CQC report explained · a nursing home
What the CQC found at Challoner House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, suitable recruitment checks, clear risk assessments and safe medicines arrangements. Infection control systems were in place and staff were following COVID-19 guidance.
- Effective?
- Good
- This area was not inspected during this focused visit. The previous comprehensive rating was used when calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this focused visit. The previous comprehensive rating was used when calculating the overall rating.
- Responsive?
- Requires improvement
- This area was not inspected during this focused visit. The previous comprehensive rating was used when calculating the overall rating.
- Well-led?
- Good
- Inspectors found an open culture, supportive management, regular audits and a stable staff team. Relatives and staff gave positive feedback about communication and leadership.
What inspectors found, October 2020
Challoner House is rated Good; inspectors found safe care and stronger management, but this was a focused inspection.
Inspectors visited on 26 August 2020. They spoke with staff, relatives and a professional, observed care and medicines, and checked care, recruitment, medicines, infection control and management records.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safe recruitment, well-managed risks, safe medicines systems and infection control measures for COVID-19. Relatives generally said people were safe and well cared for.
The overall rating improved from Requires Improvement at the previous inspection. However, this visit only checked Safe and Well-led. The previous ratings for Effective, Caring and Responsive were carried forward and were not reassessed.
Staffing
Inspectors found enough staff to meet people's needs. Staff were observed responding promptly and compassionately.
“There were sufficient staff to meet people's care needs. We observed that staff were not rushed and responded promptly and compassionately to people's requests for support.” from the report
Safe medicines
Medicines were stored, administered and recorded safely. Staff were trained and checked to make sure they remained competent.
“Medicines were managed and stored safely. People received their medicines from staff that were trained to do so and who had regular assessments to ensure they remained competent to administer medicines.” from the report
Infection control
The home was visibly clean, with cleaning schedules and measures to manage infection risks. Relatives praised the response to COVID-19.
“Staff followed a daily cleaning schedule and areas of the home was visibly clean. There were no malodours around the home.” from the report
Open management
Inspectors found an open and transparent culture. Managers used audits to monitor medicines, care plans, infection control, falls and safety.
“The registered manager and senior staff used a series of audits to monitor the service.” from the report
Missed medicines signatures
minorThere had been a few errors where staff did not sign medicines records. These were found through daily checks and dealt with, but the issue is worth asking about.
“The Clinical Team Leader said there had been a few missed signatures errors, but these were quickly identified during daily peer audits and had been dealt with.” from the report
- 01How do you currently make sure there are enough staff on each shift, including when someone is absent?
- 02How are missed medicines signatures checked and prevented now?
- 03What infection control measures are currently used when people visit or when there is an infection outbreak?
- 04What were the latest ratings or findings for Effective, Caring and Responsive, since these were not checked in this inspection?
- 05How are relatives kept informed about visits, changes in care and any incidents?
This was a focused inspection of Safe and Well-led only; the previous ratings for Effective, Caring and Responsive were carried forward. This explanation was written from the published report of 23 October 2020 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, April 2019
Rated Requires Improvement; inspectors found kind care and safer medicines, but staffing and personalised activities were still not reliable, and the home had just left special measures.
Inspectors visited without notice on 26 and 27 February and 5 March 2019. They spoke with people, relatives, staff and health professionals, and checked care records, medicines, complaints, incidents and quality checks.
The home had improved since its previous inspection, when it was rated Inadequate and placed in special measures. Medicines, staff training, consent, risk assessments and dignity had improved. However, staffing was still not consistent enough, and some people did not receive activities or support suited to their individual needs.
The overall rating was Requires Improvement. Effective and Caring were rated Good. Safe, Responsive and Well-led were rated Requires Improvement. The home was taken out of special measures, but CQC said it would continue to monitor whether improvements lasted.
Medicines
Inspectors found medicines were being administered and recorded safely. Staff explained medicines and sought consent.
“At this inspection we found improvements had been made, medicines were now safe.” from the report
Kind and respectful care
People were treated respectfully and staff understood their preferences, privacy and dignity.
“All the interactions we observed between people and staff were positive and friendly.” from the report
Staff support and training
Supervision and training had improved. Staff said the training supported them in their roles.
“Records showed that improvements had been made and were ongoing to ensure all staff received appropriate training.” from the report
Risk management
Most risks had been identified and plans were in place to reduce them. Fire and emergency arrangements were also checked.
“Risks to people had been identified, assessed and had appropriate management plans in place to prevent or reduce the risk occurring.” from the report
Food and mealtimes
People received a choice of fresh food and drinks, and staff supported people appropriately during a relaxed meal.
“There was a relaxed atmosphere in the dining room, the meal was unhurried and people chatted with each other and with staff.” from the report
Staffing and response times
seriousStaffing was better but still not reliably sufficient. People sometimes waited for help, including for call bells, and inspectors found one person at risk because they were not observed while eating.
“People and relatives told us staff did not always respond promptly to alarms or call bells.” from the report
Activities for people cared for in bed
needs fixingSome people cared for in bed did not receive regular meaningful one-to-one activities. This meant they did not have the same opportunities to support their wellbeing as people attending group activities.
“People we spoke with who were cared for in bed told us they had not had meaningful one to one activities regularly and said staff did not have time.” from the report
Following an exercise plan
needs fixingFor one person, staff did not consistently carry out or record exercises set out in the care plan.
“We checked records which showed no exercises had been recorded.” from the report
Improvements not yet secure
needs fixingThe provider had made changes, but CQC said these needed to be embedded and sustained. The home also did not have a registered manager at the time of inspection, although an application was in progress.
“At this inspection we found improvements had been made, however, there was a need to sustain the improvements made and to make further improvements.” from the report
- 01How many care staff are planned for each shift, including weekends, and what happens when staff are off sick?
- 02How quickly are call bells usually answered, and how is this checked?
- 03How will you make sure a person at risk of choking is observed while eating?
- 04What regular one-to-one activities are available for people who are cared for in bed?
- 05How do you check that care plans, such as prescribed exercises, are followed and recorded?
This was an unannounced enforcement follow-up that reviewed all five key questions, the overall rating and progress since the previous inspection. This explanation was written from the published report of 17 April 2019 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 Challoner House
4 rated inspections over 4 years: the service has held its Good rating throughout.
- October 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- April 2019Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- January 2019Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2015
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 2011.
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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