About the service:

Chase House Limited is a care home. It provides personal and nursing care for up to 50 younger adults and older people. Some of the people living at the service were living with dementia, long term health conditions and physical disabilities. At the time of the inspection, 49 people were living at the service.

People’s experience of using this service:

People's experiences of the service were quite positive. However, Well-led was rated 'requires improvement'. This was because the provider needed to improve their quality monitoring systems to show that actions were always taken to make sustained improvements.

Staff had been trained in how to protect people from harm, and they knew how to report concerns. Potential risks to people’s health and wellbeing were assessed and minimised. There were enough staff to meet people’s needs safely. People's medicines were managed safely. Staff followed effective processes to prevent the spread of infection.

Staff had been trained and had the right skills to meet people's needs effectively. Staff were well supported and had information they needed to meet people’s assessed needs. Staff supported people to have enough to eat and drink. Staff supported people to access healthcare services when required, to help maintain their health and well-being.

People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were fully involved in making decisions about their care and support. People were involved in the planning and reviewing of their care plans. People told us staff were caring and friendly. Staff respected and promoted people’s privacy, dignity and independence.

Information in people's care plans supported staff to deliver person-centred care that met people’s needs. The registered manager sought feedback from people about the quality of the service provided. The registered manager worked in partnership with other professionals to ensure people received care that met their needs. There was a system to ensure people’s suggestions and complaints were recorded, investigated, and acted upon to reduce the risk of recurrence.

Rating at last inspection:

The service was rated 'good' when we last inspected it. That report was published in August 2016.

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor all information we receive about the service and schedule the next inspection accordingly.

This inspection took place 6 & 7 July 2016 and was unannounced.

The inspection was carried out by one inspector.

Chase House Residential and Nursing Home provides nursing and personal care for up to 50 older people. Most people who use the service are living with dementia. On the day of our inspection 48 people were using the service.

There was a registered manager in post.

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.

People felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and knew how to report any concerns. People had risk assessments in place, which had been reviewed, to enable them to be as independent as they could be.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs. Effective recruitment processes were in place and followed by the service to ensure appropriate staff were employed to provide care for people.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.

Staff received a comprehensive induction process and on-going training. They were well supported by the registered manager and senior staff and had regular one to one time for supervisions. Staff had attended a variety of training to ensure they were able to provide care based on current practice when supporting people.

Staff gained consent before supporting people. People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people.

People were able to make choices about the food and drink they had, and staff gave support when required. People were encouraged to have a healthy balanced diet. Special diets were catered for.

People were supported to access a variety of health professional when required, including opticians and doctors.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times.

People were supported to follow their interests and join in a variety of activities. Specific activity staff were employed who arranged a number of activities.

A complaints procedure was in place and accessible to all. People knew how to complain. Effective quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement where necessary.

During our visit to Chase House on 4 June 2013, we observed a friendly environment, with positive interactions between staff and residents. People looked relaxed and well cared for, and we saw staff took time to talk with people.

At the time of our visit, 50 people were living in the home. We spoke with 11 of the 50 people, although due to some people's dementia needs, not everyone was able to tell us about their experiences. We therefore used a number of methods to help us understand the experiences of people using the service, including observation and talking with people's relatives and care staff.

One person’s relative said they were generally happy with the care provided and the environment. People who spoke with us told us they felt cared for and well supported by staff. Two people said the care was "wonderful", and one person said, “The staff are so lovely."

We observed staff providing respectful care and support to people, and saw this was delivered in line with the care records we reviewed to meet people's needs.

Clear processes were in place to ensure that the home remained clean and tidy. Staff had sufficient personal protective equipment to use when attending to personal care needs for people.

We saw that staff received regular on-going training which provided them with the appropriate skills to carry out their roles.

During our visit on 4 October 2012 we looked at the standard relating to the management of medicines. We found that the provider had made improvements in the way medicines were managed. We spoke with two people who told us they always received their medicines on time. We found that appropriate arrangements were in place in relation to obtaining, handling, recording, administering and storing medicines.

During our visit on 12 July 2012, we spoke with seven people who lived at Chase House Limited, and two people’s relatives. All the feedback we received was very positive.

People told us they were happy with the care provided and felt their needs were met. One person told us, “If you want anything they are always there for you. You only have to ask.” A relative said, “If the Queen had to pick a care home, she couldn’t pick a better one than this.”

One person living at the home said, “[The staff] do listen if I say I want something done differently. If I’ve not been happy about something I’ve said and [the staff] have taken that on board.” Other people echoed this view. They told us that staff members were flexible about the times they got up and went to bed and that there was a good choice of food being offered to people.

People told us about day trips and holidays to the seaside in addition to more local visits, such as coffee mornings at the local library and visits to the local garden centres and pub. One person told us, “There’s no time to get bored, there’s plenty to do and visits organised for us.”

We received very positive feedback about the staff, with comments such as, “The staff are really good and provide good care”, “The staff know what they are doing” and, “There’s nothing [the staff] could do better.”

Four people told us that the staff looked after their medicines. They said they always received them on time and that their medicines had never been forgotten. However, we could not be certain that people always received their medicines as prescribed because, of the four people’s medicines and records we checked, three were inaccurate or incomplete. This means people were at risk of not receiving their medicines as prescribed.

People we spoke with during our visit to Chase House on 17 February 2012, and the family members we met, were very positive about the service people receive at this care home. They told us they are happy here, the food is good, the staff are lovely, and they feel safe. They are given opportunities to be involved in deciding on the care they receive, and to comment on the quality of the service. Our observations showed that generally staff treated people with respect, offered care in a discreet and sensitive way and were attentive to people’s needs.

Chase House has undergone a vast amount of building work and refurbishment over the past few years. This was almost completed when we visited, with the last two bedrooms undergoing a complete alteration and redecoration process. This work has resulted in a large extension, tastefully designed to fit in with the original Victorian house. New, very large conservatories have been built to add additional communal lounge areas, and every part of the existing home has been refurbished. A number of new ensuite shower rooms and toilets had been created, and every room redecorated. This had resulted in a very comfortable, well-maintained and well decorated home for people to live in, which showed the level of respect the providers had for the people living there.