Chadwell House Residential Care Home

Chadwell House Residential Care Home is a care home providing personal and nursing care to up to 60 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 56 people using the services. The accommodation was arranged across 6 separate units. Most bedrooms have en-suite facilities. There is a large communal lounge and a garden.

People’s experience of using this service and what we found

Systems were in place to protect people from the risk of abuse. Risk assessments had been carried out to identify the risks people faced. These included information about how to mitigate those risks. Steps had been taken to help ensure the physical environment was safe.

The service had enough appropriately skilled staff to meet people's needs and keep them safe. People and relatives were happy with staffing levels. The provider had a safe staff recruitment process in place. Staff understood how to protect and safeguard people.

People received their prescribed medicines in a safe way. The service uses electronic Medicines Administration Records (MAR) to record all administrations. Regular medicine audits were taking place. Infection control and prevention systems were in place. Accidents and incidents were reviewed to see if any lessons could be learnt from them.

The service had a complaints policy in place and staff were aware of how to support people should they wish to complain. The manager of the service was approachable and open, staff and people in their care felt supported.

Quality assurance and monitoring systems were in place to help drive improvements at the service. Relatives and staff told us there was an open and positive culture at the service. People were supported to express their views. The provider was aware of their legal obligations and worked with other agencies to develop best practice and share knowledge.

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 Chadwell House Residential Care Home was good (published 06 November 2018).

Why we inspected

We undertook a focused inspection to review the key questions of Safe and Well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Chadwell House Residential Care Home on our website at www.cqc.org.uk.

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.

Follow up

We will continue to monitor information we receive about Chadwell House Residential Care Home, which will help inform when we next inspect.

At the last inspection in February 2016 the service was rated Good. At this inspection we found the service remained Good.

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.

The registered manager had various policies, procedures and practices in place, which made people feel safe. Staff had attended various training such as adult safeguarding and knew what to do if they had concerns about people's wellbeing.

The staff recruitment process ensured new staff were appropriately checked, had the necessary skills and experience, and were safe to support people who used the service. The registered manager kept the staffing level under review to ensure there were enough skilled staff to meet people's needs.

People received their medicines safely, as prescribed by their doctors. Care staff worked with local services to make sure people's health care needs were met in the service.

There were systems in place to ensure people were protected from the spread of infections.

Staff had regular supervision, training in key areas and felt supported by their line managers and the registered manager.

The service provided varied and nutritious meals that reflected people's medical, cultural and religious preferences.

People benefitted from a variety of activities in and outside the service.

The registered manager worked well with local organisations such as the health and social care services to make sure people received care and support that met their needs.

Staff sought people's consent before providing care and support. The registered manager understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were not deprived of their liberty unlawfully.

People and their relatives told us staff were kind, caring and treated them with respect. Staff told us they enjoyed working at the service and we observed they showed a caring attitude to people.

Each person had a care plan which was based on their assessed needs and provided guidance for staff on how to support them. The care plans were reviewed to ensure any changes to people's needs were identified and staff responded to them.

Staff ensured people's privacy whilst promoting their independence when supporting them with personal care.

Staff had good relationships with people and their relatives. They knew the needs of each person they supported.

The registered manager and staff supported people at the end of their life to have a comfortable, dignified and pain-free death.

The registered manager recorded, investigated and responded to any complaints they received. People enjoyed a range of activities.

People, their relatives and staff told us they felt the service was well-managed. Survey questionnaires were used to encourage people, their relatives and staff to give feedback about the quality of the service. There were various auditing systems in place to monitor the quality of various aspects of the service and to make improvements.

Chadwell House is a purpose built care home for 60 people living with dementia. It is spread over six units housing 10 people on each unit on the ground and first floors. The units are all named after authors whose names are easily recognised by people living at Chadwell House.

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.

People, relatives and staff were complimentary about the management team and described them as approachable. There was an open and inclusive culture and an effort was made to ensure that people and their relatives were involved in care planning and activities that went on within the service.

Care delivered was responsive and bespoke to people’s needs. Care plans were comprehensive and contained in depth life histories which were used by staff to actively engage with people. They lay out of the home was conducive and felt homely as it was broken off into six separate units of ten where people lived in communities based on their preferences and interests.

Activities were ongoing throughout the day and were based on people’s personal preferences. Regular outings, birthday celebrations and outdoor activities occurred to keep people occupied and engaged. Investment was made to ensure people were kept as active and as independents as possible.

Staff underwent a comprehensive training and induction program. They were supported by regular supervision and annual appraisal. Staff we spoke with demonstrated a good understanding of the Mental Capacity Act 2005 and how it applied in practice.

People told us that they were treated with dignity and respect and that they felt safe living at Chadwell House.

Staff were aware of what abuse meant and how to safeguard people from preventable harm. Appropriate risk assessments and safety checks for people and the environment were completed to ensure people’s safety. There were aware of the procedures to follow in an emergency in order to prevent harm.

There were robust recruitment practices to ensure that only staff that had gone through the appropriate checks and had the appropriate qualifications and experience were employed. Staffing was based on people’s dependency and both staff and people told us that any absences were filled by other staff.

People were supported to eat and drink sufficient amounts of food according to their preferences. Where needed people were referred to appropriate health care professionals in order to maintain a healthy lifestyle. In addition people were supported to take their medicines at the right time by staff that had been trained and assessed as competent to administer medicine safely.

We found that medicines were safely administered by staff who were trained and competent to carry out this task. The service had appropriate staff recruitment procedures in place. People told us that they felt safe with the staff and they would raise any complaints or concerns with the manager or their relative. Appropriate records were maintained by the home to ensure that people received safe care and treatment.

People told us that the staff are very friendly and caring, and that the environment was homely, comfortable and welcoming. Staff told us that they were proud to work at Chadwell House. People received personalised care and support which reflected to their individual choices.