CQC report explained · a residential care home
What the CQC found at The Chesters Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- The home was inspected but not rated for Safe. Inspectors found that people were protected from abuse, risks were assessed and medicines were managed safely, but some medication records lacked detail.
- Effective?
- Good
- The home was inspected but not rated for Effective. Staff had training and worked with health professionals, but one professional felt staff had not always recognised changing care needs.
- Caring?
- Good
- No current Caring rating was given in this targeted inspection. The report describes positive feedback about compassionate, person-centred care.
- Responsive?
- Good
- No current Responsive rating was given in this targeted inspection. The inspection did not assess the whole question.
- Well-led?
- Good
- The home was inspected but not rated for Well-led. The manager completed quality audits and people and staff gave mostly positive feedback, but medication documentation needed improvement and some provider checks had not been as regular or detailed.
What inspectors found, May 2021
The Chesters Care Home was inspected but not rated; inspectors found safe care overall, but raised concerns about recognising changing needs and medication records.
This was a targeted inspection on 31 March 2021. Inspectors checked specific concerns about safeguarding, accidents, medicines, risks, staff skills and management. They spoke with people, relatives, staff and visiting professionals, and reviewed care records.
The inspectors found that people were protected from abuse, risks were assessed and medicines were generally given as prescribed. Infection control arrangements were also in place. However, medication records did not always contain enough detail, especially for creams, pain relief patches and thickeners.
Most feedback about staff skills and the way the home was run was positive. One visiting professional raised concerns about staff recognising when people's care needs were changing. The provider and manager had started working with the local authority and other professionals to address this.
The home was inspected but not rated because this was a targeted inspection, not a full review. The previous overall rating was Good, published on 8 February 2020, and the report says that rating remains unchanged.
Medicines administered safely
Staff had suitable training and competency checks. People told inspectors they received their medicines as prescribed.
“Medicines were managed safely. Staff had received appropriate training to support the safe administration of medicines.” from the report
Safeguarding
People told inspectors they felt safe. Staff had safeguarding training and knew how to report concerns.
“People were protected from abuse. Staff had received safeguarding training as part of their induction and they also completed refresher training.” from the report
Risk management
Care plans included detailed assessments for risks such as falls and choking. Daily handovers helped staff share information about people's health and wellbeing.
“Risks to people had been assessed. Care plans seen included detailed information to support staff to care for people safely” from the report
Person-centred care
People, most relatives and professionals gave positive feedback about the care. Inspectors found that care was person centred.
“People received person centred care. We received positive feedback from people, the majority of relatives and professionals regarding the level of care provided.” from the report
Recognising changing needs
needs fixingOne visiting professional said staff had not always recognised when people's care needs were changing. The manager and provider were working with professionals to improve this.
“However, one visiting professional told us they felt staff had not been able to recognise when people's care needs were changing.” from the report
Medication records
needs fixingRecords did not always show enough detail about creams, pain relief patches and the amount of thickener used. The provider took immediate action and was asked to review its documentation.
“A review of people's MAR charts did reveal a lack of detail regarding the recording of the application of topical medication such as creams and pain relief patches.” from the report
Provider checks
minorThe provider's own quality checks had not been completed as regularly or in as much detail during the COVID-19 pandemic. An electronic care planning system was being introduced.
“However, these had not been completed as regularly or were as detailed due to the COVID-19 pandemic.” from the report
- 01How do you train and assess staff to recognise when a person's care needs are changing?
- 02How are records for creams, pain relief patches and thickeners checked for completeness?
- 03What progress has been made with the electronic care planning system and its audits?
- 04How do you review accidents and incidents to identify repeated risks or patterns?
This was a targeted inspection of specific concerns about Safe, Effective and Well-led; it did not assess the whole of any key question, and the previous Good rating remained unchanged. This explanation was written from the published report of 7 May 2021 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, February 2020
The Chesters Care Home was rated Good; inspectors found safe, kind and personalised care, with medicines auditing still needing improvement.
This was an unannounced inspection on 16 January 2020. One inspector spoke with a person using the service, seven relatives, staff and health and social care professionals. They also observed care and checked care plans, risk assessments, medicines records, staff training, complaints and maintenance records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were safe and comfortable, staff knew their needs well, and relatives gave consistently positive feedback.
The home had improved from Requires Improvement at the previous inspection in March 2019. Safeguarding systems were improved and the previous breach was no longer in place. Inspectors recommended improving the structure of medicines audits, although they found medicines were stored, given and recorded safely.
Kind and familiar staff
The staff team was experienced, committed and stable. Relatives said this helped staff understand people living with dementia and reduced worry.
“It feels like a family – they all know her so well. They know us so well too, it reduces a lot of the worry.” from the report
Personalised care
Staff knew people's histories, preferences and communication needs. They used this knowledge to support independence and create meaningful experiences.
“Staff had an excellent understanding of people's preferences and personal history.” from the report
Activities and community links
People could take part in varied activities, outings and local community events. Inspectors found strong links with a church, nursery, museum and other organisations.
“Connections with the local community were strong and led to more opportunities for people who used the service.” from the report
Improved safeguarding
The home had improved how it recorded, investigated and shared information about safeguarding concerns. Staff had received extra training and worked with the local authority.
“Records of safeguarding issues were up to date and evidenced appropriate interactions with external agencies to keep people safe.” from the report
Medicines audit structure
needs fixingMedicines were managed safely, but the audit process was not structured enough and had missed isolated areas where practice could improve. The inspector made a recommendation for improvement.
“These would benefit from being more structured and were currently a free-text box in which the manager wrote their observations.” from the report
End of life training was still planned
minorStaff were confident supporting end of life care, but additional face to face training was planned for the month after the inspection.
“Additional face to face end of life care training was planned the following month.” from the report
- 01What changes have you made to the structure of medicines audits since this inspection?
- 02How do you check that medicines audits identify isolated areas where practice could improve?
- 03Has the planned face to face end of life care training been completed, and what difference has it made?
- 04How will you keep activities and care personalised for someone living with dementia whose needs or interests change?
- 05How do you involve relatives in care reviews and decisions about changing needs?
This was a planned, unannounced inspection that looked at the premises and care provided and assessed all five CQC questions. This explanation was written from the published report of 8 February 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 The Chesters Care Home
3 rated inspections over 4 years: the service has held its Good rating throughout.
- May 2021Inspected but not ratedcurrent ratingSafe: Inspected but not ratedEffective: Inspected but not ratedWell-led: Inspected but not rated
- February 2020Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 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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