CQC report explained · a nursing home
What the CQC found at Chandler Court
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2023
Requires Improvement; inspectors found risks and medicines were not always managed safely, and governance needed strengthening.
This was an unannounced focused inspection on 6 and 8 February 2023. Inspectors reviewed Safe and Well-led only. They spoke with people, relatives and staff, observed care, and checked care, medicine and management records.
The home did not always manage risks properly. Some choking risks were not known to staff, some people could not reach their call bells, and prescribed medicines had not always been collected or given on time. Care plans and risk assessments did not always contain the right information.
The home had suitable infection control arrangements, safeguarding systems and medicine storage. People said they felt safe and were happy with their care. However, checks and audits had not found important problems, so the overall rating changed from Good to Requires Improvement.
Infection control
Inspectors were assured that infection risks were being managed, including the use of protective equipment and up-to-date procedures.
“We were assured that the provider was using PPE effectively and safely.” from the report
Safeguarding
Staff understood how to keep people safe and knew about reporting concerns and whistleblowing.
“There were comprehensive safeguarding systems to ensure any reported concerns were actioned immediately.” from the report
People felt safe
People told inspectors they felt safe and were happy with the care they received.
“People told us they felt safe and were happy with the care they received.” from the report
Medicine systems
Staff had medicine training, and medicines were stored securely. There were also risk assessments for people's medicine support.
“People's medicines were stored safely and securely.” from the report
Choking risks
seriousSome choking risks were not known to staff and were not covered properly in care plans. One person was left with food without the required support.
“This left the person at increased risk of choking as staff did not know about the risks” from the report
Medicines delayed
seriousSome prescribed medicines had not been collected or given promptly. One person went without antibiotics for more than two weeks.
“the prescribed medicine had not been collected from the pharmacy and this left the person without the prescribed treatment for over 2 weeks.” from the report
Call bells
seriousSome people could not reach their call bells, so they did not always have a reliable way to ask for help in an emergency.
“There were insufficient measures to ensure people had the means to ask for help when it was needed.” from the report
Weak management checks
seriousAudits and other checks did not identify important risks or ensure that care plans and risk assessments were updated.
“The provider's systems and processes had failed to robustly assess, monitor and improve the quality and safety of the services” from the report
Staff supervision
needs fixingSome staff said they had not had supervision for almost a year and did not always feel listened to.
“Some staff had not had a supervision for almost a year and said they did not always feel listened to.” from the report
- 01What changes have you made to ensure choking risks are clearly recorded and understood by every member of staff?
- 02How do you now check that prescribed medicines, including antibiotics and constipation medicines, are collected and given on time?
- 03How will you ensure every person who needs one can reach their call bell at all times?
- 04What has changed in your audits and care plan checks since the inspection?
- 05Have all staff received regular supervision, and how are staff concerns now being heard and acted on?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous inspection. This explanation was written from the published report of 15 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.
What inspectors found, April 2019
Rated Good; inspectors found kind, personalised care and sound safety systems, with a gap in epilepsy knowledge to address.
This was the first full inspection since the home registered in 2018. It was unannounced and took place over 6 and 7 March 2019. Inspectors spoke with people living there, relatives and staff, and checked care records, medicines, staffing, training and the building.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were treated with kindness and respect, care was personalised, medicines were managed safely and there were enough trained staff.
The home supported people to make choices and maintain relationships, interests and religious beliefs. It also had links with local groups, schools and volunteers. Staff were supported through training, supervision and appraisals.
There were some areas to improve. Inspectors found gaps in staff knowledge about epilepsy, and work was still under way to strengthen links with the local GP practice. The Good rating means the legal requirements were met and the service was performing well at this inspection.
Kind and respectful staff
People said staff were kind and did not make them feel like a nuisance. Inspectors saw staff supporting privacy, dignity and personal choices.
“The staff are so kind here, it's been more like being on holiday.” from the report
Personalised care
Care plans described people's preferences and communication needs. Staff knew people well and responded when their needs or wishes changed.
“Care plans were person centred and reviewed and updated every month or when there was a change in the persons care needs.” from the report
Safe medicines and environment
Medicines were recorded, stored and administered safely. The building was clean, well maintained and free from clutter.
“People were administered their medicines safely. All medicines were signed for on a Medicines Administration Record (MAR) chart.” from the report
Meaningful activities and community links
Activities reflected people's interests and included links with local children, volunteers and community groups.
“There were strong links with the local community.” from the report
Epilepsy knowledge gap
needs fixingInspectors found gaps in staff knowledge about caring for people living with epilepsy. The manager said training would be addressed, so families should check what has changed since the inspection.
“During the inspection visit, it was realised there were gaps in staff knowledge for people living with Epilepsy.” from the report
GP links still being strengthened
minorThe home had access to a weekly GP visit, but inspectors said work was still under way to improve links with the local GP practice.
“Work was ongoing with the provider to strengthen links with the local GP practice.” from the report
- 01What epilepsy training has staff completed since the inspection, and how is their competence checked?
- 02How do you now work with the local GP practice, and how quickly can people see a GP when needed?
- 03How often are care plans reviewed, and how are changes in needs shared with all staff?
- 04How do you make sure agency staff know each person's care needs and preferences?
- 05How are activities chosen and adapted for the person I am considering placing here?
This was an unannounced comprehensive inspection and covered all five CQC areas, including the building and the care provided; it was the first comprehensive inspection since registration in 2018. This explanation was written from the published report of 11 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 Chandler Court
2 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- March 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2019GoodSafe: GoodWell-led: Good
- January 2018
Registered with the Care Quality Commission on 24 January 2018.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Worcestershire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 85 can care for a couple. 9 years' experience on average.
“I have never met a person who is so kind and thinks about others before himself to such an extent as Chris Malagala.”
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.