CQC report explained · a residential care home
What the CQC found at Chiswick Care Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risks were assessed and staff had guidance on reducing known risks. Medicines were administered safely, although protocols for some medicines given when needed were not always available at the time of inspection.
- Effective?
- Good
- Staff were trained and supported, and people received suitable food, healthcare and support with their health needs. Care plans did not always record mental capacity and best-interest decisions clearly, but the manager amended them after this was raised.
- Caring?
- Good
- People appeared happy and staff treated them with kindness, dignity and respect. People were supported to make everyday choices and maintain their independence.
- Responsive?
- Good
- People had detailed care plans and access to activities, community life and relationships. Inspectors found that some plans were not as personalised as they could be, and information from updated hospital passports still needed to be transferred into the main plans.
- Well-led?
- Good
- Managers were visible and quality checks were carried out. However, records did not always show the action taken or the date it was completed when audits found an issue.
What inspectors found, December 2019
Rated Good; inspectors found safe, kind and person-centred care, with some records needing improvement.
This was an unannounced inspection on 7 and 8 November 2019. One inspector reviewed care records, medicines, staff files, risk assessments, training records, complaints, audits and policies. They also spoke with people, relatives, managers and staff, and observed care.
The overall rating was Good. All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People were described as safe, happy and supported by staff who knew them well.
Inspectors found enough staff, safe medicine systems, suitable risk assessments and good access to food and healthcare. People were supported to make choices, build independence, take part in activities and maintain relationships.
The report also identified some areas to improve. These included missing guidance for some medicines given when needed, limited analysis of behaviour-related incidents, and care plans and audit records that did not always contain all the required detail.
People felt safe
People and relatives said they believed the home was safe. Staff knew how to report concerns and risk assessments gave guidance on reducing known risks.
“People told us they felt safe living at Chiswick Care Limited.” from the report
Kind and respectful care
Inspectors saw positive relationships between people and staff. Staff respected privacy, dignity, culture and religion.
“Throughout the inspection we observed caring and positive interactions between people and staff.” from the report
Choice and independence
People were involved in decisions about food, activities and daily life. Staff supported people to do things for themselves and go out into the community.
“People were actively encouraged to be involved with the planning of activities and weekly menus.” from the report
Activities and community life
People took part in day centres, shopping, cinema visits, church, the gym, art and craft sessions and holidays. Staff also asked people what they wanted to do each day.
“People attended day centres and local community centres, accessed the local community shopping area, went to the cinema, attended church, went to the gym and attended in-house art and craft sessions.” from the report
Suitable staffing and training
Inspectors found enough staff to support people safely. Recruitment checks and staff training were in place.
“We observed there to be sufficient numbers of staff available to support people safely and meet their needs appropriately.” from the report
Some medicines guidance was missing
needs fixingProtocols were not always available for medicines prescribed to be given when needed. The manager sent completed protocols after the inspection.
“However, we did find that where people had been prescribed medicines that were to be given 'as and when required' (PRN), a PRN protocol was not always available which gave direction and guidance on how and when to administer the medicine.” from the report
Behaviour-related incidents were not analysed
needs fixingThe home recorded incidents but did not have a formal process to look for patterns and trends in incidents linked to people's behaviour.
“However, where incidents recorded were related to people's behaviours, there was no formal process in place to analyse and review these so that trends and patterns could be identified to support learning and development.” from the report
Care plans needed more personal detail
needs fixingCare plans did not always include people's history, preferences, wishes, likes and dislikes. The home had started updating this information but had not yet transferred it all into the main plans.
“Although each care plan was detailed, we found that care plans were not as person centred as could be and did not always list people's likes and dislikes, history, preferences and wishes.” from the report
Audit actions were not always recorded
minorManagers carried out checks, but records did not always show what action had been taken or when it was completed.
“However, detail of actions taken and date of completion were not always recorded.” from the report
- 01Have all medicines given 'as and when required' now got clear protocols explaining when and how staff should give them?
- 02How do you analyse behaviour-related incidents and use any patterns or trends to improve support?
- 03Do current care plans include each person's history, preferences, wishes, likes and dislikes?
- 04How are best-interest decisions and mental capacity recorded in care plans?
- 05How do you record people's end of life wishes, even when nobody is currently receiving end of life care?
This was an unannounced comprehensive inspection covering all five CQC questions, the care provided and the premises; all five ratings were given. This explanation was written from the published report of 11 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, June 2017
Rated Good; inspectors found safe, kind and personalised care, but weekly medicine checks were not always recorded.
This was an unannounced comprehensive inspection on 17 May 2017. One inspector spoke with people, relatives and staff, observed care, and checked care plans, staff records, medicine records and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were happy and comfortable, staff knew them well, and relatives felt people were safe and properly supported.
Care plans included detailed information about people's needs, risks, preferences and communication. People were supported with medicines, health appointments, activities, meals and daily choices. One minor shortfall was found because weekly medicine checks were not recorded, although the manager said this would be corrected.
The home was rated Good overall at the previous inspection in February 2015, and inspectors found that it remained Good.
Personalised care
Care plans gave detailed guidance about people's needs, choices, abilities and goals. Staff used this information to support people in individual ways.
“Care plans were seen to be person centred, responsive to people's needs and provided clear and detailed information about the person” from the report
Kind relationships
People were observed to have positive relationships with staff. Relatives described the atmosphere and care positively.
“People were observed to be happy and comfortable living at the service. Interactions between people and staff were positive.” from the report
Safe staffing and recruitment
Staffing was adjusted to people's needs, including when people needed one-to-one support. Recruitment checks were completed before staff worked with vulnerable adults.
“Staffing levels were observed to be sufficient and according to the needs and requirements of the people living at the home.” from the report
Choice and independence
People were involved in menu planning and activities, and could use the kitchen and prepare food if they wished. Staff encouraged people to do tasks for themselves.
“People were supported and enabled to maintain their independence as far as practicably possible.” from the report
Health support
People were supported to attend a range of health appointments. Care records included appointment outcomes and follow-up actions.
“People were supported to access a variety of health care professionals and included GP's dentists, chiropodists, opticians, social workers and psychiatrists.” from the report
Weekly medicine checks not recorded
minorThe team leader carried out weekly medicine checks, but the checks were not recorded. The manager gave an assurance that this would be done in future.
“However, we did note that where the team leader checked medicines on a weekly basis, these were not recorded.” from the report
- 01How are weekly medicine checks recorded now, and who reviews the records?
- 02How do you make sure people's medicine records remain complete and accurate?
- 03What activities are available when people cannot access community services because of funding cuts?
- 04How are people and their relatives involved in reviewing care plans and agreeing changes?
- 05How do you check that each person's communication method, preferences and daily goals are still being followed?
This was an unannounced comprehensive inspection covering all five rating areas, and the ratings remained Good from the previous inspection. This explanation was written from the published report of 3 June 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 Chiswick Care Limited
3 rated inspections over 5 years: the service has held its Good rating throughout.
- December 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 19 April 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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