CQC report explained · a nursing home
What the CQC found at Chelmunds Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Risks, medicines, staffing and infection control were generally managed safely, although one personal evacuation plan had not been updated.
- Effective?
- Good
- Staff were trained and people had access to health professionals. People's food and drink support had improved, although one person was not using available adapted equipment to eat independently.
- Caring?
- Good
- Staff were observed to be respectful, patient and kind. People and relatives were involved in care decisions, and privacy, dignity and independence were respected.
- Responsive?
- Good
- Care was personalised and staff knew people's preferences and how to respond to anxiety. People had activities, support to maintain relationships and arrangements for end of life care.
- Well-led?
- Good
- Management and quality checks had improved since the previous inspection. Some records still needed clearer information, including recruitment, evacuation and behaviour records.
What inspectors found, October 2022
Rated Good; inspectors found kind, safe and improved care, but some records were still not clear.
Inspectors visited the home unannounced on 8 August 2022. They observed care, spoke with relatives and staff, and reviewed care records, medicines, recruitment checks, training and quality checks.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough trained staff, safe medicines arrangements, kind care, personalised support and better management than at the previous inspection.
The home had previously been rated Requires Improvement and had breached regulations. This inspection found enough improvement for those breaches to be resolved. Some records still needed clearer information, but inspectors found no negative impact on people from these recording issues.
Improved management
Inspectors found many improvements since the previous inspection. Staff said the home was better organised and they felt supported and listened to.
“The service is much better organised” from the report
Safe staffing and medicines
There were enough staff with suitable skills, and recruitment checks were completed. Medicines were stored, given and recorded safely.
“People received their medicines as prescribed by staff who had completed medication training and were deemed competent to administer medicines.” from the report
Kind and respectful care
Staff treated people with patience and kindness. Inspectors saw staff respecting people's privacy, dignity and choices.
“Staff were observed to be respectful, patient and kind in their approach to people.” from the report
Personalised support
Care plans recorded people's needs and preferences. Staff recognised signs of anxiety and responded in ways that helped people feel calmer.
“People received personalised care that met their needs.” from the report
Family involvement
Relatives were kept informed and could take part in care decisions. The home had also improved communication arrangements during the Covid-19 pandemic.
“People and their relatives (where appropriate) were involved in making care decisions to support people's needs.” from the report
Some records were unclear
needs fixingA small number of records needed clearer information. This included recruitment details, evacuation plans and records showing whether behaviour support plans were effective.
“Despite the improvements, some records needed to be clearer in areas.” from the report
One evacuation plan was out of date
needs fixingOne person's emergency evacuation plan did not reflect their increased risk and the support they would need to leave the home. The manager was told about this.
“One record we viewed had not been updated to reflect the increase in risk and level of support the person would need to evacuate the home.” from the report
Adapted eating equipment
minorOne person struggled to get food onto their fork. A plate guard and adapted cutlery were not being used at the time, although the manager said they would be made available where needed.
“A plate guard and adapted cutlery was not in use to help support the person's independence.” from the report
Complaint procedure
minorPeople and relatives knew who to approach with concerns, but it was not clear that everyone had received a copy of the complaints procedure.
“People and relatives knew who to speak with if they had any concerns or complaints despite it not being clear they had been provided with a copy of the complaint's procedure.” from the report
- 01How have you made sure every personal emergency evacuation plan reflects the person's current risks and support needs?
- 02How do you check that care, behaviour and recruitment records are complete and clear?
- 03How do you identify and provide adapted cutlery or other equipment when someone has difficulty eating independently?
- 04How are relatives given the complaints procedure, and how can they raise a concern?
- 05What improvements from the previous inspection have been maintained since this visit?
This was an unannounced follow-up inspection covering all five rating areas and infection control, after the previous Requires Improvement rating and regulatory breaches. This explanation was written from the published report of 5 October 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
Chelmunds Court was rated Requires Improvement; inspectors found risks from staffing, infection control and weak management systems.
This was a focused inspection on 19 October 2020. Inspectors checked Safe and Well-led, followed up a previous warning notice, and looked at infection control during the coronavirus pandemic. They spoke with people, relatives and staff, observed care, and checked care and medicine records.
Some improvements had been made since the previous inspection. The home had improved how it reported accidents and incidents, taken action on some medicine issues, and helped people keep in touch with relatives during lockdown.
However, inspectors found that risks were not always managed safely. Risk assessments were out of date, staff numbers and deployment did not always meet people's needs, and infection control guidance was not consistently followed. Quality checks had identified problems, but action was often delayed.
The overall rating remained Requires Improvement, as did Safe and Well-led. The report says this means there was limited assurance about safety and an increased risk that people could be harmed. The other three question areas were not reviewed during this inspection, so their previous ratings were carried forward.
Family contact
The home supported people to keep in contact with relatives during lockdown through telephone and video calls.
“Relatives had maintained some contact with their family members during the national lockdown which included video and telephone calls.” from the report
Safer recruitment
Inspectors found that recruitment checks were completed before staff started work.
“Staff confirmed recruitment checks were completed before they were able to start work at the service.” from the report
Visitor precautions
There were arrangements for visitors to book visits, use protective equipment and understand infection control requirements.
“Visits were pre booked and staggered to minimise visitor numbers.” from the report
Infection control
seriousStaff did not always use protective equipment correctly, follow isolation rules or complete Covid-19 checks as required. Cleaning arrangements were also not strong enough.
“People were not protected from the risk of infection.” from the report
Staffing levels and deployment
seriousStaff said there were not enough of them, and inspectors saw delayed care. People sometimes waited for personal care, food or drinks.
“Staff told us there were not enough of them to provide safe care.” from the report
Risk management
seriousSome risk assessments were not reviewed or updated. Risks involving choking, pain, seizures and people's behaviour were not always managed effectively.
“One person's risk assessments in regards to choking and pain had not been reviewed and updated as required by the provider” from the report
Weak management checks
seriousAudits found problems, but action was not always taken promptly. Falls monitoring and infection control oversight were not effective enough.
“Quality assurance systems remained ineffective.” from the report
Care and medicine records
needs fixingMedicine records were not always signed and dated, and records did not always show that less restrictive options had been tried before covert medicines were used.
“Handwritten entries on medicine records were not always signed and dated as required.” from the report
Person-centred care
needs fixingStaff did not always have enough time or information to provide care around people's preferences and individual needs.
“People did not always receive person centred care due to staff deployment in the home not being effective.” from the report
- 01How have you increased or changed staffing so people receive timely personal care, meals and drinks?
- 02How do you now assess and review risks such as choking, seizures, falls, pain and people's behaviour?
- 03What checks make sure staff use protective equipment correctly and follow isolation and Covid-19 testing requirements?
- 04How are medicine records checked, including records for creams and medicines given covertly?
- 05What evidence can you show that problems found by audits are now fixed promptly?
This was a focused inspection of Safe and Well-led, including the previous warning notice and infection control; the other ratings were carried forward from earlier inspections. This explanation was written from the published report of 25 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 Chelmunds Court
6 rated inspections over 4 years: the service has improved, from Inadequate to Good.
- October 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- March 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2018Inadequatestayed InadequateSafe: InadequateWell-led: Inadequate
- August 2018InadequateSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- November 2017
Registered with the Care Quality Commission on 2 November 2017.
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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