Chalfont Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home is registered to accommodate up to 10 people. At the time of our inspection there were 6 older people living in the home. Accommodation for people is arranged over two floors with stair lifts to assist people to get to the upper floor. The home had a well-maintained garden that provided a safe, accessible area for people to enjoy.

At the last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risk or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changes since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good.

Is the service safe?

People were protected from potential abuse and avoidable harm as staff were knowledgeable about recognising and reporting different signs of abuse.

There were sufficient numbers of appropriately qualified staff available on each shift to ensure people were cared and supported safely.

Risks to people were well managed and medicines were stored appropriately and managed effectively.

People were protected by the prevention and control of infection. There was a system in place to review and learn from incidents when things went wrong.

Is the service effective?

People were supported to have control of their lives with policies and systems in the service to support this.

People had access appropriate health care professionals who gave care and support to people at the home.

Staff were satisfied with the training provided, which they found effective and useful.

Staff were well supported with a clear system of supervision meetings and annual appraisals.

People were very positive about the standard of food provided and could contribute to menu planning.

Is the service caring?

People said the staff were kind, caring, friendly and patient.

Staff understood people’s needs and knew how people preferred to be given their care and support.

People were treated with dignity and respect and supported to make their own choices about how they spent their day. People’s privacy was respected.

Is the service responsive?

People received person centred care from a team of staff who knew them and their health needs well.

People’s needs were re-assessed when their health needs changed and relatives were kept informed and included.

There was a planned programme of activities for people to take part in if they wished.

People knew how to complain if they needed to and there was a clear complaints process available.

Is the service well led?

The service was well-managed and people told us they had confidence in the management team and the staff.

People were consulted and involved in their care and support.

There was a programme of quality checks and audits to ensure the quality of the service was maintained.

Further information is in the detailed findings below.

This was an unannounced comprehensive inspection that took place on 4 and 5 April 2016. At the last inspection completed in May 2014 the provider was compliant with the regulations and quality standards we reviewed.

Chalfont Care Home provides accommodation and personal care for up to 10 older people in a small homely environment. At the time of the inspection there were 9 people living at the home.

There was a registered manager at the home at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

Overall, there were high satisfaction levels about the way people were cared for and supported.

People felt safe and there were systems in place make sure that the environment and way people were looked after was safe.

Staff had been trained in safeguarding adults and were knowledgeable in this field.

Risk assessments had been completed to make sure that care was delivered safely with action taken to minimise identified hazards.

The premises had also been risk assessed to make sure that hazards to people living at the home were minimised.

Accidents and incidents were monitored to look for any trends where action could be taken to reduce the chance of such accidents recurring.

There were sufficient staff employed at the home to meet the needs of people accommodated.

There were recruitment systems in place to make sure that suitable, qualified staff were employed at the home. The home had a longstanding, small staff team who had worked at the home for many years.

Medicines were ordered, stored, administered and disposed of safely and overall there was good management of people’s medicines ensuring people had medicines as prescribed by their doctor.

The staff team were both knowledgeable and well trained.

There were good communication systems in place to make sure that staff were kept up to date with any changes in people’s routines or care requirements.

Staff were well-supported through supervision sessions, an annual performance review and also practice observations by the registered manager.

Staff and the registered manager were aware of the requirements of the Mental Capacity Act 2005. The home was compliant with the Deprivation of Liberty Safeguards with appropriate referrals being made to the local authority.

People were provided with a good standard of food, appropriate to their needs.

Relatives, staff and people were very positive about the standards of care provided at Chalfont Care Home. People were treated compassionately as individuals with staff knowing people’s needs.

People’s care and support needs had been thoroughly assessed and care plans put in place to inform staff of how to care for people. The plans were person centred and covered people’s overall needs. The plans were up to date and accurate.

There were some communal activities provided and people were happy with the support they received in this area.

There were complaint systems in place and people were aware of how to make a complaint. None had been raised since out last inspection in May 2014.

The home was well-led. There was a very positive, open culture.

There were systems in place to audit and monitor the quality of service provided to people.

We were assisted by the registered manager throughout this inspection and also by the registered providers of the service.

At the time of the inspection there were eight people living at the home. We spoke with six people about their experience of living at the home and with one member of staff.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

• Is the service caring?

• Is the service responsive?

• Is the service safe?

• Is the service effective?

• Is the service well led?

This is a summary of what we found :-

Is the service safe?

People living at the home told us that they felt safe and well cared for. In a returned quality assurance survey one relative had said, “As a family, we know she is safe and being looked after.”

Risk assessments in relation to how people’s care was delivered had been carried out to make sure that staff could support people safely.

Where people had been identified as requiring specialist equipment, this had been provided.

There were systems in place to monitor incidents and accidents as well as complaints to see if lessons or improvements could be made.

CQC monitors the operation of the Deprivation of Liberty Safeguards which apply to care homes. One application had been submitted and the required forms and records were in place.

Is the service effective?

People we spoke with were very positive about the way the care and support they received from the staff. One person told us, “I couldn’t have done better in choosing a home.” Another person told us, “They are wonderful people and couldn’t do more for us.”

People living at the home were involved in the choice about who provided their personal care.

People able to give consent received the care and support they agreed to.

People’s dietary needs were being met and appropriate action taken if people lost weight.

The registered manager was open and cooperative in discussing improvements that could be made; for instance in respect of fluid monitoring documentation for people at risk of not having enough to drink.

Is the service caring?

We received many positive comments from people we spoke with about the care they had received such as: “They really treat us well here”, and “We are killed with kindness.” One relative commented in a returned quality assurance questionnaire, “Her quality of life has improved since moving to Chalfont.”

Everyone we spoke with had no concerns about the care they received. Two people, on whose care we focused, had an up to date care plan in place that they or their relative had been involved in developing.

Is the service responsive?

People had care plans in place and received care and support that met their assessed needs.

The staff member we spoke with, the registered manager and the providers of the service were very knowledgeable about the people living at the home.

People had been referred appropriately for health conditions such as a referral to their GP if they had lost weight.

Is the service well-led?

The registered providers have had experience of running the home for over 30 years and were supported by the registered manager who had completed QCF level 5.

There were well developed systems for monitoring the quality of service provided to people. Accidents and incidents were being monitored to look for any trends. Care plans were up to date and subject to monthly review. Medication was audited each month to make sure people received the medicines they had been prescribed.

At this inspection we spoke with the manager, one member of staff on duty and five people that lived at Chalfont Care Home.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

We found that care plans accurately reflected people’s needs and had been drawn up with their involvement. People expressed satisfaction with the care they received and told us the staff were "very nice and caring". Another person told us “the staff are good and I feel safe”.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were protected from the risk of infection because appropriate guidance had been followed.

The provider had suitable quality assurance procedures in place to manage the health and welfare of people living in the home. People were able to comment on the service provided.

We carried out this inspection of Chalfont on the 30 August 2012. We

spoke with the registered manager, three people living at the home and three members of the staff team.

People living at Chalfont were very positive about their experience of living at the home. No one had any complaints or concerns about how the home was run and managed.

People told us that they had good relationships with the staff, who were described as ‘lovely’. They told us that the home was kept clean and warm. People said that the standard of food was good and there were activities to keep them occupied.

People told us that they were involved in decisions about how they were looked after and that they could choose when they got up and when they went to bed.

People who lived at Chalfont benefited from thorough processes and procedures being followed when new staff are recruited, which meant they were protected from harm.

We saw procedures were in place to make sure that all records are appropriately stored.