CQC report explained · a residential care home
What the CQC found at Chiswell Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People said they felt safe. Risks were assessed, medicines were managed safely, staffing levels were considered suitable and the home was clean.
- Effective?
- Good
- People's needs and preferences were assessed and reviewed. Staff were experienced and people could access health services, although some staff training updates were late.
- Caring?
- Good
- Staff knew people well, respected their privacy and dignity, and involved them in decisions as far as they could.
- Responsive?
- Good
- Care was flexible and personalised. People were supported to use local services, enjoy activities and maintain family relationships.
- Well-led?
- Good
- The provider was closely involved and people were treated as a priority. Audits and feedback systems existed, but inspectors said some checks and questionnaires needed to be more meaningful.
What inspectors found, December 2019
Rated Good; inspectors found safe, kind and personalised care, but some staff training was not refreshed on time.
This was an unannounced inspection on 12 November 2019. One inspector spoke with people living at the home, relatives, staff and a health professional. They observed care and checked care plans, medicine records, recruitment files and other records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People were described as safe, treated with respect and supported by staff who knew them well. Medicines, risks, staffing and cleanliness were managed safely.
The inspectors found that some staff training had not been refreshed on time. They also noted that some management checks were not meaningful enough for this small home. There was no evidence that these issues had affected the quality of care.
Safe medicines and risk management
The home had systems for storing, administering and checking medicines. Risks such as falls, choking and using the stair lift were assessed and managed.
“People's medicines were managed safely. Robust systems had been developed for receiving medicines into the home, administering and storing them appropriately.” from the report
Staff knew people well
The established staff team understood people's needs and wishes. Inspectors saw staff offering reassurance in ways that reduced anxiety.
“People were supported by an established staff team who knew them well. Staff anticipated people's needs and understood their wishes.” from the report
Flexible, personal care
Care plans were kept updated and support was adapted to individual needs. People were encouraged to make choices about daily life.
“People received care and support in a way that was entirely flexible and responsive to their individual needs.” from the report
Positive leadership
The provider was involved in day-to-day care and staff felt supported. The home focused on people's needs and worked with relatives and health professionals.
“The provider and staff team demonstrated a clear culture of ensuring people and their needs were a priority.” from the report
Training updates were late
needs fixingSome staff training had not been refreshed when it should have been. Inspectors found no evidence that this had harmed the quality of care, but staff might not all have been up to date.
“Some training had not been refreshed in a timely manner which meant that the staff team may not be fully up to date with current practice in some areas.” from the report
End of life training and wishes
needs fixingStaff had no formal end of life training. People's wishes about this stage of care had not always been explored because some people did not understand or want to discuss it.
“Staff had not received formal end of life training, however, the team were experienced.” from the report
Management checks could be stronger
minorAudits were in place, but inspectors said some were not meaningful enough for a small home. The provider was asked to improve how feedback questionnaires reflected people's lives.
“We discussed the audits were not always meaningful to the service and suggested ways they could be amended to reflect the small intimate environment of the home.” from the report
- 01Which staff training was overdue, and has all required refresher training now been completed?
- 02How will you find out and record each person's wishes about end of life care?
- 03What formal end of life training or support can staff access if someone's health deteriorates?
- 04How have you changed your audits and feedback questionnaires so they are meaningful for the six people living here?
This was an inspection covering all five CQC questions, and all five ratings remained Good from the previous inspection. This explanation was written from the published report of 7 December 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, May 2017
Rated Good; inspectors found safe, kind and personalised care, but individual emergency evacuation plans were still needed.
This was an unannounced inspection carried out over three visits. Inspectors spoke with people living in the home, staff, the manager, a visiting professional and relatives. They also checked care plans, staff records, medicines records and management records.
The home supported up to six people with mental health needs, and all six places were occupied during the inspection. Inspectors rated all five areas Good: Safe, Effective, Caring, Responsive and Well-led.
Inspectors found that staff understood people's needs, medicines were managed safely, staffing levels were suitable and people were treated with kindness and respect. Care plans were detailed and personalised, and people were supported with food, healthcare, activities and making choices.
There were two points to improve. The home did not yet have individual emergency evacuation plans for each person, and annual staff appraisals had not yet taken place. The report also says that earlier concerns about supervision records, mental capacity assessments, record keeping and quality monitoring had improved.
Personalised care
Care plans described people's history, preferences and support needs. People and, where possible, relatives or professionals were involved in reviews.
“Care plans were person-centred and contained comprehensive details of the support people needed.” from the report
Kind relationships
Inspectors saw staff talking with people, helping them and spending meaningful time with them. People described staff as friendly and helpful.
“Throughout the day we observed staff interacting with people in a positive and caring way.” from the report
Safe medicines
Medicines were given at the right times and recorded correctly. Staff who gave medicines had training and competency checks.
“We saw medicines were given at the correct time and had been recorded appropriately.” from the report
Activities and independence
People were supported to take part in activities at home and in the community. Staff helped people work towards personal goals and greater independence.
“People had been supported to attend activities within the community and at the home.” from the report
Emergency evacuation plans
seriousThe home had an overall evacuation plan, but not an individual plan for each person. Staff said they would write these plans.
“there were no individual emergency evacuation plans for people who used the service” from the report
Annual staff appraisals
needs fixingAnnual appraisals had not yet been completed at the inspection. The provider had a process ready for them to start.
“The provider had not yet undertaken annual appraisals, however we were able to see that there was a process in place for these to commence.” from the report
- 01Have individual emergency evacuation plans now been written for every person, and when were they last reviewed?
- 02Have all staff now had an annual appraisal, and what actions came from those discussions?
- 03How are care plans and risk assessments reviewed when someone's mental health or support needs change?
- 04How are medicines audits and staff competency checks carried out now?
- 05How are people's activity choices and personal goals recorded and reviewed?
This was an unannounced inspection of all five areas, based on observations, discussions and records checked across three visits; the report also compares the service with its previous inspection on 4 February 2016. This explanation was written from the published report of 11 May 2017 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 Chiswell Residential Home
4 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- December 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 7 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Hertfordshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,300 a week. 82 can care for a couple. 12 years' experience on average.
“She handled the new situation in front of her with such professionalism and I felt I could trust her 100%.”
“She was v competent and confident and we felt our mum was safe in her care. She supported us through a difficult time.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.