CQC report explained · a residential care home
What the CQC found at Chalkwell Grange
Rated Inadequate: inspectors found the home performing badly and the CQC has taken enforcement action.
What inspectors found, September 2023
Rated Requires Improvement; inspectors found unsafe medicines processes, staffing shortfalls and weak checks on quality and safety.
This was an unannounced focused inspection. Inspectors visited on 14 and 15 August 2023, reviewed records and medicines, observed care, and spoke with people, relatives and staff. They looked only at Safe and Well-led.
They found medicines were not always given or recorded safely. Risk controls were not always followed, and there were not always enough staff, particularly on the first floor. Inspectors also found that the home's checks did not reliably identify these problems.
There were some positives. Infection prevention arrangements were effective, recruitment checks were in place, staff understood safeguarding, and people and relatives gave some positive comments about the new manager and the atmosphere on the ground floor. The overall rating fell from Good at the previous inspection to Requires Improvement.
Infection control
Inspectors were assured that infection prevention measures, use of protective equipment and outbreak planning were effective.
“We were assured that the provider was preventing visitors from catching and spreading infections.” from the report
Safeguarding
Staff had safeguarding training and knew how to report concerns about people's safety.
“Staff had received safeguarding training and had guidance about what to do if they had concerns about people's safety.” from the report
Recruitment checks
The home followed recruitment checks designed to ensure staff were suitable to work with people.
“The provider followed safe recruitment procedures to ensure their staff were suitable.” from the report
Positive atmosphere
Inspectors saw a positive atmosphere on the ground floor, with people taking part in activities and daily walks to local shops.
“The atmosphere on the ground floor was very positive with people in the café involved in activities.” from the report
Medicines safety
seriousMedicine records and stock counts did not always match. Inspectors also found problems with storage, collection of medicines and recording where medicated patches were applied.
“Medicines were not always managed safely.” from the report
Staffing levels
seriousThere were not always enough staff, especially on the first floor. This meant communal areas were not monitored effectively and one person's distress escalated.
“There was not enough staff on duty to meet people's needs. This placed people at risk of harm.” from the report
Risk management
needs fixingSome people did not consistently reach the fluid targets in their care plans, with no evidence of action. One person's care plan gave limited guidance when they became very distressed.
“Fluid levels for 4 people we checked consistently did not meet the target specified within their care plans and there was no evidence of any action taken to address this.” from the report
Weak quality checks
seriousThe home's audits and monitoring systems failed to find several of the problems identified by inspectors, including issues raised at the previous inspection.
“Checks and audits undertaken had failed to identify the shortfalls we found at this inspection in relation to medicines management, risk, staffing and dependency tools.” from the report
- 01What has changed to make sure medicines are given as prescribed and that medicine records and stock counts match?
- 02How many care staff are now on each floor, including at weekends, and how do you check that staffing meets people's actual needs?
- 03How are fluid intake, distress and other identified risks now monitored, and what action is taken when care plan targets are not met?
- 04What changes have been made to audits and governance checks so they identify problems before they affect people?
- 05What is the current position on the new manager's registration application and the provider's action plan?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous inspection when calculating the overall rating. This explanation was written from the published report of 14 September 2023 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, March 2023
Chalkwell Grange is rated Good; inspectors found kind, safe care overall, but medicines and some care records needed improvement.
This was the first inspection since the home registered. It was unannounced and took place from 08 February 2023 to 10 February 2023. One inspector spoke with people, relatives, staff and managers, and checked care files, medicines, training, complaints and quality checks.
The home supported 24 people at the time, although it could support up to 48. Inspectors rated all five areas Good: Safe, Effective, Caring, Responsive and Well-led. They found enough staff, suitable infection control arrangements during a COVID-19 outbreak, good healthcare support and respectful care.
There were areas to improve. One person's medicine was not given at the time prescribed, and the application site for some medicated patches was not always recorded. Some care plans contained generic information, and one did not include important information about a person's needs. The home was given recommendations to improve medicines management and care planning.
Kind and respectful care
People and relatives were positive about the care. Staff supported people's dignity, privacy, independence and personal preferences.
“People were treated with care, kindness, dignity and respect.” from the report
Enough staff
Inspectors found staffing levels were suitable for people's needs. Recruitment checks were also completed before staff started work.
“The service was appropriately staffed to meet people's needs.” from the report
Good healthcare support
The home worked with healthcare professionals and supported people with appointments and health needs. Relatives were kept informed about healthcare matters.
“Staff worked well with other organisations to ensure they delivered good joined-up care and support.” from the report
Activities and relationships
People were supported to keep in touch with family and friends and to take part in a range of activities, including quizzes, arts and crafts and reminiscence.
“People were supported to maintain relationships that were important to them, for example, with family members and friends.” from the report
Positive leadership
Inspectors found an open, inclusive culture. Staff felt able to raise concerns, and the home used checks and reviews to identify improvements.
“There was a positive culture within the service that was person-centred, open and inclusive.” from the report
Medicines were not always managed correctly
needs fixingOne person's prescribed medicine was not given at the required time. The application site for some medicated patches was also not always recorded. Inspectors recommended independent advice to improve medicines practice.
“A person did not receive their prescribed medication in line with the prescriber's instructions.” from the report
Some care plans lacked important detail
needs fixingSome records used general information about health conditions rather than explaining the person's individual needs. One care plan did not explain how staff should respond to recorded low mood, possible self-harm or inappropriate behaviour.
“The person's care plan had not been updated to reflect this or to provide guidance to staff detailing how this should be managed.” from the report
Some risk and decision records needed updating
needs fixingCOVID-19 risk assessments were generic rather than personalised. Best-interest decisions were not recorded for people who had sensor mats or alarms.
“Improvements were required to people's COVID-19 risk assessments as these were generic, not person centred or included reference to people's underlying healthcare conditions and the impact this may have.” from the report
Feedback arrangements were still developing
minorPeople and those acting for them had not yet been asked to complete service feedback questionnaires. The manager said this would start after the home had been open for six months.
“People and those acting on their behalf had not yet been given the opportunity to provide feedback about the service through the completion of questionnaires.” from the report
- 01What has changed to make sure medicines are given at the prescribed time and medicated patch sites are recorded every time?
- 02How are care plans updated when a person's mood, behaviour or health needs change?
- 03What action has been taken to make COVID-19 risk assessments personal to each resident and their health conditions?
- 04How are best-interest decisions recorded for sensor mats and alarms?
- 05Have feedback questionnaires now been introduced, and how are the results used to improve the home?
This was an unannounced first inspection covering all five key questions, including infection prevention and control during a COVID-19 outbreak. This explanation was written from the published report of 3 March 2023 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 Chalkwell Grange
2 rated inspections over a year: the service has slipped, from Good to Requires improvement.
- September 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2023GoodSafe: GoodWell-led: Good
- October 2022
Registered with the Care Quality Commission on 18 October 2022.
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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