Archived: Chelmsford Nursing Home

Updated 6 July 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was a focused inspection to check 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.

Focused inspections evaluate the quality and safety of particular aspects of care. They take place when we are following up after a comprehensive inspection, or when we have received concerns and have decided to look into them without doing a comprehensive inspection of all aspects of the service. They only ask the relevant key question(s), rather than all of them.

This focused inspection took place on the 22 March 2016 and was unannounced. We carried out this inspection due to concerns that had been raised through our national customer support centre (NCSC). We inspected under the key questions of ‘safe’ and ‘well-led’.

The inspection team consisted of two inspectors and one specialist advisor who specialises in nursing care.

Before the inspection, we reviewed all the information we held on the service. We spoke to local commissioners and the quality improvement team at Essex County Council.

During the inspection, we spoke to 10 people using the service, and six relatives. We interviewed 10 members of staff, including three qualified nurses and the deputy manager. We pathway tracked 14 peoples individual care, reviewed five bedroom daily documentation charts on the nursing unit and carried out care observations between staff and people at the service.

Updated 6 July 2016

Chelmsford Nursing Home provides accommodation, personal and nursing care for up to 64 people, some of whom were living with dementia. There are external and internal communal areas for people and their visitors to use and the service is split over two floors. Nursing care, including palliative care is carried out on the first floor and people living with dementia reside on the ground floor of the home.

This unannounced focused inspection was undertaken on 22nd March 2016. There were 59 people receiving care at the time of inspection.

The provider had received their first ratings inspection at this location in December 2015 and the service was found to be good in all key areas. However, since the previous inspection we had received intelligence that care practices had become unsafe. The registered manager had been dismissed and the service no longer had a registered manager in position.

There had been a number of changes at the service since their last inspection. The provider had also recently changed. We found that staff morale was low and that staff felt they did not have the right amount of safe and skilled staff to care for people in an individualised way. The service relied heavily on the use of agency staff who were often deployed to manage highly complex people's needs, often isolated away from regular staff. There had been some safeguarding incidents regarding agency staff and people at the service, however, managers had not assured themselves that agency staff had the appropriate skills.

The service had not learnt from incidents of falls, challenging behaviour and recent safeguarding, and reactively managed risk rather than identifying and managing common themes. There was a lack of strong leadership at the service and the deputy manager was covering the manager position as well as their own. However, on the day of our inspection a new manager had started at the service and had made the appropriate notification’s to register with the Care Quality Commission. 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’.

The management team failed to monitor, assess, and take action to make any changes to improve the service based on feedback and incidents.

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.

You can see what action we told the provider to take at the back of the full version of the report.