Archived: Chiltingtons Residential Home

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, their relatives, the staff supporting them and from looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We saw that generally, the service was clean and improvements had been made to the maintenance of the building and to the servicing of equipment. This meant that people were not placed at unnecessary risk. People that we spoke with told us that they were satisfied with the cleanliness at the service and with the environment in which they lived. One person told us, 'I need to use the hoist to get in bed and a sliding board to get out. They (the staff) come and help me. I have one of the biggest rooms in the place. It's very bright and there is plenty of room for me to get around in my wheelchair. Someone comes and services the equipment every so often so that it's safe'. Another person told us, 'I'm happy with the levels of cleanliness. The cleaner comes three times a week'. A third person told us, 'There have been no problems with the lift for a while now; things seem to be getting better'.

Is the service effective?

Since our last inspection people told us that they had been involved in the reviewing of their care needs and had contributed to the development of their care plans. We found that care plans were now more detailed and informative. In addition, residents meetings had been re-introduced in order to support people to make decisions about their care and services provided. This meant that people were sure that their individual care needs and wishes were known and planned for.

People told us that they were satisfied with the care they received. For example, one person told us, 'I'm happy with the care given and my needs are being met'. Another person told us, 'All of them (the staff) are lovely. They are magnificent, bringing cups of tea and biscuits. They ask what you want to eat and remember what you have asked for'. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff were patient and gave encouragement when supporting people. People told us they were able to do things at their own pace and were not rushed. Our observations confirmed this. One person told us 'I prefer to stay in my room, it's my choice and staff respect this'.

Is the service responsive?

Since our last inspection people's needs had been assessed in relation to social stimulation. Records confirmed people's preferences and interests had been recorded and care and support had been provided that met their wishes. People had access to in house activities and occasional external events and had been supported to maintain relationships with their friends and relatives.

Is the service well-led?

Since our last inspection we found that improvements had been made in relation to care planning, cleanliness within the service, maintenance of the environment and record keeping. This was also confirmed by people that we spoke with and by examining records. The person in charge at the service in the absence of the provider acknowledged further steps should be taken to ensure people continue to receive a consistent, safe service.

People who used the service told us they were treated well by staff. One person told us 'I'm treated well, the girls are very nice. They've become friends.' Another person said 'The majority of staff are nice'. However, we found that a lack of cleanliness and attention to hygiene issues meant that people's dignity had not always been respected. People told us they did not feel involved in planning their care. One person told us that they had been included 'very little' in reviewing their care plan. Care plans seen did not show that people's views on how they wished their care to be provided had been adequately recorded and acted on.

We looked at the care records for four people and had concerns that lack of risk assessments and poor maintenance of care records put some people at risk of harm.

There were mixed views from people about the meals provided. Four people told us that there was a lack of alternative choices at mealtimes.

We found that people were not cared for in a clean, hygienic environment. People we talked with including the manager said this was because the cleaner did not work full time. We found that the service had not minimised the risk of cross infection. This was because not all staff adhered to good infection control practice. There was no evidence that regular audits for infection control had been undertaken.

The premises had not been adequately maintained. The decoration and furnishing in parts of the building were not kept to an adequate standard. There were areas in need of repair and redecoration in the hallways and four bedrooms. Maintenance work in the home had not been carried out in a timely manner.

People were not protected from unsafe or unsuitable equipment because the provider had not ensured that all equipment in use was regularly serviced and maintained.

We found that risk assessments and care records had not always been kept up to date. This put people at risk of inadequate treatment. We saw that care records were not held securely.

One person told us 'I'm being very well looked after.' Another person said 'I get a lot of help from the girls. They're very good.' People told us that their needs were met and that staff provided appropriate care and support. Arrangements were in place to monitor cleanliness and hygiene in the home and minimise the risk of the spread of infections.

Staff had received training and support appropriate for the work they carried out, and told us that there was a good atmosphere in the home. Records showed that the service asked people for their views about how their care and support should be provided and took account of these views. Suggestions made by people at residents' meetings were acted on. The service monitored the quality and safety of the service provided and took action where needed.

During our inspection we found that the provider had not addressed some concerns relating to the safety of the premises, and not all service safety checks were up to date. We also found that admission assessment records did not always include full information on the person's care needs, and daily records did not always record how the person's assessed needs had been met.

People said they received good care and support. One person said 'They're taking good care of me.' Another person said they liked the meals and that there was a choice of what to have for breakfast. A relative we talked with told us that good care was provided and that 'People are happy here.'

People we talked to said that they got to know staff well. A relative told us 'All the staff are efficient.' During our inspection we saw people who used the service chatted and smiled a lot with the staff who supported them in a calm and reassuring manner. We found that people were offered choices and given the opportunity to maintain their independence if they wished. People said they felt safe in the home, and we found there were good arrangements in place to protect them from harm.

The environment was generally clean. One person told us 'My bedroom is always clean and tidy and hovered well.' However an effective system was not fully in place to monitor risks of the spread of infection in the environment.

The provider had begun to make arrangements for staff to be appropriately supported in the work they carried out. Arrangements for staff training, supervision and appraisal however were not yet fully in place. We found that the provider was making checks to ensure that people were receiving safe and appropriate care, and that their views were being taken into account.