Chadderton Total Care

Updated 13 April 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 3 inspectors, 2 medicines inspectors and 2 Experts 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

Chadderton Total Care Unit Limited 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. Chadderton Total Care Unit Limited is a care home with 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

The inspection was unannounced on the first day. Inspection activity started on 22 February 2023 and ended on 2 March 2023, by which time we had received and reviewed evidence provided after our visits to the home. We visited Chadderton Total Care Unit Limited on 22, 23 and 27 February 2023.

What we did before the inspection

Prior to the inspection we reviewed information and evidence we already held about the home, which had been collected via our ongoing monitoring of care services. This included notifications sent to us by the home. Notifications are changes, events or incidents that the provider is legally obliged to send to us without delay. We also asked for 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 of this information to plan our inspection.

During the inspection

We spoke with 15 people, 8 relatives and 4 other visitors, about the home and the care provided. We also spoke with 19 members of staff, which included the registered manager and a mixture of nursing, care and ancillary staff.

We reviewed a range of records and other documentation. This included 16 people’s care records, risk assessments, safety records, supplementary charts, audit and governance information. We also looked at medicines and associated records for 13 people.

After the inspection

We requested and reviewed additional evidence and information from the provider.

Updated 13 April 2023

About the service

Chadderton Total Care Unit Limited is a residential care home providing nursing and personal care for up to 146 people. The home consists of 6 units all on ground floor level, which cater for a range of social and nursing needs, such as physical and learning disability, acquired brain injury and dementia related disease. At the time of the inspection 109 people were living at the home.

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

Improvements were required with medicines management and the audit and governance process. This included contemporaneous record keeping such as personal hygiene, oral care, repositioning and food and fluid charts.

People felt safe living at Chadderton Total Care Unit Limited. Relatives told us the home provided safe care and felt their family members were well cared for. Enough staff were deployed to meet people’s needs; however, some staff, people and relatives commented on the current high use of agency staff on some units and how the quality and competency of these staff varied. Staff received training in safeguarding and knew how to report concerns. Safeguarding alerts had been made to the local authority where required. Accidents, incidents and falls had been documented and reviewed to help identify patterns and trends. We found the home to be clean, with effective cleaning and infection control processes in place.

Staff received enough training to ensure they could complete their roles safely and effectively. Staff supervision had not been completed consistently, however; a new process had been introduced to address this. People and relatives provided mixed feedback about the meals provided. Recording of people’s food and fluid intake was being completed but further detail was needed. Clear guidance for staff was also needed, to ensure they knew what to monitor, why and what to do if people had not eaten or drank enough each day. Overall, people looked clean and well presented although record keeping around personal hygiene and oral care to was inconsistent. 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’s healthcare needs were being met, with referrals to professionals made timely when any issues had been noted or concerns raised.

Care files explained people’s needs and how they wanted to be supported, although the quality and quantity of information varied and depended on whether people had one of the new care plans recently introduced. Peoples’ social and recreational needs were met through an activities programme, facilitated by activity coordinators and staff members. The complaints process was displayed around the home and people told us they knew how to complain and would speak to staff or management if needed. Any complaints received had been dealt with in line with the provider’s complaints policy.

Regular relative and resident meetings had not taken place. However, people and relatives views were sought through surveys, which had been circulated every 3 months. People and relatives were complimentary about the home and care provided, with the majority stating they would recommend the home to others.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 27 November 2020) and there were 2 breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection not enough improvement had been made and the provider was still in breach of regulations.

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. We initially inspected the Key Questions of Safe and Well-Led. However, due to identifying ongoing concerns with medicines management and governance on the first day of inspection, we widened the scope of the inspection to include the Key Questions of Effective and Responsive.

This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive 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 remained 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 COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-led sections of the full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Chadderton Total Care Unit Limited on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to medicines management and governance processes, including record keeping at this inspection.

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.