CQC report explained · a residential care home
What the CQC found at Chadwell Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were supported safely with medicines, safeguarding, infection control and risk management. Inspectors noted that not all staff knew how to access the latest electronic risk assessments, and one medicine stock count was inaccurate.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried over when calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried over when calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried over when calculating the overall rating.
- Well-led?
- Good
- Inspectors found effective audits, clear staff roles, a positive culture and systems for listening to people, relatives and staff. The provider had improved its monitoring systems since the previous inspection.
What inspectors found, December 2022
Rated Good after improvements; inspectors found safe, respectful care, with some staffing and records issues to keep under review.
This was an unannounced focused inspection on 9 November 2022. One inspector spoke with all three people living at the home, two relatives and two staff. They observed care and checked care records, medicines records, recruitment files and management records.
The home was rated Good for Safe and Well-led. Inspectors found medicines records were accurate and up to date, staff had safeguarding and medicines training, infection control was effective, and people felt safe. Care was person-centred, and people and relatives described staff and managers positively.
The previous rating was Requires improvement, published on 2 August 2021. The provider had completed an improvement plan. Inspectors found the earlier breaches about medicines management and quality monitoring had been addressed, so the home was no longer in breach.
This inspection only examined Safe and Well-led. The other question ratings were carried over from the previous inspection when calculating the overall Good rating.
Respectful, person-centred care
People were supported to make choices about their daily lives. Inspectors found that care promoted dignity, privacy and human rights.
“Care was person-centred and promoted people's dignity, privacy and human rights.” from the report
Improved medicines management
The home changed back to paper medicines records, which inspectors found had been completed accurately and were up to date. Staff had training in safe medicines administration.
“we found these had been completed accurately and were up to date.” from the report
Improved management and oversight
The provider had introduced audits covering medicines, the environment and infection control. The earlier quality monitoring breach had been addressed.
“At this inspection we found this issue had been addressed.” from the report
Staffing for community access
needs fixingStaff said an extra member of staff would sometimes help, especially when supporting people to access the community. Inspectors recommended reviewing staffing levels.
“We recommend the provider reviews their current staffing levels to see if there are times when more staff would better enable the service to meet people's assessed needs.” from the report
Access to current risk assessments
needs fixingRisk assessments were reviewed, but not all staff knew how to access the latest electronic versions at the time of inspection. The provider later said this had been discussed with staff.
“The latest versions were stored electronically, and not all staff knew how to access them.” from the report
One medicines stock error
minorOne paracetamol stock count was inaccurate. Inspectors found no error in giving the medicine, but the count could have been identified at the next audit.
“An error had been made in counting the amount in stock, but no error had been made in administering the medicine.” from the report
- 01How do you make sure every staff member can access the latest risk assessments?
- 02How do you decide whether an extra staff member is needed to support community access?
- 03How are medicines stock counts checked, and how quickly are errors corrected?
- 04What improvements have been made since the previous Requires improvement inspection?
- 05What were the ratings for Effective, Caring and Responsive at the previous inspection?
This was a focused inspection of Safe and Well-led only; the other question ratings were carried over from the previous inspection. This explanation was written from the published report of 7 December 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, August 2021
Rated Requires Improvement; inspectors found kind, person-centred care but unsafe medicine systems and weak quality checks.
This was the home's first inspection. One inspector visited on 1 July 2021, spoke with two people and three staff, and checked medicine records, care records, staff files and management records.
The home was rated Good for Effective, Caring and Responsive. People were treated with respect, supported to make choices, and given personalised care. Staff supported people with food, health appointments, activities and communication.
Safe and Well-led were rated Requires Improvement. Medicine records were not always reliable, staff references did not always meet the home's policy, and quality checks had missed these problems. The CQC found no evidence that anyone had been harmed, but said people were at risk of harm.
The CQC identified breaches of Regulations 12 and 17. It told the provider to send an action plan and said it would continue monitoring the home until a re-inspection.
Kind and respectful care
People said they were treated well. Staff understood how to protect privacy, dignity and independence.
“People told us they were treated well and that they liked the staff.” from the report
Personalised support
Care plans covered individual needs and preferences and were reviewed as people's needs changed.
“Care plans were person centred, based around the needs of the individual, and staff had a good understanding of people's individual support needs.” from the report
Choice and independence
People were supported to make everyday choices and take part in cooking, cleaning, laundry and other daily activities.
“People told us they were able to make decisions about their daily lives.” from the report
Health and nutrition support
People could choose from meals, including a vegetarian option, and had access to healthcare professionals and dental care.
“People were supported to eat a nutritious and balanced diet.” from the report
Enough staff and safe premises
Inspectors found enough staff to support people without rushing. The home was clean and well maintained, with checks on areas such as fire safety, gas and electricity.
“There were enough staff working at the service to support people in a safe way.” from the report
Medicine records were unreliable
seriousThe electronic medicine system was not working properly and was not being used properly. Red alerts were not explained, so it was unclear whether some medicines had been given as prescribed.
“Medicines were not always managed in a safe way. This placed people at risk of harm.” from the report
Quality checks missed problems
seriousAudits failed to identify the medicine and recruitment issues. Repeated meeting minutes may not have been accurate, which could mean missed opportunities to learn and improve.
“Quality assurance and monitoring systems were not always effective. This placed people at risk of harm.” from the report
Recruitment records were incomplete
needs fixingReferences for two staff did not meet the home's own policy. Some references were not from the previous employer or lacked enough detail and proof of authenticity.
“Robust pre-employment checks were not always carried out on prospective staff before they began working at the service.” from the report
Equality needs were missed before admission
needs fixingPre-admission assessments covered many needs but did not include equality and diversity issues. The provider was asked to improve this process.
“However, assessments did not cover needs related to equality and diversity.” from the report
- 01What changes have you made to the electronic medicine system since the inspection, and how do you now check stock balances?
- 02How do you investigate and record red medicine alerts, and how can relatives be assured that medicines are given as prescribed?
- 03What action has been taken to make sure staff references meet your recruitment policy?
- 04How do your audits now identify medicine, recruitment and care assessment problems?
- 05How are equality and diversity needs recorded before someone moves into the home?
This was the first comprehensive inspection of the newly registered home and covered all five key questions, including infection prevention and control arrangements for Covid-19. This explanation was written from the published report of 3 August 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Chadwell Home
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- December 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- November 2019
Registered with the Care Quality Commission on 25 November 2019.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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