Victoria Chartwell

Victoria Chartwell is a residential care home providing personal and nursing care to 22 people aged 65 and over at the time of the inspection. It consists of a three storey building with an accessible enclosed garden. The service can support up to 22 people.

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

People at the service were safe and told us they felt safe. The provider followed safe recruitment procedures and staff were well trained. There were enough staff to give people the safe care they needed. The home was clean and uncluttered and risk assessments were carried out. The kitchen had a good food hygiene rating. Medicines were managed safely and regularly audited by a pharmacist.

People had pre-assessments before arriving at the home and had their care regularly reviewed. Staff were well trained in subjects relevant to their roles and to the people at the home. People could personalise their rooms in any way they wished people brought pictures and furniture in o the home to make it feel familiar. The chef cooked fresh food daily which people enjoyed. A person told us, “He’s a very good chef, if there’s anything you don’t like he manages to conjure up something different.”

People were well treated by polite and caring staff who were cheerful and friendly. A person told us, “We have great respect for each other.” People were involved in decisions about their care. People were able to welcome visitors at any time and were encouraged to remain active.

People took part in numerous activities organised by an activities coordinator. Activities were designed with people at the home in mind to ensure they were accessible to all. A person told us, “The activities girl is amazing, I don’t know where she gets her ideas from, there is always so much to do.” Staff helped people to keep in contact with the wider community. Complaints were dealt with promptly and the management staff were keen to be seen as approachable at all times.

There was no registered manager at the time of the inspection. However the staff were supported by a care quality manager, the provider and the wider management team of the Victoria Nursing Group. Staff told us they felt well supported. The service worked with outside agencies and specialist healthcare providers. A visiting healthcare professional told us, “The residents all seem really happy, the staff actively look out for the patients.”

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.

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 24 January 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Victoria Chartwell is a nursing home registered for up to 22 people. It provides nursing care and personal support to older people with nursing care needs usually over sixty-five years of age. There were 19 people living at the service. The service is in a large detached house, arranged over three floors accessed by a passenger lift. The ground and first floor was used to provide people with nursing care, support and treatment. Long term care and respite care was provided. At the time of the inspection a contract was in place to provide six community short term beds (CSTS.) This is where people have been in hospital, or to prevent hospital admission and need a short period of rehabilitation before returning home.

This short-term rehabilitation is a joint partnership between Brighton and Hove City Council and the Sussex Community NHS Trust who work together to provide co-ordinated care. People have the guidance and regular support from the physiotherapists, occupational therapists, consultants for elderly care, GPs and a community mental health nurse. These specialists had worked with people to improve their independence and mobility prior to returning home.

There was a registered manager for the service. 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.

Senior staff carried out a range of internal audits, including care planning, checks that people were receiving the care they needed, medication, and infection control. However, we examined fluid charts and saw that care staff were offering fluids to people at risk of dehydration hourly, but there was no record on the amount of fluids to be given in a 24 hour period. Charts were not totalled to give care staff information on the level of fluids people had had during the day. We spoke with the care staff who demonstrated a good awareness of the fluids which had been provided, but the recording did not fully support this. Regular fire and health and safety checks of the building had not been completed in line with the provider’s policy and procedure. Residents meetings had not been regularly held to enable them to give their views on the care and support provided. Although there were opportunities for people to give feedback using the Choices NHS website, questionnaires had not been used to gain feedback in the service. Therefore people had limited opportunities to formally give their feedback, and for the staff to demonstrate how the service has moved forward and made improvements following feedback received. These are areas of practice which require improvement.

People told us they felt safe. One person told us, “I am safe because there are always staff available and I wake up to a happy face.” Another person told us about one member of staff who was, “A lovely jolly person, he really cares and looks in often to see if I am alright.” A member of staff told us, “We are here to protect them from harm and we know the numbers we need are in the office.” Accidents and incidents had been recorded and appropriate action had been taken and recorded by the registered manager.

Staff were aware of their responsibilities from the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS.) Where people lacked capacity to make decisions about their care and treatment this had been considered in their best interests.

People and their relatives told us staff were kind and caring. They said there were adequate care staff on duty to meet people’s care and support needs. A compliment received by staff was, ‘Thank you for all the laughter and kindness, tea and cakes support and care that you all gave in your own ways to (Person’s name) and us for the last seven years.’ One person told us, “They always make me feel special.” People were treated with respect and dignity by the staff. They were spoken with and supported in a sensitive, respectful and professional manner. Senior staff monitored people’s dependency in relation to the level of staffing needed to ensure people’s care and support needs were met. People were cared for by staff who had been recruited through safe procedures. Staff told us they were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. Training records were kept up-to-date, and plans were in place to promote good practice and develop the knowledge and skills of staff.

Medicines were stored correctly and there were systems to manage medicine safely. Audits and stock checks were completed to ensure people received their medicines as prescribed.

There was a maintenance programme in place which ensured repairs were carried out in a timely way.

People told us they had felt involved in making decisions about their care and treatment and felt listened to. Care and support provided was personalised and based on the identified needs of each individual. People’s care and support plans and risk assessments were detailed and reviewed regularly giving clear guidance for care staff to follow. People’s healthcare needs were monitored and they had access to health care professionals when they needed to. One compliment received by staff said, ‘This home has provided first class care for my wife over the last six months. It is friendly and they listen to suggestions and comments by the residents and loved ones. It is a happy caring place and nothing is too much trouble for the staff. The food is excellent, could not be better. Nowhere could be as nice.’

People were supported to take part in a range of recreational activities. These were organised in line with peoples’ preferences. Family members and friends continued to play an important role and people spent time with them. One visitor told us, “The carers are very jolly, he doesn’t always go down, but they have good activities. The room is kept very clean and they always ring me to discuss any problems that might arise.”

Staff told us that communication throughout the service was good and included comprehensive handovers at the beginning of each shift and regular staff meetings. They felt they knew people’s care and support needs and were kept informed of any changes. Senior staff used handover notes between shifts which gave them up-to-date information on people’s care needs. They confirmed that they felt valued and supported by the managers, who they described as very approachable. They told us the team worked well together.

People’s nutritional needs had been assessed and they had a selection of choices of dishes to select from at each meal. People said the food was good and plentiful. Staff told us that an individual’s dietary requirements formed part of their pre-admission assessment and people were regularly consulted about their food preferences.

People were comfortable talking with the staff, and told us they knew who to speak to if they had any concerns.