CQC report explained · a residential care home
What the CQC found at The Chimes Residential 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
- People were not fully protected from infection because some staff did not follow current COVID-19 guidance. Recruitment checks were not always robust, although there were enough staff, medicines were managed safely and people had risk assessments.
- Effective?
- Good
- This area was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Well-led?
- Requires improvement
- Management systems did not reliably keep policies and safety records up to date or provide clear audit trails. Inspectors also found that the home had not consistently acted on water temperature and other governance issues.
What inspectors found, August 2021
The Chimes Residential Home was rated Requires Improvement; inspectors found infection-control and management weaknesses, although people received medicines safely and were supported by enough staff.
This was an unannounced focused inspection on 24 June 2021. Two inspectors looked only at Safe and Well-led, after concerns about medicines, cleanliness and management, as well as routine checks of COVID-19 infection control.
The home was not always following current COVID-19 guidance. Some staff did not use masks or hand hygiene correctly. The infection-control policy was out of date, and some surfaces and equipment were difficult to clean. Recruitment checks and employment history checks were also not always completed properly.
Inspectors found enough staff, safe medicines practice, risk assessments and safeguarding arrangements. People said they felt safe and were happy with their care. However, management systems did not reliably keep policies, safety records, water temperature checks and incident audits up to date.
The overall rating remains Requires Improvement. Safe and Well-led were both rated Requires Improvement. The other three areas were not inspected during this visit, so their previous ratings were used. This was the home's third consecutive Requires Improvement rating.
Enough staff
Inspectors found enough staff to meet people's needs safely and promptly. People said they received support when they needed it.
“There were enough staff on duty to meet people's needs in a safe and timely way and people told us they had support when they needed it.” from the report
Medicines
People received their medicines safely and on time. Staff were trained and their competence was checked.
“People received their medicines safely and on time and said they were happy with the support they received.” from the report
Risk support
People's risks were identified and plans were in place to help staff support them safely. Staff understood the risks linked to people's health and mobility.
“People's risk assessments included measures to minimise risk as much as possible.” from the report
People felt safe
People told inspectors they felt safe and appeared comfortable and relaxed with staff.
“People told us they felt safe with staff and living at the home.” from the report
Infection control
seriousSome staff touched or wore masks incorrectly, did not always clean their hands between people, or wore jewellery that could prevent effective hand hygiene. The policy was also out of date, and some areas and equipment were difficult to clean.
“People were not fully protected from the risk of infection.” from the report
Recruitment checks
needs fixingReferences were not always obtained promptly or properly checked. Gaps in employment history were not always explored and recorded.
“References need to be obtained in advance so the provider has sufficient time to examine them.” from the report
Water temperature records
seriousHot water was often recorded above the acceptable level, with no recorded remedial action. Inspectors said this placed people at risk of scalding.
“Hot water temperatures around the home were often recorded as higher than acceptable and no remedial action was recorded.” from the report
Weak management records
seriousImportant policies and environmental safety records were out of date, difficult to find or missing. Records of actions after incidents were also not always clear.
“The provider's environmental safety and maintenance records were not always available, managers had difficulty locating them and a lot of information was out of date.” from the report
- 01What changes have you made to ensure all staff follow current infection-control guidance, including mask use, hand hygiene and jewellery rules?
- 02How do you now check staff references and investigate gaps in employment history before staff start work?
- 03How often are hot water temperatures checked now, and what happens immediately if a reading is too high?
- 04Can you show us the current fire risk assessment, infection-control policy and other key safety records?
- 05How do you record and review actions after falls, accidents and other incidents?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 13 August 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, January 2021
Requires Improvement; inspectors found medicines and infection control were safe, but risk records and management checks were not always reliable.
This was a focused inspection on 30 November 2020. Inspectors looked only at Safe and Well-led, following concerns about people's care and safety. They spoke with people, staff, managers and relatives, observed care, and checked records.
The home had enough staff, people said they felt safe, medicines were given as prescribed, and infection control arrangements were suitable. However, some risk assessments and care records were out of date or incomplete. Records did not always show that people had been repositioned as planned.
Management checks did not always find these problems. Recruitment records were incomplete for one staff member, and accidents were recorded but not analysed for patterns. The home was no longer in breach of Regulations 12 and 17 from the previous inspection, but both Safe and Well-led remained Requires Improvement.
The overall rating stayed Requires Improvement. Effective, Caring and Responsive were not inspected, so their previous ratings were used in the overall rating.
Medicines
Medicines were given as prescribed, stored safely and checked through staff training, competency checks and audits.
“People had their medicines managed safely. Records demonstrated that people had received their medicines as prescribed, in a way they preferred.” from the report
Infection control
Inspectors were assured that the home used PPE safely, followed infection control measures and had an up-to-date policy.
“We were assured that the provider was using PPE effectively and safely.” from the report
Staffing and safeguarding
People said they felt safe, staff understood safeguarding, and inspectors found enough staff to meet people's needs.
“People told us they felt safe with the care they received from staff.” from the report
Communication with relatives
Relatives gave positive feedback about communication from the home during the pandemic.
“Relatives were positive regarding the communication they'd received from the service during the pandemic.” from the report
Out-of-date risk information
seriousSome risk assessments and care plans did not reflect people's current needs. Records also showed that two people were not always repositioned at the intervals set out in their care plans.
“Risks to people's safety were not always accurately assessed and planned for.” from the report
Management checks missed problems
needs fixingAudits did not always identify incomplete care records, missing repositioning records or a missing recruitment check. This meant the home did not consistently spot and correct weaknesses.
“The registered managers audits weren't effective in identifying full recruitments checks had taken place and people who required repositioning, the recording was taking place.” from the report
Accidents were not analysed
needs fixingThe manager recorded and reviewed accidents but did not analyse them for patterns or trends. This reduced the opportunity to prevent similar incidents happening again.
“Lessons were not always learned when things had gone wrong.” from the report
Incomplete recruitment evidence
needs fixingOne staff member did not have evidence of being a person of good character, such as references from previous employers, until this was raised during the inspection.
“One staff member, who had been employed by the service since late 2019, did not have any evidence to show they were a person of good character, such as references from previous employers.” from the report
- 01How are you checking that each person's risk assessment and care plan reflects their current needs?
- 02What changes have you made to make sure repositioning records are completed at the required intervals?
- 03How do your audits now identify missing or out-of-date care records?
- 04How do you analyse accidents and falls for patterns, and what action has followed?
- 05Have all recruitment checks and references now been completed and recorded for every staff member?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 14 January 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.
Every inspection of The Chimes Residential Home
5 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- August 2021Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- December 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- May 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2015
Registered with the Care Quality Commission on 27 March 2015.
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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