About the service Cheney house provides residential care for up to 34 older people, including people living with dementia. There were 24 people receiving care at the time of the inspection.
Cheney house is set out over 2 floors with a communal lounge and dining room.
People’s experience of using this service and what we found
People were not always safeguarded from the risk of abuse. Unexplained bruises had not always been investigated and checks to ensure people’s safety had not been recorded.
Risks to people had not been consistently assessed. Not all known risks had appropriate strategies in place to mitigate them. Staff had not recorded the actions taken to reduce the risks to people’s skin integrity.
Records required improvement. We found gaps in the recording of peoples care needs, handover information and behaviour charts.
Staffing levels required reassessing. The tool used by the provider to calculate staffing levels showed that on average the service was running 41% of staff hours below the assessed amount.
The provider and registered manager lacked oversight of the service. Audits completed did not identify the issues found on inspection, and audits had not been completed regarding the recording of people's care needs.
People and relatives told us they felt the staff team worked well and that staff knew people and interacted well with them. The registered manager and staff supported communication between people and their families throughout the pandemic.
People received their medicines as prescribed by staff who had received the appropriate training and support.
People were protected against infection. Staff wore appropriate personal protective equipment [PPE] and the home appeared clean.
People, staff and relatives were encouraged to feedback on the service and make suggestions to improve. Staff felt supported by the registered manager and felt their views were valued.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 05 December 2018).
Why we inspected
We received concerns in relation to people’s dignity not being respected, staffing concerns, medicine administration and the safety of people living at Cheney House. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
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 coronavirus and other infection outbreaks effectively.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cheney House on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.
We have identified breaches in relation to staffing, safe care and treatment, protecting people from abuse and oversight of the service at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.