CQC report explained · a residential care home
What the CQC found at Chignal House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, staffing levels were suitable, medicines were given safely and the environment was well maintained.
- Effective?
- Good
- Staff understood people's complex needs and care plans gave practical guidance. Improvements had been made in staff understanding of the Mental Capacity Act.
- Caring?
- Good
- Staff were kind, patient and respectful. They used people's gestures, facial expressions and other ways of communicating to understand their wishes.
- Responsive?
- Good
- Care was tailored to people's preferences and communication needs. People were supported with activities, education, leisure, community access and relationships with family.
- Well-led?
- Good
- Management had improved its oversight of the home. Audits had clear actions, and the home used an action plan to monitor improvements.
What inspectors found, August 2019
Chignal House is rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced, comprehensive inspection on 1 May 2019. One inspector spoke with staff, the manager, one person using the service and a health professional. They also observed care, checked records and reviewed information from other organisations.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were safe, staff understood complex needs, medicines were managed safely and people could access healthcare.
Staff were described as kind and respectful. People were supported to make choices, keep relationships, take part in activities and use the community. Care plans were detailed and regularly updated.
The report says improvements had been made since the previous inspection. Staff had improved their understanding of the Mental Capacity Act, and management had improved its use of audits and oversight of the home.
Kind and respectful staff
Inspectors observed staff showing patience, empathy and respect. Staff knew people well and supported their dignity and independence.
“We observed staff interacting with people. Staff showed kindness and empathy.” from the report
Personalised communication
Staff adapted how they communicated for people who could not speak verbally. Care plans recorded communication needs and staff allowed people time to express themselves.
“Staff were patient allowing people the time they needed to talk about topics of interest and communicate their views.” from the report
Safe medicines and staffing
Staff had medicines training and daily records showed when medicines had been given. Inspectors also found staffing levels appropriate for people's needs.
“Daily records were maintained by staff showing when people had received their medicines as prescribed.” from the report
Activities and community life
People were supported to go out, attend education and leisure activities, visit family and take holidays of their choosing.
“People were supported to access the community to attend educational and leisure activities.” from the report
Improved management oversight
The report found that earlier concerns about audits and management oversight had been addressed. Actions were now recorded and followed through.
“Audits were clear with actions highlighted and signed off when achieved.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you assess and support my relative's communication needs if they cannot communicate verbally?
- 02How would you manage my relative's specific health risks, such as seizures or other complex needs?
- 03How do you support people to make everyday choices while following the Mental Capacity Act?
- 04What activities, education, outings and family contact would be available for my relative?
- 05How do you check that medicines have been given correctly and that any changes are acted on?
This was an unannounced follow-up comprehensive inspection covering all five key questions; the previous inspection had been focused on Safe and Well-led. This explanation was written from the published report of 22 August 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.
What inspectors found, January 2019
Rated Good; inspectors found safer medicines management and stronger leadership, but some records and procedures still needed improvement.
This was an unannounced focused inspection over 11 and 12 December 2018. Inspectors looked at whether people were safe and whether the home was well-led. They spoke with people, a family member, staff, managers and the provider. They also reviewed care records, staff files and other documents.
The home had improved since the previous inspection, which was rated Requires Improvement overall. Medicines management, risk assessments, safeguarding and quality checks had improved. Inspectors found enough safely recruited staff, a clean and homely environment, and staff who knew people well.
The home was rated Good for Safe and Good for Well-led. Some records and processes were not yet streamlined, some guidance was out of date, and the registered manager was still managing two other services. The provider had plans to address these issues.
Improved medicines safety
Staff received refresher training and had clearer guidance. Managers increased medicine audits and competency checks.
“The registered manager had significantly enhanced the administration of medicine.” from the report
Staff knew people well
There were enough safely recruited staff, and the home rarely used agency staff because it wanted people to be supported by familiar staff.
“There were enough safely recruited staff to meet people's needs.” from the report
Better risk management
Personalised risk assessments gave staff clearer guidance while allowing people to continue activities and make choices.
“Staff adjusted their support in line with people's flexible timetables.” from the report
Improved leadership and oversight
The provider and registered manager introduced regular quality checks and meetings to track concerns and improvements.
“Since our last inspection the provider had started quarterly formal checks, which highlighted issues of concern.” from the report
Manager’s workload
needs fixingThe registered manager was still responsible for three services. Inspectors found limited impact at this home, but said the manager was stretched and noted plans for deputy support.
“Although the registered manager was still stretched as they were managing two other services, the provider was addressing this issue.” from the report
Records were not streamlined
needs fixingStaff spent a lot of time writing records, and information was not always easy to find.
“They had not fully streamlined processes so staff were spending a lot of time writing and information was not always easy to find.” from the report
Outdated guidance
needs fixingSome guidance documents and procedures did not reflect current best practice. The manager had plans to update them.
“We also found some guidance documents and procedures were outdated and did not represent current best practice.” from the report
Consultation records
minorPeople and families were consulted, including about building work, but the home did not always record their views formally.
“There was scope to improve and record the consultation with people in some of the more formal processes, such as during the provider's quarterly check, to ensure people's voice was captured formally.” from the report
- 01How have you kept medicines training, competency checks and audits up to date since this inspection?
- 02Who now provides day-to-day support when the registered manager is managing the other two services?
- 03Have you streamlined the records so staff can find important safety information quickly?
- 04Which guidance documents and procedures were updated after inspectors found they did not reflect current best practice?
- 05How are people’s and families’ views now recorded during formal quality checks?
This was a focused inspection of Safe and Well-led only; the report does not give detailed ratings for Effective, Caring or Responsive. This explanation was written from the published report of 19 January 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 Chignal House
5 rated inspections over 4 years: the service has held its Good rating throughout.
- August 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- May 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- February 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 January 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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