Chatterwood Nursing Home

Updated 30 October 2020

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 Care Act 2014.

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 two inspectors 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

Chatterwood Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission at the time of the inspection. This means the provider is legally responsible for how the service is run and for the quality and safety of the care provided. A new manager had been appointed and started in this role on the day of our inspection.

Notice of inspection

Inspection activity started on 1 September 2020 and involved reviewing records, seeking feedback from relatives, staff and other health and social care professionals.

We gave the service 30 minutes notice of the inspection visit as we needed to be sure the inspection could be undertaken safely.

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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We reviewed care records for eight people, all staff training records and three staff recruitment records, policies and procedures and governance records. We also spoke with four staff members, three people who use the service and nine people’s relatives by phone. We used all this information to plan our inspection.

During the inspection

We spoke with five members of staff, the provider and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spent time observing the support and interactions between people and staff. We also reviewed the environment and equipment in place. We reviewed a range of records. This included people’s daily care records and multiple medication records.

After the inspection

We spoke with the nominated individual, a training provider and the deputy manager by phone as we continued to seek clarification to validate evidence found.

Updated 30 October 2020

About the service

Chatterwood Nursing Home is a residential care home providing personal and nursing care to 18 people aged 65 and over at the time of the inspection. The service can support up to 37 people. Chatterwood Nursing Home accommodates people over two floors in single or double rooms, the majority of which have ensuite facilities.

People’s experience of using this service and what we found

People and relatives told us the service provided safe care. However, the reporting of incidents including those which could indicate abuse required improvement. We found not all incidents were identified or investigated to ensure people were safe and used to inform learning and improvements. The recording of incidents where people had been supported in their ‘best interests’ when they were resistant to care did not always explain how staff had provided this support. We have made a recommendation about this.

The system in place to monitor the safety and quality of the service had not identified the incidents we found. The provider acted to address this. Incident reporting needed to be more robust to ensure the provider could always meet their responsibilities under the duty of candour. The provider had started to collect feedback from people, relatives and other professionals at the time of our inspection. Relatives told us they did not always feel involved in the service and the provider is acting to address this.

Staff reported the culture in the service had improved since the previous inspection and all those we spoke with told us the home was a ‘happy’ place to work. People told us they were happy living at Chatterwood and feedback on the internet showed the home had received many positive comments.

Risks to people had been assessed and plans were in place and implemented to minimise these. People had achieved positive outcomes as a result. Staff were safely recruited and there were enough staff to meet people needs. Peoples medicines were managed safely, and we were assured the procedures in place to promote safety and prevent the spread of infection were being implemented.

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. Staff completed an induction and training in their role. People had been effectively supported to reduce risks to them from poor nutrition and hydration. People’s oral health care was assessed but actions taken to support people who refused oral health care were not always clear. We have made a recommendation about this. People’s healthcare needs were met by health professionals in the service and in the community. The environment was in good decorative order with adaptations to meet people’s needs. Some signage could be improved.

People and relatives spoke positively about the caring approach of staff. Staff told us the improvement in the culture of the home had impacted positively on teamwork and the care people received. Staff understood how to promote people’s dignity when delivering care.

Peoples care plans reflected their current needs and were person centred. Relatives told us they were not involved in care planning although they were informed of concerns or incidents. The provider told us it had been difficult to involve people meaningfully during the covid 19 pandemic and they planned to improve this going forward. Relatives had praised the home for the quality of the care shown to their relatives at the end of their life.

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 Inadequate ( published 22 October 2019) and there were multiple breaches of regulation. We placed conditions on the provider’s registration requiring them to undertake certain activities and audits and to report to us on a monthly basis and placed the service in special measures. The provider sent us an action plan to show what they would do and by when to improve. At this inspection we found the provider was still in breach of one regulation.

This service has been in Special Measures since 01/08/2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. 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.

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.