Archived: Chilterns Manor

We returned to the service on 25 July 2014. This was after the date the provider told us all actions to improve the service would be completed.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to check that the service had made improvements to become safe and well-led.

This is a summary of what we found -

Is the service safe?

We found Chilterns Manor provided a safe service. People were now cared for in a clean, hygienic environment. We saw new cleaning schedules were in place. These had been completed each day by housekeeping staff, to show which parts of the home they cleaned. A senior member of staff countersigned the record each day, after they checked the work had been completed. This ensured appropriate standards of cleanliness were maintained at the home.

There was improvement to storage of mops. These were now stored upright, out of the buckets, to ensure they dried between use. This followed good practice guidance on infection control.

We found the provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. We saw carpet had been replaced on a stairway where there had been a worn patch. This removed the trip hazard we found previously.

We saw flammable and combustible materials had been removed from the area behind the laundry room. These were now stored away from the main building, where they were less likely to be a fire hazard. We also found the ceiling in a cleaning cupboard had been repaired.

The provider may find it useful to note there was still a risk of people being injured in the downstairs bathroom. This was due to the position of stopcocks adjacent to the toilet. There was a risk of people injuring themselves if the stopcocks remained uncovered.

Is the service well-led?

We found Chilterns Manor provided a well-led service. People who used the service and their representatives were asked for their views about their care. For example, quality assurance questionnaires were sent out annually and following respite care stays. Monthly feedback surveys were also distributed to people who used the service.

We saw accidents and incidents were properly recorded at the home. A falls register was maintained and there was an accident analysis form to highlight if any patterns were evident. Action was taken to reduce further falls, where possible.

Staff meetings were held regularly at the home. We read minutes of six meetings held this year. These showed, for example, staff were informed of the findings of our last visit and the improvements that were needed at the home.

The provider had an effective system to regularly assess and monitor the quality of service that people received. For example, various audits were carried out at the home each month. These included sampling care plans to ensure they met expected standards, checking medication practice and catering audits. The manager or another senior completed a monthly quality assurance report. This looked at several areas of practice such as whether there had been any complaints, hospital admissions, falls or accidents and provided an overview of significant events at the home.

We spoke with people who lived there and they told us they were happy and well cared for. Two people told us there were few activities, but added they were happy to sit and chat with their friends. They said the food was home cooked and they enjoyed it.

People told us they felt safe and that if they had any concerns, they knew how to raise them.

We toured the building and noted some areas were dirty and that there was an unpleasant odour upstairs. One room we entered had faeces and urine on the carpet. Another room was substantially malodorous with faeces on tissues on the floor.

We reviewed the medications policy and practice. There had recently been one error, but this was dealt with quickly and appropriately.

On our inspection of the building we noted some areas that required attention to make them safer for the people who lived and worked there.

We examined the staffing rosters and discussed staffing with the Manager.

We looked at the quality assurance of the service; we found that issues of concern were not always followed up in a timely manner.

We observed social and care interactions between staff and people using the service. For example, one person had chosen to stay in her room because she felt a little sad that day. Staff used appropriate conversation and gentle touch which the person responded to positively. This demonstrated that staff were able to effectively manage different behavioural situations.

People told us they had helped to devise new menu plans, the food was good and the portions plentiful. We heard positive comments about the lunchtime meal. One person said they loved the fish pie, and another person told us they looked forward to the Sunday roast.

We heard that people who use the service liked the home because it was clean and attractive, and one person praised the in-house laundry for its' efficiency in returning their clothes quickly.

People told us the staff were efficient and friendly. One relative described the staff as " helpful and pleasant". They told us they were "sure they had made the right decision" in choosing Chilterns Manor, and said how good the care was. They also described the manager as "efficient and kind".