Chantry House Residential and Nursing Home

Updated 4 November 2022

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 Health and Social Care Act 2008.

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 carried out by an 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.

Service and service type

Chantry House Residential and Nursing home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Chantry House Residential and Nursing home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Inspection activity started on 5 October 2022 when we visited the home and ended on 14 October 2022 when detailed feedback was given.

What we did before the inspection

We reviewed information we had received about the home since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with five people who lived at Chantry House Residential and Nursing home to seek their views of their care and support. Not everyone who used the service were able to tell us about their experience of receiving the service, so observations of care and support were made. We spoke with two relatives and a healthcare professional when we visited the home. The Expert by Experience made telephone calls on 7 October 2022. They spoke with two people who lived in the home and with four relatives.

We spoke with the provider’s nominated individual, the clinical lead, an agency nurse, a senior carer, four care staff, administrator, head of housekeeping, maintenance person and two ancillary staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We received written feedback from five staff and four health and social care professionals involved with the home.

We reviewed the care records of three people who used the service and several medicines records. We also reviewed a range of records in relation to the governance and management of the service, including audits, policies and procedures, training information and the recruitment records of three staff members.

Updated 4 November 2022

About the service

Chantry House Residential and Nursing Home provides accommodation and personal care for up to 24 people. At the time of our inspection there were 22 people living in the home. The majority were being supported with their mental health needs and some were also living with varying levels of dementia.

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

We found concerns at our last inspection and rated the home requires improvement in four key questions and overall. We also found several breaches of the Health and Social Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found that progress had been made and the provider was no longer in breach of regulations. However, further improvements were still needed to fully embed a person centred approach in the home.

The culture in the home was task led and not always person centred. Emphasis was placed on meeting people's medical needs and associated risks and at times there were missed opportunities for meaningful engagement.

We were encouraged by the actions the provider was taking to address this but these had not been fully implemented. Therefore, we were unable to assess there effectiveness. We have made a recommendation that the provider considers current guidance and best practice to ensure care records are detailed, accurate and person centred.

People told us they felt safe and we observed they were at ease in the company of the staff that cared for them. Visitors could freely visit the service and were welcomed.

People were protected from the risk of potential harm; safeguarding policies and processes were in place and staff had received appropriate training.

Staff were recruited safely. There was mixed feedback about staffing levels and the use of agency staff. On the day of our visit there were sufficient staff to meet people’s needs. However, we have made a recommendation about staffing arrangement in the home.

Risks to people were regularly assessed with measures in place to mitigate them. This included timely referrals to healthcare services.

Staff were kind, caring and treated people well. They supported people in a discreet and dignified way which maintained people's privacy and independence. 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

The home was clean and hygienic with good infection control procedures carried out. Staff wore appropriate personal protective equipment (PPE). Safe management of medicines was in place.

There was clear leadership in the home. Governance systems supported the provider and management team to identify shortfalls in the home and address them. Processes were in place to learn lessons when things had gone wrong with actions taken to reduce future incidents happening.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 5 May 2019) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of the regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.