CQC report explained · a residential care home
What the CQC found at Chirnside House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found gaps in employment histories, references and agency staff induction records. Medicines were being given as prescribed, but there were some minor gaps in administration practice.
- Effective?
- Good
- This key question was not inspected during this visit. The report says ratings for questions not inspected were carried over from the previous inspection.
- Caring?
- Good
- This key question was not inspected during this visit. The report says ratings for questions not inspected were carried over from the previous inspection.
- Responsive?
- Good
- This key question was not inspected during this visit. The report says ratings for questions not inspected were carried over from the previous inspection.
- Well-led?
- Requires improvement
- The provider did not have reliable systems to oversee quality and safety. Some policies were out of date, and there were no checks on the registered manager's practice by the provider.
What inspectors found, June 2023
Rated Requires Improvement; inspectors found good-quality, caring support but unsafe recruitment systems and weak oversight.
This was an unannounced inspection. Inspectors visited on 28 March 2023, spoke with people, relatives, staff and professionals, observed care, and checked care, medicine, recruitment and management records.
The overall rating fell from Good to Requires Improvement. Safe and Well-led were both rated Requires Improvement. Inspectors found gaps in staff recruitment checks and no reliable system for the provider to monitor the home's quality and safety.
There were also positive findings. People and relatives were mostly very positive about the care and said people felt safe. Infection control was stronger than best practice, medicines were being improved with help from a pharmacist, and managers were open when things went wrong.
The provider took action during and after the inspection. CQC identified two breaches and one recommendation, and said it would monitor progress with the local authority.
Positive care experience
People and relatives were mostly very positive about the care. They said people felt safe and that the home was well managed.
“We found the care demonstrated to be of good quality and feedback from almost all the people we talked with was very positive about everything in the home” from the report
Infection control
Inspectors were assured about infection prevention, including the use of protective equipment, cleanliness and managing outbreaks.
“The service was going beyond best practice with regards to infection prevention and control to ensure the safety of people.” from the report
Open response to incidents
Managers were open about mistakes and recorded incidents such as falls, including actions and changes to care plans.
“The registered manager was transparent when seeking to learn lessons from events that happened in the home to improve the service and embraced a continuous learning approach.” from the report
Choice and least restriction
Staff worked within the Mental Capacity Act and supported people to make choices wherever possible, using the least restrictive approach.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests” from the report
Staff recruitment
seriousRecruitment records had missing or incomplete employment histories and references. There was also no record showing that agency staff had received an induction at the home.
“Systems had not been established to ensure safe staffing and recruitment.” from the report
Provider oversight
seriousThe provider did not have a system to understand the home's overall quality and safety. Some policies referred to outdated legislation, and management checks were not in place.
“Systems had not been established to ensure good governance.” from the report
Medicine administration
needs fixingPeople received their medicines as prescribed, but inspectors found some minor gaps in administration practice. A pharmacist was helping the home put newer systems into practice.
“We noted staff had acted and improved their management of medicines from their action plan, although we found a few minor gaps in medication administration practices.” from the report
Relative involvement in meetings
minorSome relatives did not know about residents' meetings or had not seen the minutes. This may make it harder for families to know how their views are being used.
“Some relatives would attend at times. Some relatives didn't know they happened.” from the report
- 01How have you checked and corrected the missing employment histories, references and other staff recruitment records?
- 02How do you now record the induction given to agency staff before they work in the home?
- 03What checks does the provider now carry out on the home's quality, safety and the registered manager's practice?
- 04What medicine changes did the pharmacist recommend, and how do you know the new systems are now consistently followed?
- 05How are relatives told about residents' meetings, surveys and the changes made in response to their views?
This was an unannounced focused inspection of Safe and Well-led; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 13 June 2023 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, October 2020
Chirnside House: inspected but not rated; inspectors were assured about infection prevention and control.
This was an announced, targeted inspection on 14 October 2020. It looked only at infection prevention and control measures during the coronavirus pandemic.
Inspectors found that the home had infection control training, risk assessments, extra cleaning, suitable protective equipment and processes for testing. The environment was clean and free from clutter.
The home was supporting safe visiting, contact with relatives through tablets and telephones, and access to health professionals using electronic communication. CQC was assured about the infection control arrangements, but did not give a quality rating.
Staff training
Staff had detailed infection control training, and their competence was checked. Staff said they felt confident using what they had learned.
“The registered manager had ensured staff could access comprehensive and informative training in various aspects of infection control.” from the report
Clean environment
The home was clean and uncluttered. Extra cleaning and specialist cleaning equipment were being used.
“The environment had been arranged to minimise the risk of infection and was clean and clutter free.” from the report
Safe visits
Visits were arranged in advance, with handwashing facilities, infection control gel and protective equipment available.
“Visitors arranged to visit people at the service in advance and handwashing facilities, infection control gel and personal protective equipment (PPE) was available to support safe visits.” from the report
Contact with relatives
Staff helped people keep in touch with loved ones using electronic tablets and telephones.
“Staff supported people to use electronic tablets and telephones to maintain contact with loved ones.” from the report
Infection control processes
The home had risk assessments and practical processes such as temperature checks, safe waste disposal and increased cleaning.
“Processes to minimise the risk of infection were known by staff and carried out to minimise the risk and spread of infection.” from the report
Further development
minorCQC signposted the provider to resources to develop its approach. The report does not explain what specific improvement was needed.
“We have also signposted the provider to resources to develop their approach.” from the report
- 01How have your infection prevention and control arrangements changed since the inspection on 14 October 2020?
- 02How are visits currently arranged, and what handwashing facilities and protective equipment are available?
- 03How do you support people to keep in contact with relatives when face-to-face visits are limited?
- 04How are people and staff supported with testing now?
- 05How do you keep care records updated when health professionals give advice remotely?
This was a targeted inspection of infection prevention and control during the coronavirus pandemic; the service was inspected but not rated and the other care areas were not assessed. This explanation was written from the published report of 24 October 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 Chirnside House
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- June 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2020Inspected but not ratedSafe: Inspected but not rated
- May 2018Goodstayed GoodSafe: GoodWell-led: Good
- May 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 22 November 2010.
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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