CQC report explained · a nursing home
What the CQC found at Chiltern Grange Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured about visitors, admissions, testing, cleanliness, infection control policies and outbreak planning. They were only somewhat assured about PPE use and isolation arrangements during the recent outbreak.
- Effective?
- Good
- Does the care work? Training, consent, food and drink, working with GPs and nurses.
- Caring?
- Good
- Are people treated with kindness and dignity?
- Responsive?
- Good
- Is care built around the person? Care plans, activities, complaints.
- Well-led?
- Good
- Is the home run well? The manager, the culture, how problems get found and fixed.
What inspectors found, January 2021
Inspected but not rated; inspectors found strong infection control overall, but some PPE and isolation practices needed improvement.
This was a targeted inspection on 18 December 2020 during the COVID-19 pandemic. Inspectors checked infection prevention and control arrangements after a recent outbreak. The inspection was announced by phone on arrival.
Inspectors found safe arrangements for visitors, admissions and COVID-19 testing. The home was clean, staff had suitable protective equipment, and infection control audits and policies were in place.
There were isolated examples of poor PPE practice. Inspectors also found areas to improve in isolating people during the outbreak, particularly where people living with dementia were independently mobile. The home responded immediately and shared an action plan.
The service was inspected but not rated. This report only gives a view of the infection prevention and control arrangements checked during this targeted inspection. It is not an overall quality rating for the home.
Safer visiting
Visitors had health checks, handwashing and PPE arrangements. Screens and booked visiting slots were used when guidance allowed visits.
“We observed safe arrangements for visits, including the use of substantial screens between the resident and visitors, designed to reduce the risk of viral transmission.” from the report
Testing and admissions
The home was registered for regular testing of staff and residents. New arrivals were tested and isolated to reduce the risk to existing residents.
“Safe admission processes were in place when people arrived from the community or a hospital setting.” from the report
Clean environment
Inspectors saw regular cleaning and frequent sanitising of higher-risk surfaces. The home was described as clean and hygienic.
“The home environment was kept in a clean and hygienic condition throughout.” from the report
Action after feedback
The home responded immediately to feedback about PPE areas and produced a detailed plan for managing future outbreaks.
“The service responded to our feedback immediately to confirm they had taken appropriate action.” from the report
PPE practice
needs fixingInspectors saw isolated examples where PPE was not used well. They also suggested improvements to areas where staff put on and remove PPE.
“We observed isolated examples of poor practice in relation to the use of PPE and suggested improvements to PPE donning and doffing areas.” from the report
Isolation during outbreaks
needs fixingThe home needed to improve how it isolated people during an outbreak, including people living with dementia who were independently mobile.
“We identified areas for improvement in relation to the isolation of individuals during a recent outbreak of COVID-19.” from the report
- 01What changes have you made to the PPE areas since the inspection, and how do you check that staff use PPE correctly?
- 02What did the detailed outbreak action plan change in practice?
- 03How do you safely isolate residents living with dementia who are independently mobile during an outbreak?
- 04How often are staff and residents tested, and what happens when someone cannot consent to a COVID-19 test?
- 05How are cleaning, infection control and PPE audits reviewed by the home?
This was a targeted inspection of infection prevention and control, focused on Safe; the service was inspected but not rated and the other areas were not assessed. This explanation was written from the published report of 21 January 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, February 2018
Chiltern Grange Care Home was rated Good; inspectors found safe, kind care and significant improvements since the previous inspection.
This was an unannounced inspection on 15 and 16 January 2018. Inspectors observed care, spoke with people, relatives and staff, and reviewed care plans, medicines records, audits and recruitment documents.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that risks were recorded clearly, medicines were given on time, staffing had improved, and people were supported with food, healthcare and activities.
The inspection followed several concerns found in April 2017. The report says these areas had improved, including care records, mental capacity and liberty safeguards, confidential information, end of life planning and notifications to the CQC.
Clear risk records
Care plans and risk assessments were up to date and explained the steps staff should take to reduce risks.
“Records related to risks had clearly identified the risk and the methods used to minimise risk.” from the report
Medicines given safely
Inspectors found that medicines were given at the prescribed times. Records and audits were being used to check this.
“During this inspection we found medicines were administered in line with the prescribed times.” from the report
Kind and respectful staff
People and relatives spoke positively about staff. Inspectors saw staff protecting privacy, seeking consent and treating people gently.
“People and their relatives spoke positively about the staff, the care they provided and the senior staff.” from the report
Activities and social contact
People took part in activities that reflected their choices, including trips, quizzes, music, gardening and contact with a therapy dog.
“People participated in activities they appeared to enjoy, were in line with their choices and protected them from the risk of social isolation.” from the report
Improvements after the previous inspection
The report says earlier problems with records, staffing, mental capacity safeguards, confidentiality and end of life planning had been addressed.
“During this inspection we found improvements had been made to all the areas that we previously reported as required improvement.” from the report
One mixed feedback response
minorFive of six questionnaire responses were positive, but one relative said their experience had not been as positive as expected. The report says the manager addressed the situation and it had improved.
“For one relative their experience was not as positive as they had expected.” from the report
- 01How do you now keep care plans and risk assessments accurate and up to date?
- 02What checks make sure medicines are given at the prescribed times, and how are any errors dealt with?
- 03How are each person's end of life wishes recorded and reviewed with them or their representative?
- 04How do you make sure activities match each person's interests and choices?
- 05How do you decide how many staff are needed on each floor, and how much agency staff is currently being used?
This was an unannounced inspection of all five key questions and included follow-up checks on concerns and recommendations from the April 2017 inspection. This explanation was written from the published report of 14 February 2018 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 Chiltern Grange Care Home
6 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- January 2021Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- February 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2015Requires improvementdown from GoodSafe: Requires improvementEffective: InadequateCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2015Goodup from Requires improvementSafe: GoodEffective: GoodResponsive: Good
- April 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- September 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- February 2013
Registered with the Care Quality Commission on 24 February 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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