CQC report explained · a residential care home
What the CQC found at The Old Chapel Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment checks, organised medicines systems and improved risk assessments. Staff were not initially recording when thickener was added to one person's drink, but this was corrected during the inspection.
- Effective?
- Good
- People's needs were assessed and reviewed, staff received training and supervision, and people were supported with food, fluids and healthcare. The home identified that its own records of staff training dates needed improvement.
- Caring?
- Good
- People and relatives spoke highly of the care. Inspectors observed kind and caring staff who respected privacy, dignity, independence and people's choices.
- Responsive?
- Good
- Staff knew people's likes and dislikes, and care records had improved and were detailed. People could influence menus and activities, and they were confident that concerns would be acted on.
- Well-led?
- Good
- People, relatives and staff had confidence in the management and described a positive team culture. The manager carried out audits, but had not audited the service against CQC key lines of enquiry or benchmarked it against rating characteristics.
What inspectors found, February 2020
Rated Good; inspectors found kind, personalised care and clear improvements since the previous Requires Improvement rating, with a medicines-recording issue fixed during the inspection.
This was a planned, unannounced inspection after the previous Requires Improvement rating. One inspector spoke with four people, two relatives and four staff. They reviewed care, medicines, recruitment, training and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicine systems, suitable training, fresh food, personalised care and a positive atmosphere.
There were still some areas to improve. Staff had not recorded when thickener was added to one person's drink, although records were put in place by the second day. The provider had also previously failed to display its ratings and paid a fixed penalty.
Enough staff
Inspectors found staffing levels were sufficient to meet people's needs. Recruitment checks were also completed safely.
“There were sufficient staff to meet people's needs, which was confirmed by people using the service, and staff.” from the report
Kind and respectful care
People and relatives spoke positively about the care. Inspectors observed a friendly atmosphere and staff who treated people with kindness and dignity.
“We found staff were very kind and caring and there was a really happy atmosphere in the home.” from the report
Personalised support
Staff knew people's preferences and supported them to make choices about their care, meals and activities.
“The care staff are excellent. The little attention to detail. They know everyone's likes and dislikes.” from the report
Fresh food and support with drinks
Meals were prepared in the home using fresh ingredients. People were offered choices and drinks were topped up when needed.
“The food was made from fresh ingredients and was nutritious.” from the report
Improvement since the last inspection
Risk assessments and care records had improved. The Safe, Effective and Well-led ratings moved from Requires Improvement to Good.
“Significant improvements were found at this inspection; risks had been assessed and care plans contained information to mitigate the risks to people” from the report
Thickener was not initially recorded
seriousStaff were not recording when thickener was added to one person's drink, which could affect monitoring of their prescribed needs and choking risk. The provider put records in place by the second day.
“Staff were not recording when they had added thickener to a person's drink to reduce the risk of choking.” from the report
Training records
needs fixingSome training data had been lost after a problem with the previous online training provider. Staff were refreshing their training, and the manager needed to improve the home's own record of training dates.
“The registered manager had identified they needed to improve the way they recorded staff training to ensure they kept their own record of staff training dates.” from the report
Quality checks
needs fixingThe manager carried out audits, but had not used CQC key lines of enquiry or rating characteristics to benchmark the service and evidence its good practice.
“The registered manager had not undertaken an audit against the key lines of enquiry or benchmarked themselves against the characteristics of ratings.” from the report
People had not seen their care plans
minorPeople said they were involved in decisions about their care, but had not seen their care plans.
“People told us they were involved in making decisions about their care, although they had not seen their care plans.” from the report
- 01How do you now record when thickener is added to drinks, and how do you check that this is done every time?
- 02How do you keep your own up-to-date record of staff training dates after the previous loss of training data?
- 03How do people and their relatives see and contribute to their care plans?
- 04What quality checks do you now use to identify improvements and compare the home with CQC expectations?
- 05How are people's views used to decide activities, menus and changes to the home?
This was a planned, unannounced inspection covering all five CQC questions and followed the previous Requires Improvement rating. This explanation was written from the published report of 6 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.
What inspectors found, January 2019
Rated Requires Improvement; inspectors found kind, responsive care, but records, staff supervision and quality checks needed strengthening.
This was the home's first inspection. It was unannounced and took place on 6 November 2018. Inspectors looked around the home, observed care, checked records and spoke with nine people, four relatives or friends, five staff and the registered manager.
People said they felt safe and staff were kind and caring. Staffing levels were suitable, call bells were answered promptly, medicines were generally managed safely, and the home was clean and well maintained. People's health, food and social needs were met.
The main weaknesses were in recording and checking care. Some risk assessments and care plans lacked important detail or evidence that care had been provided. Formal staff supervision was not regular, dietary information was not always passed to kitchen staff, and audits did not reliably identify problems.
The overall rating was Requires Improvement. Caring and Responsive were rated Good. Safe, Effective and Well-led were rated Requires Improvement.
Kind and respectful staff
People described staff positively, and inspectors saw staff listening, offering choices and supporting independence.
“People told us the staff were extremely caring and well-informed about their needs.” from the report
Clean and comfortable home
The home was clean, pleasant and well maintained. People had en-suite facilities and could personalise their rooms.
“People lived in a clean, pleasant, safe and well-maintained environment, and were comfortable in their surroundings.” from the report
Enough staff
People, relatives and staff said there were enough staff. Inspectors found that call bells were answered promptly and staffing rotas matched the staff on duty.
“We noted that call bells (used by people if they needed assistance) were answered promptly.” from the report
Activities and social contact
People joined in activities such as exercise, quizzes, manicures, bingo, film sessions and bowling.
“Staff spent time with people, engaged in meaningful discussions and activities.” from the report
Incomplete risk records
seriousSome risk assessments did not contain enough detail or records to show that planned care had been carried out. This included repositioning and nutritional risk information.
“However, some risk assessments required more detail to show the risk was being managed.” from the report
Care plans lacked detail
needs fixingSome care plans did not explain clearly enough how needs should be monitored or when staff should seek medical advice. End of life preferences were also not always recorded.
“Although we saw some aspects of care planning were effective we also identified gaps in the care planning process.” from the report
Staff supervision was not regular
needs fixingStaff received day-to-day support and training, but formal supervision sessions had fallen behind and structured support was not yet established.
“However, the registered manager told us that supervision sessions for all staff had fallen behind.” from the report
Quality checks missed problems
needs fixingThe home had some audits, but these did not reliably identify areas needing improvement. The provider was starting to develop its care planning and monitoring systems.
“However, these did not identify areas for improvement.” from the report
Dietary information was not always shared
needs fixingKitchen staff were not aware that two people had diabetes. The registered manager agreed to make sure important dietary information was shared with the kitchen.
“However, we found two people who were diabetic.” from the report
- 01How are you now recording and checking risks such as pressure areas, nutrition and repositioning?
- 02How do you make sure every person's care plan contains clear instructions for staff, including diabetes care and end of life wishes?
- 03Have regular staff supervision sessions and medicine competency checks now been introduced?
- 04How do you pass information about diabetes, allergies and other special diets to kitchen staff?
- 05What audits are now carried out, and how do you make sure they identify and fix problems?
This was the home's first, unannounced inspection and covered all five CQC questions, including the premises and the care provided. This explanation was written from the published report of 16 January 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 Old Chapel Care Home
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- February 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2019Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017
Registered with the Care Quality Commission on 7 November 2017.
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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