CQC report explained · a residential care home
What the CQC found at Chaston House Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, June 2022
Rated Requires Improvement; inspectors found kind care and good support, but safety, activities and management checks were not reliable.
The inspection was unannounced and took place on 31 May 2022. Inspectors spoke with people using the home, a visitor and staff. They reviewed care records, medicines records, staff files, audits and safety checks.
People said they felt safe and were happy with their care. Staff were kind, trained and supported. Healthcare professionals said the home worked well with them. Infection prevention measures were also found to be effective.
However, some risks were not properly managed. Medicines records did not always match the medicines remaining. Safety checks were overdue, garden items created a risk, and records about care assessments and activities were incomplete.
The overall rating is Requires Improvement. The home breached Regulation 12 on safe care and treatment and Regulation 17 on good governance. The previous rating was Inadequate, and improvements were found in effective and caring care, but the service had been Requires Improvement or Inadequate for the last three inspections.
Kind and respectful care
People said staff were kind, listened to them and respected their privacy and choices.
“The staff supported people with kindness and respect.” from the report
Staff training and support
Staff received relevant training, induction, supervision and competency checks.
“People were supported by staff who were well trained, supervised and appraised.” from the report
Good healthcare links
Staff worked with healthcare professionals and acted on changes in people's health.
“Healthcare professionals we contacted were happy with the service and the way people were supported.” from the report
Infection control
Inspectors were assured about infection prevention, use of protective equipment, testing and outbreak arrangements.
“We were assured that the provider was using PPE effectively and safely.” from the report
Improvements since earlier inspections
The home had improved its approach to dignity, communication, end-of-life care and the environment.
“At this inspection, we found improvement had been made and the provider was no longer in breach of this regulation.” from the report
Risk records were not reliable
seriousRepositioning records were disorganised and a large recorded weight loss was not followed up. This meant inspectors could not be sure risks were being managed as planned.
“This meant we could not be sure the person was being supported with repositioning in line with their care plan.” from the report
Medicines discrepancies
seriousThe number of tablets left did not always match staff signatures, and one as-required medicine was not recorded on the medicines administration record.
“People did not always receive their medicines safely and as prescribed.” from the report
Overdue safety checks and garden hazards
seriousSome checks had not been completed for several months. Discarded items piled up in two parts of the garden and posed a safety risk.
“There were discarded items piled up in two areas of the garden which posed a safety risk to people.” from the report
Activities were not planned clearly
needs fixingPeople took part in activities on the inspection day, but there were no individual activity plans or board showing planned activities.
“However, people still did not have individual activity plans, and there was no board displaying the activities planned for each day.” from the report
Quality checks missed problems
seriousThe provider's audits and monitoring systems did not identify the shortfalls found by inspectors. This was a repeated governance breach.
“We found no evidence that people had been harmed. However, the provider did not have effective arrangements to assess, monitor and improve the quality of the service.” from the report
- 01What changes have been made to ensure medicines counts and records always match?
- 02How are repositioning records, weight changes and other personal risks now checked and followed up?
- 03Have all overdue health and safety checks been completed, and how often will they be repeated?
- 04How are individual activity plans now prepared and shared with residents?
- 05What evidence can you show that the new quality audits identify problems before they put people at risk?
This inspection considered all five CQC questions and infection prevention and control, but some improvements from the previous inspection were checked through follow-up rather than a full earlier assessment. This explanation was written from the published report of 28 June 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, December 2020
Requires Improvement overall; inspectors found better staffing and care, but gaps remained in risk records, infection checks and quality monitoring.
This was an unannounced, focused inspection on 4 November 2020. The inspector checked whether earlier warning notices about safe care and quality monitoring had been met. They spoke with two people, three staff and the registered manager, and reviewed care, medicines, staffing and management records.
The home had improved since the previous inspection, which was rated Inadequate. Staffing was sufficient and people’s needs were being met. However, one person did not initially have a risk assessment, some safety checks were not recorded, and staff did not always follow COVID-19 visitor checks.
The home was rated Requires Improvement overall. Safe and Well-led were both rated Requires Improvement. The home had left Special Measures, but the provider remained in breach of Regulation 17 about good governance and was asked to provide an action plan.
Staffing levels
The inspector found that all shifts had been covered for the previous three months and that there were enough staff to meet people’s needs.
“We looked at the staff rota for the last three months and saw that all shifts were covered and there were enough staff to provide support to people and meet their needs.” from the report
Improved risk management
Most risk assessments were detailed and included steps to reduce risks. Staff also took appropriate action for people with specific medical conditions and risks of falls.
“The registered manager had assessed other risks to people's safety and wellbeing.” from the report
Medicines processes
Medicines records were generally clear, staff had training and competency checks, and errors were followed up. The inspector found no serious medicines errors since the previous inspection.
“We saw there had not been any serious errors since the last inspection.” from the report
Supportive atmosphere
People appeared settled and supported. Staff said they felt supported by the manager and worked well together.
“There was a calm and relaxed atmosphere in the lounge and people were listening to classical music.” from the report
Missing risk assessment
seriousOne person was at risk of skin deterioration but did not have a risk assessment in place when inspectors visited. The manager sent one the next day.
“There was no risk assessment in place for one person who used the service whose skin was at risk of deterioration.” from the report
Safety checks not recorded
needs fixingSome checks on window restrictors and water safety had not been recorded for recent months. The manager said the checks had been done but not written down.
“However, we saw some of these were out of date.” from the report
Weak quality monitoring
seriousThe monitoring systems did not identify all the problems found during the inspection. This was a repeated breach of Regulation 17.
“The provider did not have effective arrangements to assess, monitor and improve the quality of the service.” from the report
Limited involvement
needs fixingThere were no meetings for people using the home, and people were not routinely involved in planning home improvements. Staff meetings had also been infrequent.
“We saw there were no meetings for people who used the service.” from the report
- 01What risk assessments are now in place for every resident, especially for skin deterioration and other health risks?
- 02How do you make sure window restrictor, water, fire and equipment safety checks are completed and recorded on time?
- 03How are visitors checked for temperature, COVID-19 symptoms and recent contact with anyone who had symptoms?
- 04What changes have you made to the quality monitoring system since the repeated Regulation 17 breach?
- 05How often are resident and staff meetings now held, and how are residents involved in decisions about home improvements?
This was a focused inspection of Safe and Well-led, including infection prevention and control; Effective, Caring and Responsive were not inspected and their earlier regulatory breaches were not checked. This explanation was written from the published report of 3 December 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.
Every inspection of Chaston House Care Home
5 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- June 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2020Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- April 2020Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- March 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- April 2013
Registered with the Care Quality Commission on 16 April 2013.
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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