Archived: Chichester Hall Care Home

We found the following examples of good practice:

All staff and essential visitors used appropriate personal protective equipment (PPE).

The home had sufficient supplies of appropriate PPE which was stored hygienically and kept safe.

Staff were provided with separate areas to put on, take off and dispose of PPE safely.

Staff supported people's social and emotional wellbeing. Where people required additional support, they were referred to appropriate services.

The provider explained the quality systems they had in place to check the service was providing safe care.

Deep cleaning of all areas of the home was completed and recorded. The registered manager had identified areas of the home that required redecoration. The provider had arranged for redecorating to take place.

All staff, including catering and housekeeping staff had completed training in infection prevention and control. This included putting on and taking off PPE, hand hygiene and other Covid-19 related training.

The provider supported the well-being of their workforce.

Further information is in the detailed findings below.

We undertook this unannounced inspection on the 12 September 2018. We inspected the service against three of the five questions we ask about services: is the service well led? is the service effective? and is the service safe? This is because concerns had been raised that the service was not meeting some legal requirements. No risks, concerns or significant improvement were identified in the remaining Key Questions through our on-going monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.

This inspection took place on the !2 September 2018 and was unannounced.

Chichester Hall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Chichester Hall accommodates up to 20 people in a converted period property. At the time of our inspection 15 people were living there. The service is located in the seaside town of Silloth.

The service had a registered manager in post. 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.

Risk assessments and care plans were in place that correctly identified people's needs. The staff were able to demonstrate their knowledge of this whilst helping people to mobilise safely. The staff team told us they understood how to protect vulnerable adults from harm and abuse. Staff talked to us about how they would identify any issues and how they would report them. Medicines were managed appropriately and equipment was properly maintained and serviced.

Business continuity plans were in place and each person had a personal evacuation plan to help keep them safe in the event of a fire or flood. Any accidents or incidents had been reported to the Care Quality Commission as necessary. The home was clean and odour free.

People were supported to take adequate nutrition and hydration and told us the food was satisfactory. People were not unnecessarily deprived of their liberties.

Staff were well trained and people and their relatives told us they were competent and confident in supporting people correctly.

Quality assurance systems were in place. and the registered manager had clear ideas for the future of the service and shared their values with the staff.

There was a registered manager in place. 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 the last inspection the service was rated Good. At this inspection we found the service remained Good.

During the inspection visit we found staff were kind, patient and treated people with respect. This was confirmed by comments we received from professional health visitors, people who lived at the home and relatives. One relative said, “The staff are so caring and lovely.”

We found staff had been recruited safely, received ongoing training relevant to their role and were supported by the registered manager. They had skills, knowledge and experience required to support people in their care. Staffing levels were sufficient to meet the needs of people who lived at the home.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. Care records showed they were reviewed and any changes had been recorded.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices. Staff training records and discussion with staff members confirmed this.

Medication procedures observed protected people from unsafe management of their medicines. People received their medicines as prescribed and when needed. Records had been completed as required.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required.

We observed staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection. We found supplies were available around the building for staff to use when required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People who lived at the home told us the food was good and they had a choice. One person who lived at the home said, “As you can see, good food with fresh vegetables, that’s how I like it.” Another person said, “We have good cooks here so no complaints with the food.”

People told us staff treated them as individuals and delivered person centred care. Care plans seen confirmed the service promoted people’s independence and involved them in decision making about their care.

People who lived at the home told us they enjoyed a variety of activities and outside entertainers at the home. In addition singalong events took place daily and at lunchtime we observed people join in with songs by the staff members. A relative commented, “It is a lovely atmosphere.”

The registered manager about access to advocacy services should people require their guidance and support. The service had information details for people and their families if this was needed. ‘People first’ brochures were available this information ensured people’s interests would be represented and they could access appropriate services to act on their behalf if needed.

There was a complaints procedure which was made available to people on their admission to the home and their relatives. People we spoke with told us they were happy and had no complaints.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included regular audits, staff, relative and ‘resident’ meetings to seek their views about the service provided.

"This is my home now and I am happy here."

"We get very good care and we are quite happy here."

"It is all very good here...food, the care and I like my room."

We saw that people received good levels of personal and emotional care and support.

We looked at the nutritional planning in the service and we saw that people received good quality food and were helped to eat as well as possible. People told us that:

"The food is very good here and I enjoy all my meals...I like the home baking."

"It is all very nice, home cooked and plenty of choice."

We checked on the environment and we saw that the home was orderly, clean and homely. We judged that some aspects of the exterior needed some work and we asked the provider to consider dealing with these issues.

The service made sure they only recruited people who were suitable to care for vulnerable older people. There were measures in place to deal with any issues where staff were no longer suitable to work in the service.

We looked at a wide range of records held in the home and found that the records helped the service to run smoothly and gave staff good levels of information that helped them care for people properly.

We had evidence to show that people were happy with the care they received.

One person said:

"I don't just get physical help I get emotional support too. Staff are wonderful. I am told to ring the bell when I want anything because that's their job."

We read a number of written plans of care and these were detailed and focussed on the individual's needs and preferences.

We had evidence to show that care delivery was good. We spoke to health care professionals who were happy with how their patients were cared for. One person said:

"I like this home because here it is about quality of life not just about health care...I see patients getting good care and being happy."

We checked on medication kept in the home and found that this was well managed. Medication was ordered, stored, recorded and disposed of correctly. No one was given unnecessary medicines and people were given suitable pain relief and treatment for any medical condition.

The home was suitably staffed with experienced and trained staff. Staff were trained to diploma level in care.

The home had received no complaints and none of the people in residence had any concerns or complaints.

"I have never had a concern...never feel frightened and never had a need to complain."