CQC report explained · a nursing home
What the CQC found at Chase House Limited
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, August 2021
Chase House Limited is rated Good overall, but inspectors found weaknesses in management checks and medicine-recording systems.
This was an unannounced, focused inspection after concerns about medication errors and staffing levels. Inspectors visited on 8 July 2021 and gathered further information up to 21 July. They spoke with people, relatives and staff, observed care, and checked care, medication, recruitment and management records.
The home was rated Good for Safe. People were supported by suitable staffing levels, care plans and risk assessments were in place, medicines were generally given safely, and infection control arrangements were effective. People and relatives said they felt safe and spoke positively about the care.
The home was rated Requires Improvement for Well-led. The quality checks did not always identify or fix problems. Medicine stock balances were incorrect, staff were finding the new electronic medicine system difficult to use, and planned further training had not yet been completed. The overall rating remained Good, using this inspection and ratings carried over from the previous comprehensive inspection.
People felt safe
People and relatives told inspectors they felt safe and had confidence in the care. Staff knew how to report safeguarding concerns.
“People and their relatives told us they felt safe at the service.” from the report
Risk management
Care plans and risk assessments gave staff guidance about people's needs and were reviewed when necessary.
“Care plans and risk assessments had been completed for each person and provided information and guidance to staff” from the report
Staffing and recruitment
Inspectors found staffing levels were adequate and recruitment checks had been completed. Relatives said staff responded quickly and knew the people they supported.
“A recruitment process was in place to ensure staff were recruited to the service safely.” from the report
Activities and communication
Staff encouraged people to join activities based on their interests. The management team kept in touch with relatives in several ways during visiting restrictions.
“Activity co-ordinators were knowledgeable of peoples interests and hobbies and were passionate in providing a range of activities for all.” from the report
Medicine records and stock checks
needs fixingThe new electronic medicine system was not being used consistently. Stock balances were wrong and the reason could not be identified, although inspectors found that people received medicines safely.
“medicine stock balances were incorrect and the reason for this could not be identified.” from the report
Management audits
needs fixingThe home's quality assurance process needed stronger oversight so that it reliably led to change and improvement.
“An audit process was in place however this required review and oversight to ensure it was robust in driving change.” from the report
Outstanding system training
needs fixingStaff said they found the electronic medicine system difficult to use. Further training had been planned but was not complete when inspectors visited.
“This had not been completed at the time of the inspection.” from the report
- 01What further training has staff completed on the electronic medicine recording system?
- 02How do you now check and investigate differences between recorded and actual medicine stock?
- 03What changes have been made to the audit system, and who is responsible for checking that improvements are completed?
- 04How do you make sure staffing levels remain adequate when agency staff are needed?
- 05What were the ratings for Effective, Caring and Responsive at the previous comprehensive inspection?
This was a focused inspection of Safe and Well-led only; the other ratings carried over from the previous comprehensive inspection. This explanation was written from the published report of 12 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.
What inspectors found, March 2019
Chase House Limited was rated Good overall; inspectors found safe, kind and personalised care, but leadership and quality checks required improvement.
Inspectors visited without notice on 13 February 2019 and reviewed records, policies, staff files and the premises. They spoke with people living in the home, relatives and staff, and observed care.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found enough staff to meet people's needs safely, medicines were managed safely, and people received kind, respectful and personalised care.
Well-led was rated Requires Improvement. Quality checks did not always show that problems had been fixed and improvements sustained. Staff supervision and training records had not always been up to date, although new systems had recently been introduced.
The overall rating was Good, the same as at the previous inspection published in August 2016. This means the home met the required standards overall, but its management systems needed strengthening.
People felt safe
People and relatives told inspectors they felt safe. Staff knew how to report safeguarding concerns and risks to people's health and wellbeing were assessed.
“People told us they felt safe living at the service and with how staff supported them.” from the report
Kind and respectful care
People said staff were kind, caring and polite. Inspectors observed respectful support and a peaceful, respectful culture.
“People and relatives told us staff were kind, caring and polite.” from the report
Personalised support
Care plans included detailed information about people's preferences and routines. Staff supported people to make choices and remain as independent as possible.
“People's care and support needs were being met by the service in a personalised way.” from the report
Activities and environment
People had access to activities, hobbies, pets and community links. Inspectors described the reminiscence street and other areas as pleasant and stimulating.
“This provided a really pleasant and stimulating environment for people living at the service.” from the report
Safe medicines and healthcare
Inspectors observed medicines being given safely and found complete medicine records. Staff helped people access health professionals when needed.
“We observed safe medicine administration practices.” from the report
Quality checks were not strong enough
needs fixingAudits and records did not always show what action had been taken after shortfalls or concerns, or whether improvements had lasted. Inspectors asked the manager to show more clearly how learning was shared.
“Their quality monitoring systems were not always robust enough to show what action had been taken to make sustained improvements” from the report
Agency staff competence
needs fixingThe home regularly used agency staff because of vacancies. Inspectors saw one agency worker supporting someone to eat at an uncomfortable pace, and found there was no formal process to check agency staff competence.
“They did not have a formal process to do this.” from the report
Supervision and training records
minorStaff had not always received regular supervision, and training had not been up to date when the local authority inspected in October 2018. New systems had been introduced, but inspectors could not yet judge whether they would last.
“At this inspection, it was too early for us to judge whether the provider would sustain this in a consistent way.” from the report
- 01How do you now check the skills and competence of agency staff before they support people?
- 02What system is now used to ensure all staff receive regular supervision and their training stays up to date?
- 03How do your quality audits show that problems have been fixed and that improvements have lasted?
- 04How is learning from incidents, complaints and audits shared with staff and checked later?
- 05How will my relative's care plan be reviewed with them and with our family?
This was an unannounced planned inspection covering all five CQC questions, including the premises, care records, staff processes and quality systems. This explanation was written from the published report of 22 March 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 Chase House Limited
3 rated inspections over 5 years: the service has held its Good rating throughout.
- August 2021Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2019Goodstayed GoodSafe: GoodWell-led: Requires improvement
- August 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 22 December 2010.
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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