13 June 2017
During a routine inspection
Chalkdown House is a specialist neuro-behavioural service for people with a non-progressive acquired brain injury. The service provides specialist rehabilitation. Chalkdown House was previously registered with the Care Quality Commission as an independent hospital. Prior to the inspection the provider applied to register as a care home providing accommodation with personal care. This was the first inspection carried out under the adult social care registration. The service was registered to provide support for up to 20 people, which included two self-contained flats. At the time of the inspection there were six people living in the service.
There was a registered manager in post. 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.
At the previous inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found improvements had been made. Records relating to people’s observations were accurate and complete. Staff had completed training appropriate to their role and were competent to support people using the service.
The staff team were uncertain about the future direction of the service, especially following the recent changes in registration; the provider was aware of these concerns and was working to provide support to staff.
The registered manager promoted an open and transparent culture in the service. Although there were anxieties within the staff team, staff maintained a focus on people to ensure their needs were met and they were not unsettled by any changes.
The service was concentrating on discharge planning for people using the service. The management and staff team were working closely with people, relatives and commissioners to identify suitable onward placements.
People were safe in the service. Risks to people were identified and managed. People were supported to be as independent as possible. Positive risk taking was identified to improve people’s independence and well-being.
Medicines were managed safely. People received their medicines as prescribed and there was clear guidance for staff where medicines had specific instructions relating to administration.
There were sufficient staff to meet people’s needs and to enable them to access activities both within and outside the service. Staff understood their responsibilities to identify and report any concerns relating to abuse.
Staff felt valued and listened to by the management team at the service. Staff were supported through regular supervision.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were supported by caring staff who had a clear understanding of people’s complex needs. People were treated with dignity and respect and were involved in all decisions about their care.
There were a range of clinicians employed in the service. Where needed people were supported to access additional specialist to ensure their health and well-being was maintained.
Care plans were detailed and contained a wealth of information about people’s needs. However, it was not always easy to find information and some information was duplicated.
People and their relatives knew how to complain and were confident to do so. Complaints were investigated and responded to in line with the provider’s policy.
There were effective systems in place to monitor and improve the service.