Cheswardine Hall Nursing & Residential Home

Updated 28 August 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

Inspection team

The inspection was undertaken by two adult social care inspectors and two Experts 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

Cheswardine Hall Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (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 was an unannounced inspection.

What we did

Our planning considered information the provider sent us since the last inspection. We also considered information about incidents the provider must notify us about, such as abuse or other concerns. We obtained information from the local authority commissioners and other professionals who work with the service.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection, we spoke with 13 people living in the home and one family member to ask about their experience of care. We also spoke with the registered manager and nine members of staff. We received feedback from two visiting professionals and two commissioners of care at the home.

We looked at four people’s care records and a selection of other records including quality monitoring records, training records, staff records, and records of checks carried out on the premises and equipment.

Updated 28 August 2019

About the service:

Cheswardine Hall Nursing and Residential Home provides accommodation and nursing for up to 48 people in a large 19th century house. There were 31 people accommodated at the time of the inspection.

People’s experience of using this service

People told us they felt supported and listened to as individuals. However, the formal assessment and planning of people’s care in care records lacked detail in some instances with some important care needs omitted and not referenced. We made a recommendation regarding this.

We saw there were systems in place to monitor medication so that people received their medicines safely. All the people we reviewed had received their medications. We found some minor recording anomalies in the medication records and discussed improvements to help ensure continued safe standards.

The registered manager could evidence a series of quality assurance processes and audits carried out internally and externally by staff and visiting professionals. These were overall effective in managing the home and were based on getting feedback from the people living there. These checks and audits were mostly effective in identifying any issues that required further development. The managers of the home were very responsive in responding to feedback we gave.

Arrangements were in place for checking the environment to ensure it was safe. We found the environment safe and well maintained.

There was a positive and relaxed atmosphere in the home which we found to be homily and well run. People living in the home interacted freely and staff were seen to be caring and supportive.

We were given positive feedback from the people we spoke with who were living at Cheswardine Hall. They told us they enjoyed living at the home and their quality of life was good. People said they were well cared for. People were listened to and felt they had the support they needed to express their needs and wishes. People could make decisions and choices. They were treated with respect and kindness.

All the people we spoke with told us they felt safe and well supported. One person said, “I feel very safe because there are always staff that pop in to check on me and see how I am or if I want anything.”

The home was staffed appropriately and consistently. Staff could explain each person’s care needs and how they communicated these needs. People told us that staff had the skills and approach needed to ensure they were receiving the right care.

The staff we spoke with described how they would recognise abuse and the action they would take to ensure actual or potential harm was reported.

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. We discussed how best interest decisions, in some instances, could be better referenced.

We saw people’s dietary needs were managed with reference to individual needs and choice. Meal times provided a good social occasion.

Rating at last inspection:

The last rating for this service was Good (published 4 January 2017).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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