Chiltern Rest Home

Updated 18 September 2019

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.

Inspection team

The inspection was carried out by one inspector 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

Chiltern Rest Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was not present on the day of the inspection.

Notice of inspection

This inspection was unannounced.

Inspection activity started and ended on 15 August 2019.

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 used all this information to plan our inspection.

During the inspection

We spoke with seven people who used the service and one relative about their experience of the care provided. We spoke with three care staff, the head cook, assistant cook, a domestic and the assistant manager. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included three people’s care records and multiple medication records. A variety of records relating to the management of the service, including staff training records and quality audits.

Updated 18 September 2019

About the service

Chiltern Rest Home is a residential care home registered to provide accommodation and personal care to up to 21 people. At the time of the inspection the home was fully occupied. The provider offered a service for older people and people living with dementia.

Chiltern Rest Home is located on two floors. Bedrooms, bathrooms and shower areas were situated on both floors. A lounge/dining area was located on the ground floor. A stair lift, and passenger lift were in place to enable people to access both floors. People had access to a secure garden.

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

The provider’s governance was ineffective to review, assess and monitor the safety of the environment which placed people at potential risk of harm. Systems were in place to monitor hygiene standards within the home. However, the layout of the laundry was unsuitable to ensure clean linen did not come into contact with unclean linen.

Staff had the skills to recognise abuse and knew how to safeguard people from this. People were supported by skilled staff to take their prescribed medicines. Staff had access to risk assessments that supported their understanding about how to care for people safely. People were cared for by sufficient numbers of staff who had been recruited safely. When things went wrong action had been taken to reduce the risk of it happening again.

The assessment of people’s needs ensured they received a service that met their preferences. People were cared for and supported by staff who were skilled and who had access to one to one supervision sessions. People had access to a choice of meals and staff were aware of suitable meals for the individual with regards to their health condition, likes and dislikes. The provider worked with other organisations to ensure people received a seamless service. People had access to relevant healthcare professionals to promote their physical and mental health.

The home had been adapted for people with reduced mobility, having grab rails, assisted baths and showers. 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 were caring and compassionate and had a good understanding of people’s specific needs. People were involved in decisions about their care and their right to privacy and dignity was respected by staff.

Equality, diversity and human rights were explored during people’s assessment to ensure they were not discriminated due to their culture, religion, sexuality or protected characteristics. People were encouraged by staff to pursue social activities. People were able to maintain contact with people important to them. Complaints were listened to, taken seriously and acted on. At the time of our inspection visit no one was receiving end of life care.

There was a clear management structure in place and people who used the service and staff were aware of who was running the home and were very complimentary about the management support. People’s views and opinions were sought through meetings and quality assurance surveys.

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 4 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.