Background to this inspection
Updated
14 September 2023
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, a medicines 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
Chorley House 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. Chorley House is a care home without 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 CQC 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
We gave the service 24 hours’ notice of the start of our inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us. Follow up inspection visits were unannounced.
Inspection activity started on 24 May and ended on 6 July 2023. We visited the location’s service on 8, 10 and 15 June 2023. We carried out further analysis of evidence sent to us by the provider during and after our visits to the service.
What we did before the inspection
We reviewed information we had received about the service 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 3 people and 3 relatives to understand their experience of the care and support provided. We spoke with 5 professionals who work with the service and 8 staff including the nominated individual, the registered manager and 6 support staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We made observations of support provided and how communication was tailored to people’s needs. We reviewed a range of records including 2 people’s care plans, daily records and medication records. We looked at 3 staff files in relation to recruitment, staff supervision, competency assessments and training. A variety of records relating to the management of the service including audits, policies and procedures were also reviewed.
Alongside our visits to the service, we used technology such as video calls to enable us to engage with staff, and electronic file sharing to enable us to review documentation.
Updated
14 September 2023
About the service
Chorley House is a small residential care home providing accommodation, personal or nursing care and support for up to 4 people with learning disabilities and/or autism. At the time of our inspection there were 4 people using the service.
Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support: People were supported extremely well by staff who had a strong understanding of how to promote their independence and provide the maximum choice possible. Staff supported people to achieve their goals and aspirations by providing support where needed and promoting and identifying people’s strengths. People enjoyed a fulfilled life with activities meaningful to them both within the service and while accessing their local community. They were able to personalise their rooms with personal items which were important to them. The support people received was adjusted to specifically meet their individual needs. The provider undertook robust compatibility assessments when considering new people coming into the service, how this would impact them and the people already living at the service.
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.
Right Care: People’s diverse needs were considered in all aspects of the service; this included care planning, risk assessing and the day to day support people received. Staff were guided on how to provide extremely individualised person-centred support with detailed care plans which provided clear guidance on people’s wishes. The provider worked in partnership with external professionals involved in people’s care and ensured decisions involved them, the people important to them and people who knew them well. Staff had a good understanding of how to support people safely and demonstrated their knowledge of safeguarding. Communication needs were identified as a priority. The provider and staff understood the importance of adjusting their approach to people’s preferred way of communicating. People received support to maintain a healthy diet while having their choices around meals respected; people decided when they wanted to eat and were able to choose from multiple options. People’s medicines were managed safely, and they were consulted on how they wished to take their medication; staff asked people if they wanted their medication and involved them by explaining what each medicine was for.
Right Culture: One of the key strengths of the service was the registered manager and the values they implemented within the service. People led inclusive, empowered lives. This was consistently driven by the registered manager and subsequently staff who felt they were supported well by the registered manager and provider. People were supported by staff who fully understood best practice in relation to promoting their strengths and offering support only where required. People were constantly supported to achieve their goals and develop their aspirations through innovative care and support. Quality of life was enhanced by a culture of consistent development, improvement and working in partnership with people, and those important to them including external professionals. Any concerns or complaints were managed professionally, transparently and with integrity.
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 good (13 September 2019).
Why we inspected
The inspection was prompted in part due to concerns received about the governance of the service, complaints and staff practice. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective, caring, responsive and well-led sections of this full report.
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 the service, which will help inform when we next inspect.