Chiltern Rest Home

Chiltern Rest Home is a residential care home registered to provide accommodation and personal care to up to 21 people. At the time of the inspection the home was fully occupied. The provider offered a service for older people and people living with dementia.

Chiltern Rest Home is located on two floors. Bedrooms, bathrooms and shower areas were situated on both floors. A lounge/dining area was located on the ground floor. A stair lift, and passenger lift were in place to enable people to access both floors. People had access to a secure garden.

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

The provider’s governance was ineffective to review, assess and monitor the safety of the environment which placed people at potential risk of harm. Systems were in place to monitor hygiene standards within the home. However, the layout of the laundry was unsuitable to ensure clean linen did not come into contact with unclean linen.

Staff had the skills to recognise abuse and knew how to safeguard people from this. People were supported by skilled staff to take their prescribed medicines. Staff had access to risk assessments that supported their understanding about how to care for people safely. People were cared for by sufficient numbers of staff who had been recruited safely. When things went wrong action had been taken to reduce the risk of it happening again.

The assessment of people’s needs ensured they received a service that met their preferences. People were cared for and supported by staff who were skilled and who had access to one to one supervision sessions. People had access to a choice of meals and staff were aware of suitable meals for the individual with regards to their health condition, likes and dislikes. The provider worked with other organisations to ensure people received a seamless service. People had access to relevant healthcare professionals to promote their physical and mental health.

The home had been adapted for people with reduced mobility, having grab rails, assisted baths and showers. 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.

Staff were caring and compassionate and had a good understanding of people’s specific needs. People were involved in decisions about their care and their right to privacy and dignity was respected by staff.

Equality, diversity and human rights were explored during people’s assessment to ensure they were not discriminated due to their culture, religion, sexuality or protected characteristics. People were encouraged by staff to pursue social activities. People were able to maintain contact with people important to them. Complaints were listened to, taken seriously and acted on. At the time of our inspection visit no one was receiving end of life care.

There was a clear management structure in place and people who used the service and staff were aware of who was running the home and were very complimentary about the management support. People’s views and opinions were sought through meetings and quality assurance surveys.

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 4 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Chiltern Rest Home are registered to provide accommodation with personal care for up to 21 people. People who use the service may have physical disabilities and/or mental health needs such as dementia. At the time of the inspection the service supported 19 people.

There was a registered manager at the service. 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.

We found that improvements were needed to ensure that effective systems were in place to consistently maintain care records that were accurate and up to date. When care records are not accurate and up to date, people are placed at risk of receiving inconsistent or unsuitable care.

People felt safe when they were supported. Staff understood how to recognise possible signs of abuse and the actions they needed to take if they had any concerns.

People’s risks were assessed and managed to keep people safe from harm.

There were enough suitably qualified staff available to keep people safe and the provider had a safe recruitment procedure in place.

Medicines were administered in a safe way. There were systems were in place to ensure people were protected from risks associated with medicines management.

People were supported by staff who had received training, which gave staff the knowledge and skills to provide appropriate care that met people’s needs.

People consented to their care where able and the provider followed the requirements of the Mental Capacity Act 2005 (MCA) where people lacked the capacity to make certain decisions about their care. Staff understood their responsibilities and followed the requirements of the MCA when they provided support.

People told us that they enjoyed the food. Where people were at risk of malnutrition and/or dehydration monitoring was in place to ensure people were eating and drinking sufficient amounts to keep them healthy.

People were supported to access health professionals in a timely manner to maintain their health and wellbeing.

People were supported in a caring and compassionate way by staff who knew people well. People’s privacy and dignity was protected when staff provided support and staff promoted and listened to people’s choices in care.

People were involved in their care. People received care that met their preferences because staff knew people well and knew how they liked their care to be provided.

People were encouraged to be involved in meaningful hobbies and interests within the service to promote their emotional wellbeing.

The provider had a complaints policy available and people knew how to complain and who they needed to complain to.

There was an open and honest culture within the service and the registered manager was approachable to people, staff and professionals.

The registered manager was aware of their responsibilities and had informed us (CQC) of any notifiable incidents that had occurred at the service.

The registered manager had effective systems in place to assess, monitor and improve the quality of care. Plans were in place to ensure improvements to the service were continually reviewed and changes were made where needed.