We inspected this service on 6 December 2016 and it was unannounced, we returned announced on 7 December 2016.At the last inspection 25 August 2015 we told the provider that improvements were needed in the management of medicines, risk assessments, recruitment procedures, providing people with a balanced diet, ensuring referrals for health care services were followed up, ensuring that MCA and DoLS legislation was adhered to, that audits were carried out and that a registered manager was in post. This inspection looked at whether the provider had made improvements.
Chataway Care Home provides residential care for up to 14 people. There were 14 people living at the service at the time of the inspection. The accommodation was provided over two floors and there was access to the upper floor via a stair lift. There was a small accessible garden that people could use.
It is a requirement that the home has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. At the time of our inspection the manager had submitted their application to become the registered manager.
People told us that they felt safe. Staff were aware of how to keep people safe knew how to report actual or suspicions of abuse. However they had not received regular training to support their understanding.
The registered manager had investigated accidents and incidents to look at ways to prevent them from reoccurring. Improvements to risk assessments identified what risks people were vulnerable. There were plans in place that were available to staff to support people to keep safe during emergencies.
People received their medicines as prescribed by their doctor, though the reasons people refused medicines were not always consistently recorded. Protocols for medicines prescribed to be taken as and when required where not in place.
People’s needs had been assessed prior to them moving into the service and plans of care had been developed from these. Staff were deployed appropriately to keep people safe. Recruitment of new staff was robust and the manager had carried out checks on prospective staff before they started work.
People were being supported by staff that knew about their roles and responsibilities. Staff training was limited but they received on-going support from the manager.
The manager was aware of their responsibility to notify us of any successful DoLS application. Staff had an understanding of the Mental Capacity Act (2005) and understood how to obtain people’s consent before they offered care and support. Staff knew how to support people to make decisions for themselves. Where people may have lacked the capacity to make their own decisions, the provider had followed the requirements of the Act.
Improvements had been made in ensuring referrals to healthcare services were followed. People using the service had access to the required healthcare services, were supported to maintain good health and received ongoing healthcare support.
Improvements had been made in providing people with nutritionally balanced diet People were provided with a choice of meal at each mealtime. Staff understood the need monitor people’s food and fluid intake where a risk was identified.
We observed people using the service being treated in a caring and considerate manner. They were involved in making choices about their care and support and when they made their choices, these were respected by the staff team.
People said that they were sometimes bored and would like the opportunity for more activities, particularly in the evenings.
People’s preferences were detailed in their care plans and we found things that were important for people to be in place. For example, what time a person preferred to go to bed.
People’s care plans were being reviewed regularly which meant staff had up to date information about people. However it was not always clear that people and their relatives were involved in these reviews.
Staff meetings and surveys had been completed. This provided people with the opportunity to be involved in how the service was run.
Staff knew the aims and objectives of the service and worked towards them to deliver a quality service. The manager was described as approachable and supportive.
People felt listened to and knew how to make a complaint if they needed to. The manager understood the requirements of their role. They had carried out quality checks to monitor and improve what the service was offering people.