The Chadwick

Updated 15 January 2021

The inspection

This was a focused inspection to check whether the provider had made the required improvements following the last inspection. We will assess all of the key questions at the next comprehensive inspection of the service.

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 undertaken 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

The Chadwick 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 had a manager who was 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.

Notice of inspection

We gave five minutes notice so we could clarify the services COVID-19 Personal Protective Equipment (PPE) practice for visiting professionals and identify persons who were shielding so we could respond accordingly.

What we did before 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 did not request a 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 of this information to plan our inspection. We had requested information from the provider prior to the inspection and this information was used as part of the inspection plan.

During the inspection

We spoke with seven members of staff, the registered manager and operations manager. We spoke with eight people who used the service and received feedback from 11 relatives. We spoke with a visiting health care professional. We contacted the local authority for their feedback.

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.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 15 January 2021

About the service

The Chadwick is a care home providing accommodation for up to 67 people older people, some of whom are living with dementia. At the time of the inspection there were 47 people living at the home.

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

At the last inspection, the service was failing to ensure people’s safety was promoted, did not have effective governance systems and did not comply with duty of candour or send the required notifications. As a result, there were found to be multiple breaches of regulations and the home was put into special measures.

At this inspection we found that the required improvements had been completed and systems implemented to address the shortfalls had been effective.

People felt safe and told us the staff were kind and friendly. Relatives felt the staff team were very good and the new registered manager had made a difference to the home. People’s safety and welfare was monitored. If an incident or concern arose, the management team identified and resolved it. Incident, events and unexplained injuries were recorded and investigated. Where needed, incidents were reported appropriately.

People were treated with dignity and respect. People and staff had developed positive relationships and staff knew people well. Care plans were detailed, giving staff the appropriate information to meet people’s needs.

Records were reviewed to help ensure people’s needs had been met. Staffing was monitored and call bells audited to ensure staffing numbers were effective. Some people living on the first floor told us they thought more staff were needed as at times they had to wait, and activities were not frequent enough. However, they said staff worked hard and were always helpful.

Staff felt they had enough training and support to do their role and found the leadership of the management team to be good. Training relating to infection control and COVID-19 had been delivered. Staff knew how to reduce the risk of transmission of COVID-19. Staff worked safely in relation to COVID-19.

The recruitment process was robust, including all required checks to help ensure staff employed were fit to work in a care setting. Medicines were now managed safety and these were checked through an audit system.

Governance systems needed to monitor and identify concerns had been developed and these had been effective as the number of incidents since the last inspection had reduced.

Rating at last inspection

The last rating for this service was Inadequate (published 28 February 2020) and there were multiple breaches of regulation. The provider sent us an action plan stating how they would make the required improvements. We imposed a condition on the service meaning that they could not admit new people to the home without our permission.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 20 January 2020 and 06 February 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection, to show what they would do and by when, to improve governance, safe care and treatment, duty of candour, notifications of other incidents and safeguarding service users from abuse and improper treatment.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Inadequate to Requires Improvement. This is based on the findings at this 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.

Please see the safe section of this full report. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Chadwick on our website at www.cqc.org.uk.

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.