CQC report explained · a residential care home
What the CQC found at Chimnies Residential Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People generally felt safe and received their medicines, food and drink. However, inspectors found one choking risk, windows without restrictors and gaps in recruitment information.
- Effective?
- Good
- Care plans, staff training and support had improved. Staff worked with health professionals and supported people's nutrition, health needs, choices and independence.
- Caring?
- Good
- This question was not assessed during this focused inspection. People told inspectors staff were kind and caring, and observations showed warm interactions.
- Responsive?
- Requires improvement
- This question was not assessed during this focused inspection. Inspectors saw that people could choose where to spend their time and had personalised rooms.
- Well-led?
- Requires improvement
- Management systems had improved and the provider was no longer in breach of the regulations checked. Inspectors said the changes still needed to become established in daily practice.
What inspectors found, September 2022
Rated Requires Improvement; inspectors found major progress, but some safety and management systems still needed strengthening.
This was an unannounced focused inspection on 15 August 2022. Inspectors spoke with people, a relative, staff and healthcare professionals. They observed care and checked care plans, medicines, recruitment records, incident records and management systems.
The home had improved a lot since its previous inspection. People said they felt safe and staff were kind, helpful and available. Medicines, infection control, staffing, training, consent and healthcare support had improved.
Some risks were not identified or recorded promptly. Inspectors also found gaps in recruitment records. These issues were addressed during or shortly after the inspection, but the home was asked to keep reviewing its systems.
The overall rating was Requires Improvement. Safe and Well-led were rated Requires Improvement, while Effective was rated Good. The home had previously been rated Inadequate and placed in Special Measures, but it was no longer Inadequate or in Special Measures after this inspection.
Kind and available staff
People said staff were kind and helpful. Inspectors saw staff attending to people's needs and did not see anyone waiting for care.
“People were happy living at Chimnies. They told us staff were kind and caring and they did not have to wait long to receive staff input if they rang their bell.” from the report
Improved care records
Care plans were more detailed and better organised than at the previous inspection. They gave staff useful information about people's needs and backgrounds.
“People's care plans were more detailed and better organised to give sufficient information for staff to know how to care for people.” from the report
Medicines managed safely
Inspectors saw staff giving medicines competently. Records included photographs and allergy information, and staff checked that medicines had been taken before signing.
“Staff did not sign a person's MAR until they had ensured the person had taken their medicine.” from the report
Good health support
Staff involved outside health professionals when needed. People were referred for support with issues including nutrition, diabetes, mobility and hearing.
“There was evidence of staff working with external agencies to support people to remain as healthy as possible and to address any needs they had in relation to their health.” from the report
People had choice
People could choose where to eat and spend their time. The home provided different communal areas and equipment to support independence.
“People were seen eating their meal in a place of their choice.” from the report
Risk of choking
needs fixingOne person was seen eating while lying flat. Staff acted immediately and created a new risk assessment, but the incident showed that risk information had not been identified beforehand.
“We saw one person lying flat in their bed eating biscuits.” from the report
Window safety
needs fixingSome bedroom windows did not have restrictors, creating a possible risk of harm. The manager arranged for restrictors to be fitted within two days.
“We also observed in some people's rooms their windows did not have window restrictors.” from the report
Recruitment records
needs fixingSome prospective staff had not provided information about their fitness to do the job, and profiles were missing for some agency staff. The manager corrected these issues during or shortly after the inspection.
“However, we found the registered manager had not always followed guidance around good recruitment practices.” from the report
Changes still bedding in
minorManagement systems and improvement work had made progress, but inspectors said the changes were not yet fully embedded in everyday work.
“Although improvements were still being imbedded into daily practice.” from the report
- 01How do you now check that every person's risks, including eating and choking risks, are identified and reviewed?
- 02Have window restrictors been fitted wherever they are needed, and how do you check that they remain safe?
- 03What checks are completed before new and agency staff start work, including information about their fitness for the role?
- 04How will you make sure the recent improvements remain part of everyday practice?
- 05What is the current plan to improve the Safe and Well-led ratings?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and the overall rating used the previous ratings for those areas. This explanation was written from the published report of 1 September 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, March 2022
Rated Inadequate and placed in special measures; inspectors found serious risks involving safety, staffing, medicines and management.
This was an unannounced focused inspection on 18 November 2021. Inspectors reviewed Safe, Effective and Well-led. They spoke with people, relatives and staff, observed care, and checked care, medicines, staffing and management records.
People and relatives said they felt safe and were happy with the care. Inspectors also found some positive practice, including regular access to healthcare, social mealtimes, safe recruitment and people being supported to raise ideas.
However, inspectors found serious concerns. Risks such as fire, choking, epilepsy and falls were not always assessed or managed. Medicines records were inaccurate, staffing levels were not sufficient, safeguarding concerns were not always reported, and staff training was incomplete.
The overall rating fell from Requires Improvement at the previous inspection to Inadequate. The home was placed in special measures. The provider had conditions imposed on its registration and was required to make significant improvements.
People felt cared for
People and relatives told inspectors they were happy with the care and support. Staff were described as kind and gentle.
“People told us they felt safe and well cared for.” from the report
Food and social mealtimes
People and relatives said the food met people's needs. Mealtimes gave most people an opportunity to eat together and chat.
“Mealtimes continued to be a social occasion where most people ate at dining room tables and had the opportunity to chat together.” from the report
Healthcare access
People were supported to see healthcare professionals when needed. Inspectors saw staff seek medical advice when someone became unwell.
“People were supported to access healthcare services when they needed them.” from the report
Safe recruitment
The home completed criminal record and reference checks for the staff files inspectors reviewed.
“Staff were recruited safely. Disclosure and Barring Service (DBS) criminal record checks were completed as well as reference checks.” from the report
Fire and personal safety risks
seriousFire doors were propped open and equipment was charging in protected stairwells. Some people did not have adequate emergency evacuation plans, and individual risks such as choking and epilepsy were not properly assessed.
“Fire doors were propped open with items which meant that people would be at risk if a fire started.” from the report
Medicines management
seriousMedicine quantities did not always match the records, some doses were not clearly recorded, and information about as-needed medicines and allergies was incomplete.
“Our checks identified discrepancies in quantities of prescribed medicines against records.” from the report
Staffing levels
seriousThe rota did not show enough staff at night to meet people's needs. Inspectors also found that staffing decisions were not based properly on people's care needs.
“The staffing rota showed there were not enough staff on shift at night to safely meet people's needs.” from the report
Safeguarding concerns
seriousA concern about rough personal care had not been reported to the local authority. The manager did not understand all the actions needed after allegations of abuse.
“Safeguarding concerns had not always been reported to the local authority.” from the report
Training and competency
seriousStaff had not received enough training for conditions including diabetes, Parkinson's and epilepsy. Moving and handling skills were not competency checked.
“Some people lived with diabetes, no staff had undertaken diabetes training.” from the report
Weak oversight and records
seriousAudits did not identify important shortfalls in care, staffing, medicines, fire safety, infection control, training or records. This problem had continued from the previous inspection.
“The systems in place to audit the quality of the service were not robust or sufficient to alert the provider or registered manager of concerns and issues within the service.” from the report
- 01What changes have been made to the staffing rota, including night staffing, and how is the number of staff matched to people's needs?
- 02How are medicines now checked, recorded and audited, including as-needed medicines and allergy information?
- 03Can you show us the updated risk assessments and emergency evacuation plans for the people we are considering placing here?
- 04What training and competency checks have staff completed for diabetes, Parkinson's, epilepsy, moving and handling, and pressure area care?
- 05What conditions has CQC imposed on the registration, and what evidence can you provide that the required improvements have been completed?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not reviewed, and the inspection was prompted by concerns about safety and staffing as well as the previous rating. This explanation was written from the published report of 18 March 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.
Every inspection of Chimnies Residential Care Home
5 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- September 2022Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Chimnies Residential Care Home →
- March 2022InadequateSafe: InadequateEffective: Requires improvementWell-led: Inadequate
Read what inspectors found at Chimnies Residential Care Home →
- November 2020Inspected but not ratedSafe: Inspected but not rated
- March 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- July 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 10 March 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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