Archived: Childwick House

Updated 4 July 2018

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.

This comprehensive inspection took place on 27 March, 28 March and 10 April 2018 and was unannounced. The inspection team consisted of one inspector on all three days.

Before the inspection, we requested that the provider complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This was received from the provider.

We also reviewed information that we held about the service. Providers are required to notify the Care Quality Commission about events and incidents that occur including unexpected deaths, injuries to people receiving care and safeguarding matters. We also sought views from commissioners who funded the care for some people and the local Healthwatch branch.

We looked at the care records of three people in detail to check they were receiving their care as planned. We also looked at other records including staff records, training records, meeting minutes, medicines records and quality assurance records. With their permission, we met with five people who were receiving the regulated activity of personal care. We spoke with and had contact with a total of seven care staff as well as the registered manager. We also left contact details for any relatives who may have wished to provide us with feedback but did not receive any responses.

Updated 4 July 2018

This inspection took place on 27, 28 March and 10 April 2018 and was announced. We gave the service 48 hours’ notice of the first day of our visit inspection as the service is community based and we needed to ensure the registered manager would be available. We arranged the subsequent days with the registered manager so they could request and arrange appointments for us with people so we could obtain their feedback.

Childwick House consists of 24 self-contained flats, three of which have two bedrooms for double occupancy. The service is situated centrally within the town of Newmarket and within close vicinity of the local amenities. The service provides support to people to live in their accommodation, with their own tenancy agreements. The aim of the service is to provide people with support they need to live as independently as possible. The people who used the service received individual bespoke support hours depending on their assessed needs.

The service provides care and support to people living in specialist 'extra care' housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people's personal care and support service. Not everyone living at Childwick House received the regulated activity; on the day of our visit 15 people were receiving a personal care service.

At the last inspection in October 2016, we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We were concerned because the provider had failed to assess all risks to health and safety and failed to manage medicines. We also had concerns that the provider was failing to ensure that there were sufficient numbers of suitably qualified, competent, skilled and experienced staff. We asked the provider to take steps to improve and complete an action plan to show what they would do and by when to improve. At that inspection we rated the service Requires Improvement overall and in four of the key questions we ask of each service. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Childwick House on our website at www.cqc.org.uk

At this inspection in March and April 2018 we found improvements had been made in some of these areas however we still had concerns about staffing levels and also we had additional concerns. As a result the service has been rated Requires Improvement again. We have also made a recommendation that the provider considers good practice guidance to ensure that the service understand and meets the requirements set out in the Mental Capacity Act 2005.

There was a registered manager in post at the time of the inspection. 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 service was not always acting in accordance with the Mental Capacity Act 2005. People’s rights were therefore not always being promoted. Staff did not always work within these principals when supporting people who lacked the mental capacity to make decisions.

There was a quality assurance audit in place however the system was not always effective because issues identified at the inspection had not been recognised during the monitoring and auditing process.

Medicines were managed in a safe way and support was offered by staff when needed. Risks to people and staff had been assessed. People felt safe and when risks to people were identified action was taken to reduce these risks.

People were protected from the risk of infection by staff that complied with their infection prevention policy.

People were happy with the support they received to eat and drink, and were supported to maintain good health and had access to healthcare when required.

Staff provided a service which was caring, respectful and promoted people's privacy and dignity. Staff encouraged people to be as independent as safely possible.