Archived: The Chapel House Nursing Home

There was a registered manager in post who was present during the inspection. 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 2008 and associated Regulations about how the service is run.

At our last inspection on 26 and 27 August 2015 the service was rated as Good. At this inspection we found that the provider had further developed the service and was now Outstanding.

The service was extremely well-led. The provider and the registered manager were very passionate about their work and were committed to providing an excellent service for people and their relatives.

The provider used innovative ideas and demonstrated how they achieved outstanding practice to enhance people’s quality of life. They were proactive in their approach and always looked at ways they could improve the care and support they provided. They were keen to share their knowledge and experience with partner agencies to achieve better dementia care in the wider community and care sector. The introduction of the Namaste Programme had clearly had a positive impact on people’s lives.

The registered manager demonstrated a strong and supportive leadership style and had effective systems in place to monitor the quality and safety of the service. They actively sought and welcomed feedback from people, their relatives and staff alike to drive improvements in the service. Staff were impressed with the quality and variety of training available to them and felt very well supported. There was a real sense of teamwork that made the home an enjoyable place to work. Staff were proud to work at the home and felt valued.

There was an open and inclusive culture at the service. People, their relatives and healthcare professionals were consistently positive about how the home was run. They found the registered manager to be approachable and easy to talk with. Everyone without exception was very impressed with the warm and welcoming atmosphere created by the staff and management.

The provider proactively sought ways of engaging with the local community. They had recently opened a café within the grounds of the home much to the delight of people and their relatives. The provider worked in partnership with other organisations to ensure current practice and to share their experience and knowledge with the wider community.

People received individualised care that was tailored to their needs and preferences. Staff knew people very well and were able to recognise and respond to changes in their needs in a prompt and effective manner. Staff knew about people’s past lives, what was important to them and what they liked doing. They arranged activities that were meaningful and based on people’s past history, interests or hobbies. People’s care plans were detailed and promoted person centred care.

People were cared for by staff who were kind, compassionate and highly motivated. Staff had formed positive working relationships with people and their relatives and contributed to the continuous improvements in their care and support. People and their relatives were actively involved in decisions about their care and felt listened to. Staff consistently respected people’s privacy and dignity. People receiving end of life care, their relatives and people who were important to them were treated with exceptional care and compassion both prior to and following the person’s death,

People continued to receive care and support that protected them from ill treatment and abuse. People were supported safely by staff who were aware of the risks associated with their needs and knew how to minimise these. The provider followed safe recruitment procedures to ensure that staff they employed were suitable to work with people who lived at the home.

People received support to take their medicine as prescribed. Only staff who had received training in the safe management of medicines were able to administer them. The provider looked at ways of supporting people to reduce the use of medicine to manage their behaviours. People were supported to see other health care professional when needed to maintain good health.

There were enough staff available to meet people’s needs in a safe and person centred manner. The registered manager kept staff levels under review to ensure consistent and effective care.

Staff sought people’s consent before supporting them. Staff provided information to people in a way they could understand to enable them to make their own decisions. Where people were unable to make decisions these were made in their best interest by people who knew them well to protect their rights.

People were offered a choice of what they wanted to eat and drink. Where required people received support to eat their meals independently in a calm and dignified manner.

Further information is in the detailed findings below.

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We spoke with three people who used the service, three relatives, five staff and one visiting professional. People who used the service said: 'The staff are very kind', 'The food is good and plentiful' and 'The staff are lovely.'

Relatives commented: 'The home is clean and odour free', 'I am full of admiration in the home' and 'The staff are friendly and nice.' All the people spoken with said they didn't have any concerns or complaints.

Staff commented: 'The training is good', 'All the staff are nice and we help each other out' and 'I like working with the people. It is a happy and friendly place here.' All the staff said they got good support from the management team and the registered manager was good and very approachable.

The professional said: 'The home is clean', 'The staff are very helpful.' They said they had no issues or concerns with the home.

We looked at staff recruitment and found that robust recruitment procedures were in place.

We observed interactions between the people who used the service and staff and found there was a relaxed and friendly atmosphere between them.

During a tour of the home we found it was clean and odour free. People who used the service and relatives confirmed that the home was clean and odour free.

People who used the service said "The staff are lovely", "I like living here", "The food is good".

We spoke with three relatives and they commented "The staff are very caring", "My relative enjoys the food here", "The staff are very pleasant" and "The home is always clean". They all confirmed they had no concerns with the home. We also spoke with a local GP who commented "I think the staff here do a difficult job well. The nursing staff are competent and alert to any problems with the people who live at the home."

We looked at three care records and all had an assessment of their health and social needs completed. There were individual care plans and risk assessments in place. There was evidence to show they were evaluated on a regular basis. This meant the service could demonstrate they could meet people's needs and maintain their well being.

We found that the service had systems in place in relation to supervision and training. We spoke with three staff members who commented "The staff team are nice and helpful", "The manager is very good", "I like my job and helping people", "The staff work well as a team" and "We get good training".