Background to this inspection
Updated
10 January 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
On the first day the inspection team consisted of 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. On the second day a single inspector returned to complete the inspection.
Service and service type
Welcome House - The Chestnuts is a care home registered to provide accommodation and personal care for up to 15 people with mental health needs who do not require nursing 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.
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 looked at all the information we held about the service. This information included important events or incidents that the service had notified the Care Quality Commission. A notification is information about important events that the service is required to send us by law. 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 also contacted the commissioners and the local authority safeguarding team for their feedback about the service. We used all of this information to plan our inspection.
During the inspection
We spoke with the registered manager, two staff members, and three people who used the service to seek their views about the service. We looked at three people’s care records, three staff records, and records related to the management of the service, such as accidents and incidents, medicines management, safeguarding, audits, and policies and procedures.
Updated
10 January 2020
About the service:
Welcome house – The Chestnuts is a care home which provides accommodation and personal care for up to 15 people with mental health needs. At the time of our inspection, eight people lived in the home. They were fairly independent therefore required minimal support with their personal care needs.
People’s experience of using this service:
The provider failed to always assess and mitigate risks to the health and safety of people. The provider had not always completed incidents and accidents records. The systems and processes to assess, monitor and improve the quality and safety of the service were not wholly effective.
We have made two recommendations about accessible communication and relevant activities for people.
People gave us positive feedback about their safety and told us that staff treated them well. Staff administered prescribed medicines to people safely and protected people from the risk of infection. The provider carried out comprehensive background checks of staff before they started work. The provider had a system to manage accidents and incidents.
Staff received support through training, supervision and appraisal to ensure they could meet people’s needs. Staff told us they felt supported and could approach the registered manager at any time for support. The registered manager worked within the principles of Mental Capacity Act (MCA). Staff asked for people’s consent, where they had the capacity to consent to their care. 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 assessment of people’s needs had been completed to ensure these could be met by staff. The registered manager worked with other external professionals to ensure people were supported to maintain good health. People were involved in making decisions about their care and support. People were treated with dignity, their privacy was respected, and supported to be as independent in their care as possible.
Staff showed an understanding of equality and diversity. Staff respected people’s choices and preferences. People knew how to make a complaint. The registered manager knew if someone required end of life care.
There was a management structure at the service. Staff were aware of the roles of the management team. They told us the registered manager was approachable. People and their relatives commented positively about staff and the registered manager. The registered manager had worked in partnership with a range of professionals.
Rating at last inspection and update
The last rating for this service was good (published 23 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to risk assessment and their management and effective quality assurance systems at this inspection.
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 from 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.