Background to this inspection
Updated
15 April 2022
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
This inspection was carried out by one inspector.
Service and service type
Chardwood Rest Home 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. Chardwood Rest Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This service is required to have a registered manager. Chardwood Rest Home has two registered managers who share the overall role. One of the registered managers is also the owner/provider. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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
The first day of the inspection was unannounced.
What we did before the inspection
We contacted the local authority market support team for feedback. We reviewed information we hold about the service including enquiries and notifications. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We used all of this information to plan our inspection.
During the inspection
We spoke with six people living at Chardwood Rest Home, five staff including both registered managers, care and housekeeping staff. We reviewed a range of records. This included two people’s care plans in full and a further three peoples to look at specific areas in relation to their health and care needs. We also reviewed other documentation in relation to people’s safety, including medicine administration, accidents, incidents and risk assessments. We looked at staff training and competencies, and a variety of records relating to the management of the service, including audits, policies and procedures.
After the inspection
Following the inspection, we continued to seek clarification from the registered manager/provider to validate evidence found. We also spoke to the local authority market support team.
Updated
15 April 2022
About the service
Chardwood Rest Home is converted property located in Pevensey Bay providing care and support for up to 15 older people including some people living with mild dementia and memory loss. There were 12 people living at the home, one person was in hospital at the time of the inspection,
People’s experience of using this service and what we found
Risks to people were not always assessed and reviewed effectively. Care plans and risk assessments had not been reviewed and updated when changes had occurred. One person’s PEEPs had both of their names written incorrectly, this had not been identified by management or staff. This would put them at risk in the event of an emergency evacuation. Care folders had not been maintained to ensure information was easily accessible clear and up to date.
Medicine processes had not been safely maintained. People were not receiving their medicines in accordance with their prescriptions. PRN medicines did not have protocols in place to ensure they were administered, monitored and reviewed regularly. Rationales behind decisions had not been recorded.
Governance systems needed to be improved. Quality assurance systems were not robust and had not identified the issues and concerns found during the inspection. The provider confirmed that audits had not been effective, and improvements were needed.
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. People had the opportunity to feedback their views and opinions of the service.
The service had a relaxed, homely feel. People’s rooms were personalised and staff told us they knew people well. Feedback from people and relatives was positive. One told us, “The owner is lovely; she looks after us all.” Daily records were written at the end of each shift and relevant information handed over verbally to staff coming on duty. The provider was also one of the registered managers. They spent a lot of time at the home providing care and supporting staff. Both managers covered care duties and also cooked meals when no cook was available.
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 19 May 2018).
Why we inspected
We received concerns in relation to staffing, training, infection control, documentation management and leadership of the service. A decision was made for us to inspect and examine these risks.
As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
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 COVID-19 and other infection outbreaks effectively.
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 based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to safe care and treatment, risk management, medicines and the management and governance at the service.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.