Archived: Chalkney House

Updated 23 March 2015

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 planned to check whether the provider was 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.

This inspection took place on 11 November 2014 and was unannounced.

The inspection team consisted of two inspectors and a specialist advisor who was a registered nurse.

Before the inspection we reviewed the information we held about the service including recent inspections, complaints, safeguarding and comments from people who shared their experience with us. We also reviewed notifications received from the home. A notification is used by the home to tell us about events affecting the well-being and or safety of people using the service.

Before the inspection, we asked the provider to complete a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. They did not return a PIR and we took this into account when we made the judgements in this report.

We spoke with two night staff; three ancillary staff, three care staff, two senior care staff, the activities co-ordinator and the registered manager. We spoke with 13 people using the service, two relatives and observed the care provided to 15 people. We looked at seven care plans and other records such as medication records and audits around the safety and suitability of the service and in particular the management of falls.

During the inspection we used the Short Observational framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We carried out a SOFI observation during lunchtime.

Updated 23 March 2015

The inspection was carried out on the 11 November 2014 and was unannounced.

We last inspected this service in July 2014 to follow up on enforcement action we had commenced in May 2014 with regard to poor care and welfare of people using the service. During our inspection in July 2014, we noted the home had made some improvements but we still had some concerns. We followed these up as part of this inspection and the required improvements have been made.

Chalkney House provides accommodation for up to 47 people who require nursing or personal care. On the day of our inspection there were 36 people living at the home some of whom had dementia.

There was a registered manager in post. 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 and associated regulations about how the service is run.

CQC is required by law to monitor the operation of the Mental Capacity Act, 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions for themselves and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others.

The service was acting lawfully to support people around decisions about their care and welfare.

At this inspection we identified poor systems around the safe storage and administration of medicines. This meant we could not be assured that people received their medicines safely. ‘You can see what action we told the provider to take at the back of the full version of the report.’

The home was clean and in good decorative order. However we identified concerns with infection control practices which could increase the risk of acquired infections spreading from one person to the next.

There were sufficient staff to meet people’s needs because the manager showed us the staffing rotas which matched the number of staff working. Staff were attentive to people and met their needs in a timely, appropriate way.

Improvements were needed in the way the provider assessed staffs competency, and evaluated staff training to make sure it was effective. Training records were not up to date and for temporary staff there was no induction records so we were unable to see that all staff had sufficient experience or skills to perform their role.

Staff were kind and caring to people using the service and regularly engaged with people thus promoting their sense of well- being. People had sufficient to eat and drink for their needs and staff encouraged and supported people at mealtimes.

Records told us about people’s needs and how they should be cared for. However we found improvements with record keeping was required because they were not always up to date. Staff spoken with demonstrated a good knowledge about how to care and support people. People we spoke with said they were well cared for and we observed care being provided which was in line with people’s plan of care.

The manager was proactive in managing complaints and reporting any concerns about people’s well-being to the local authority. We saw this from their records and had spoken with staff from the Local Authority who told us the manager reported concerns as appropriate.

Improvements were required in the way the home was managed and the service delivered. Audits did not always identify deficiencies in the service delivery or clearly show what actions had been taken to address these shortfalls. This meant the auditing process was ineffective and we could not always see how the service addressed people’s views and needs.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.