Chorleywood Beaumont DCA

Not everyone using Chorleywood Beaumont DCA receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided

People’s experience of using this service:

Medicines were not managed safely. There was a lack of oversight of medicines management, and we could not be assured that people were receiving their medicines as prescribed.

There was a lack of oversight by both the provider and registered manager. The divisional clinical lead nurse from the provider was present at the inspection and told us that because the service was not providing nursing care, there were no audits of people’s medicines routinely completed by the provider.

People told us they sometimes had to wait to receive support. The registered manager had not looked into why people sometimes had to wait. We have made a recommendation regarding monitoring the time people had to wait to receive support.

The registered manager told us that accidents and incidents which occurred when staff were not present were not routinely recorded. There was a risk that trends and patterns may not be identified, and ways of reducing the chances of them happening again may not be implemented. We have made a recommendation regarding the monitoring of accidents and incidents.

Some of the issues regarding analysis of accidents and incidents and separating out records relating to the DCA and the nursing home also managed by the registered manager had been identified, although not yet addressed.

The registered manager did not routinely audit and check people’s daily notes, and a recent compliance audit by the provider had failed to identify the issues we found regarding people’s medicines.

People told us that they had built up strong relationships with staff and were treated with respect and dignity.

People were supported to eat meals and attend activities run by the nursing home, on the same site as their flats.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff told us they felt supported by the registered manager and received the regular supervision and appropriate training to complete their roles effectively.

People told us that they thought the registered manager was approachable and people knew how to complain if necessary.

Rating at last inspection: At the last inspection the service was rated Good. (Report published 7 July 2016)

Why we inspected: This was a planned inspection based on the previous rating of the service.

Follow up: Please see the ‘action we have told the provider to take’ section towards the end of the report. We will ask the provider to send us an action plan regarding how they are going to improve and continue to monitor the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

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The service provides personal care and support to people who lived in their own flats within the grounds of the care home. On the day of the inspection there were 14 people being supported by the service.

The service had 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 2008 and associated Regulations about how the service is run.

There were risk assessments in place that gave guidance to staff on how risks to people could be minimised. There were systems in place to safeguard people from risks of possible harm and suitable equipment was in place so that people were supported safely.

The provider had effective recruitment processes in place and there were sufficient numbers of staff to support people safely. Staff received supervision and support, and had been trained to meet people’s individual needs.

Staff understood their roles and responsibilities to seek people’s consent prior to care being provided. Where people did not have capacity to makes decisions or consent to their care, this had been provided in line with the requirements of the Mental Capacity Act 2005 (MCA).

People were supported by caring and respectful staff. They were supported to access other health and social care services when required to maintain their health and wellbeing.

People’s needs had been assessed and they had care plans that took account of their individual needs, preferences, and choices.

The provider had a formal process for handling complaints and concerns. They encouraged feedback from people so that they could use their comments to improve the quality of the service. People’s comments suggested that they were happy with the service they received.

The provider had effective quality monitoring processes in place and these had been used effectively to drive continuous improvements.

Records pertaining to people's care and support were not always updated and appropriately maintained.

We looked at five outcomes and found that they were all met. Staff consulted people on all aspects of their care prior to delivering it this ensured people had their needs met. Records were kept appropriately and all the people told us that they felt safe.

People referred to the staff as being wonderful and very kind and caring.