Archived: Cheyne House Nursing

Updated 10 August 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 4 and 5 January 2017 and was unannounced. This inspection was completed to check that improvements to meet legal requirements had been made. We also looked at the progress the provider had made against the conditions of registration which we had put in place following our inspections on 30 June 2016 and 4 July 2016.

The inspection team was made up of one inspector and an expert by experience on day one of our inspection and two inspectors on day two of our inspection. An expert by experience is a person who has personal experience of using services or caring for someone who requires this type of service.

Before the inspection we looked at previous inspection reports and we reviewed other information that we held about the service such as notifications, which are events which happened in the service that the provider is required to tell us about, and information that had been sent to us by other agencies. We used this information to help plan our inspections.

We looked at a range of records related to the running of and the quality of the service. This included staff training information and staff meeting minutes. We also looked at the quality assurance audits that the registered manager and the provider completed which monitored and assessed the quality of the service provided.

During our inspection we spoke with the provider, the registered manager, two registered nurses, two housekeepers, two members of care staff, the cook and the activity coordinator. We also spoke with five people who lived at the service and one visiting relative. In addition, we observed staff interacting with people in communal areas and providing care and support.

We looked at the care plans and daily care records for ten people and medicine administration records for five people. A care plan provides staff with detailed information and guidance on how to meet a person's assessed social and health care needs. In addition, we undertook a Short Observation Framework for Inspection (SOFI) in the dining room on day one of our inspection. SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We asked the local authority and commissioners of healthcare services for information in order to get their view on the quality of care provided by the service.

Updated 10 August 2017

This inspection took place on 4 and 5 January 2017 and was unannounced.

Cheyne House Nursing is registered to provide accommodation and nursing and personal care for up to 26 older people or people living with dementia. There were 15 people living at the service on the day of our inspection.

We carried out an unannounced comprehensive inspection of this service on 2 July 2015. Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.

We undertook a focussed inspection on 30 June 2016 and 1 July 2016 to check that they had followed their plan and to confirm that they now met legal requirements. Breaches of legal requirements were found. Following this inspection we imposed conditions on the registered provider. These conditions meant that the provider was required to take specific actions to improve the service and meet legal requirements.

We undertook a focussed inspection on 23 August 2016 following information received about concerns to check that the provider had taken action with regard to issues raised by ourselves and other agencies who commission care for people living at the service. We also wanted to confirm their progress against conditions of registration which were put in place following the inspection in June and July 2016 met legal requirements. At our inspection on 23 August 2016 we found that the provider continued to be in breach of the regulations and had not made sufficient progress against the conditions of registration we had put in place.

At this inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and breaches in Care Quality Commission (Registration) Regulations 2009. The provider had not ensured that people were kept consistently safe from the risk of harm or neglect, that people were provided with person centred care, did not follow safe recruitment practices, there were weaknesses in monitoring the quality of the service and the provider did not display their ratings from their last inspection.

There was a registered manager in post. 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.

The provider did not follow safe and effective recruitment procedures and did not ensure that all safety checks had been made. Fire safety evacuation plans put people and staff at risk of harm in event of a fire. We found that infection control practices had improved and people were now cared for in a clean environment.

Staff did not always have the knowledge and skills to provide people with effective care that met their care needs. Staff had received appropriate training, and understood the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. However, staff did not follow the correct procedure when a person was unable to consent to their care and treatment. People received a balanced and nutritious diet and drinks and snacks were provided between meals.

People were cared for by kind and caring staff. Care plans were not always person-centred and people were not involved in planning their care.

There was poor communication between staff and the registered manager that resulted in people not always receiving appropriate care in a timely manner. Activities provided to people did not reflect their interests and pastimes.

The provider did not ensure that the audits undertaken reflected the care that people received and there was no follow up to check that identified actions had been completed.

The overall rating for this service is inadequate and therefore the service is in special measures.

Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded