safe. Staff received appropriate training and were supported through the use of one to one supervision and appraisal.

People felt safe and staff knew how to identify, prevent and report abuse. Plans were in place to deal with foreseeable emergencies. The home was well maintained with procedures in place to ensure this continued.

People were positive about the service they received. They praised the staff. A range of varied individual and small group mental and physical activities were offered with people able to choose to participate or not.

People were able to complain or raise issues on an informal basis with the registered manager and were confident these would be resolved. This contributed to an open culture within the home. Visitors were welcomed and staff worked well together which created a relaxed and happy atmosphere, which was reflected in people’s care.

The registered manager was aware of key strengths and areas for development of the service. Quality assurance systems were in place with regular contact by the provider’s senior management team and the registered manager with people and staff.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.