CQC report explained · a residential care home
What the CQC found at The Chace Rest 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
- Inspectors found enough staff and good infection control, but some risk records were incomplete. They also found weaknesses in patch and as-required medicines records, window restrictors and accident and incident reviews.
- Effective?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried forward for the overall rating.
- Caring?
- Good
- This question was not inspected during this focused inspection. Inspectors did report that care was person-centred and that relatives spoke positively about staff.
- Responsive?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried forward for the overall rating.
- Well-led?
- Requires improvement
- Quality checks and management systems did not always identify and correct problems. Care plans were not always updated, accident reviews were not robust enough, and this led to a breach of Regulation 17.
What inspectors found, June 2023
The Chace Rest Home rated Requires Improvement; inspectors found person-centred care and enough staff, but weaknesses in safety records, medicines management and quality checks.
This was an unannounced, focused inspection on 26 April 2023. Two inspectors and an Expert by Experience spoke with people, relatives, staff and a healthcare professional. They also observed care and checked care, medicines, recruitment and management records.
The home provided person-centred care and people were supported by enough staff. Staff were attentive, safeguarding arrangements were understood, the home was clean and infection control measures were in place. Relatives gave positive feedback about the staff and improvements under the newly registered manager.
However, some safety records were incomplete. There were problems with patch and as-required medicines records, window restrictors and the review of accidents and incidents. Quality checks had not consistently found or corrected these issues, and the home breached Regulation 17 on good governance.
The overall rating was Requires Improvement. Safe and Well-led were also rated Requires Improvement. The inspection did not assess Effective, Caring or Responsive, so the previous ratings for those areas were carried forward. The home had been rated Requires Improvement at the previous two inspections and for three consecutive inspections.
Person-centred care
People received care that was tailored to them and achieved good outcomes.
“People were supported in a way that was person-centred and achieved good outcomes.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. Staff were available and responded when people used their call bells.
“There were enough staff to meet the needs of the people living at the home.” from the report
Positive staff relationships
Relatives described staff positively and reported a better atmosphere and improved communication under the new manager.
“There is a different atmosphere for the better” from the report
Infection control
Inspectors were assured that the home had suitable measures to prevent and manage infections.
“We were assured the provider was preventing visitors from catching and spreading infections.” from the report
Incomplete repositioning records
needs fixingFor one person at risk of skin damage, records did not always show that repositioning had happened at the required times. The person said staff repositioned them regularly, but the records did not provide reliable confirmation.
“However, for one person at risk of skin damage, records were not always completed to confirm they had been repositioned at the required time intervals.” from the report
Medicines records
needs fixingStaff were not initially recording where skin patches were applied. Records for as-required medicines did not always explain why they were given or whether they worked.
“However, records were not always kept about the circumstances that resulted in PRN medicine being given and whether it had been effective.” from the report
Window restrictors
seriousSome window restrictors were not correctly fitted or secured, which could have allowed people to remove them.
“some restrictors were not the right type or fitted with the correct tamper proof screws or covers to prevent people from removing them.” from the report
Weak quality checks
seriousThe home's audits and reviews did not consistently identify or correct problems. This included issues with medicines, care plans, accident reviews and changing risks.
“This was a breach of regulation 17(1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
- 01What action has been completed to make sure window restrictors are the correct type and securely fitted?
- 02How do you now record the application sites and rotation of medicines given through skin patches?
- 03How do you record why as-required medicines are given and whether they were effective?
- 04How are care plans updated when a person's needs or risks change?
- 05How are accidents and incidents now reviewed for patterns, trends and immediate actions?
This was an unannounced focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous inspection. This explanation was written from the published report of 3 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, May 2019
Rated Requires Improvement; inspectors found kind and responsive care, but weaknesses in safety checks, risk records and management oversight.
Inspectors visited the home without notice on 12 and 13 March 2019. They observed care, spoke with people living there, relatives, staff and managers, and checked care, medicine and management records.
People generally said they felt safe and described staff as kind, respectful and responsive. The home was rated Good for effective, caring and responsive care. Staff supported people with food, health appointments, choices, activities and medicines.
The home was rated Requires Improvement for Safe and Well-led. Inspectors found unlocked cleaning products, unclean equipment and side tables, incomplete risk guidance, missing personalised instructions for some medicines, and quality checks that did not always identify problems.
The overall rating remained Requires Improvement, the same as at the November 2017 inspection. The report says the manager took some immediate and later actions, and CQC would continue to monitor the home.
Kind and respectful care
People and relatives spoke positively about how staff treated them. Inspectors saw warm, gentle support that respected people's dignity and choices.
“People told us they felt safe living at the home. They told us the staff team were kind and caring and they treated them in a considerate and respectful way.” from the report
Prompt support
People received help when they needed it. Inspectors saw staff respond to call bells without unnecessary delay.
“During our inspection we saw staff were responsive to people's needs without unnecessary delay which could compromise people's safety.” from the report
Staff training and support
Staff had relevant training, regular one-to-one meetings and an induction programme. Inspectors found staff knowledgeable about people's needs.
“Staff training records confirmed there was a rolling programme of relevant training to ensure staff were able to undertake their role and fulfil their responsibilities.” from the report
Healthcare support
People were supported to attend appointments and access health professionals. Records showed staff worked with other professionals when people's health needs changed.
“The registered manager ensured joined up working with other agencies and professionals, so people received effective, timely care.” from the report
Open management
The manager was visible and approachable. People, relatives and staff said they could raise concerns and that management listened.
“The registered manager showed an open and responsive management style.” from the report
Unsafe storage
seriousCleaning and showering products were found in two unlocked cupboards in a communal bathroom. The manager removed them on the first day of the inspection.
“However, we found items of cleaning and showering products in two unlocked cupboards within one communal toilet/bathroom.” from the report
Incomplete risk records
seriousSome care records did not give staff enough guidance about repositioning, skin care or behaviour that could challenge. The manager later sent CQC details of actions taken.
“Although staff knew people well and how to support people while reducing risks to their safety and welfare risk assessments were not as robust as they could be.” from the report
Infection control checks
needs fixingSome side tables and hoists were unclean, and pedal-operated bins were not initially available in communal bathrooms. The manager took action during and after the inspection.
“Some areas of the home environment required a better system of monitoring infection control standards to avoid them being missed.” from the report
Medicine instructions
needs fixingPersonalised guidance was not always available for medicines given when needed. The deputy manager added guidance during the inspection.
“Clear guidelines were not always in place where people needed 'as required' medicines.” from the report
- 01Have all personalised risk assessments and care instructions been completed, including guidance about repositioning, skin care and behaviour?
- 02How are cleaning products, hoists, side tables and communal bathroom bins checked now, and who reviews these checks?
- 03What personalised instructions are now in place for each person's 'as required' medicine?
- 04How do managers check daily staff practice and make sure problems lead to prompt action?
- 05What further changes have been made to provide more personalised activities and a more dementia-friendly environment?
This was an unannounced inspection of the care home covering all five CQC questions, including the premises and care provided. This explanation was written from the published report of 9 May 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.
Every inspection of The Chace Rest Home
6 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- June 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- February 2018Requires improvementdown from GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- September 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.
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