Chirnside House

Updated 13 June 2023

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 Health and Social Care Act 2008.

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

The inspection was carried out by 2 inspectors and 1 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

Chirnside House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Chirnside House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 13 March 2023 and ended on 21 April 2023. We visited the location on 28 March 2023.

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 used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 9 relatives and 1 person about their experience of the care provided. We observed how staff interacted with people. We spoke with the registered manager, deputy manager and 3 members of the care team. We spoke with the provider’s nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We asked for and received feedback regarding the performance of the managers, staff, and service from health professionals.

We looked around the home and reviewed a range of records. This included 5 people’s care records and 3 people’s medicine administration records. We observed medicines processes, spoke with staff, and looked at the governance arrangements for the safe handling of medicines. We looked at records related to recruitment and training for 4 staff. We also looked at a variety of records relating to the management of the service.

Updated 13 June 2023

About the service

Chirnside House is a residential care home providing personal care to up to 30 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 19 people using the service.

Chirnside House is one large, adapted building over 2 floors with private bedrooms and many different communal areas, and garden areas outside.

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

The provider did not have governance systems in place to monitor the performance of the service.

The provider did not have robust recruitment systems in place to ensure all staff were fit and proper persons. There were systems in place that had gaps or were outdated.

The provider was being supported by a pharmacist to ensure best practice with medicines administration and some systems were new and not yet embedded.

We found the care demonstrated to be of good quality and feedback from almost all the people we talked with was very positive about everything in the home, stating the care was good, they felt safe, and the home was well managed.

The service was going beyond best practice with regards to infection prevention and control to ensure the safety of people.

The registered manager was transparent when seeking to learn lessons from events that happened in the home to improve the service and embraced a continuous learning approach.

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 16 May 2018).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

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 the service can respond to COVID-19 and other infection outbreaks effectively.

This inspection looked at the key questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this report. During the inspection the provider took appropriate action to address the shortfalls and mitigate risks.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Chirnside House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified 2 breaches and 1 recommendation during our inspection. One breach in relation to fit and proper persons employed and 1 breach regarding good governance. We also identified 1 recommendation regarding following best practice guidance with medication administration to embed the new systems. Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.