Sefton New Directions Limited – Chase Heys Resource Centre is a purpose built establishment providing accommodation and personal care for 30 older people. The service has 19 respite places and 11 intermediate care places (these are places supported by rehabilitation services from the local NHS provider.) The service accommodates people across three separate units. At the time of our inspection there were 15 people using the service.

Sefton New Directions Limited - Chase Heys Resource Centre is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection.

This was an unannounced inspection which took place on 8 June 2018. The last inspection was on 4 and 5 October 2017 when the service was rated as ‘Required improvement’.

The service had a registered manager in post. A registered manager is a person who has registered with the CQC 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.

At our last inspection, we identified breaches of Regulations 12 (safe care and treatment), Regulation 16 (receiving and acting on complaints), Regulation 17 (good governance), and Regulation 19 (fit and proper persons) of the Health and Social Care Act (Regulated Activities) Regulations 2014. During this inspection we checked to see if sufficient improvements in these areas had been made and we found that they had.

At our last inspection, the way staff were recruited was not always robust. This was because the required pre-employment checks necessary to ensure staff were suitable to work with vulnerable adults had not always been made. At this inspection, we saw that this had been addressed. We looked at the recruitment records for three members of staff. We saw that each staff member's suitability to work at the home had been checked prior to employment.

At our last inspection we found that some medication administration records (MARs) could be improved upon with regards to being double signed. Most MARs had been double signed by two members of staff as best practice to help ensure a correct record of medicines but three had not. Medication storage facilities for people who self administered their own medication also required improvement. During this inspection we found that people's MARs were now completed appropriately and that people who self administered their own medication had safe storage facilities to ensure their medicines were kept secure at all times.

At the last inspection we found that the care plans belonging to people in receipt of intermediate care were not fully developed with regard to people's care choices. In addition, some people told us that they did not always receive a bath or shower when they had asked for one.

We looked at the care records belonging to four people. We saw that they contained a detailed assessment on people's admission to the home. This helped to identify people’s requirements and preferences in relation to their care, whether people preferred a bath, shower or full body wash. People’s choice and preferences were also now reflected in other areas of their care plan for staff to be aware of. For example, the types of food people enjoyed and how they preferred their tea or coffee to be prepared were specified.

At the last inspection, we found that quality assurance processes to seek the views of people using the service and their families were not always collated or used to improve the service. At this inspection people's suggestions and opinions on the service had been sought and acted upon where practicable. For example, more choice had been provided at mealtimes in response to people's feedba

Sefton New Directions Limited - Chase Heys Resource Centre is a purpose built establishment providing accommodation and personal care for 30 older people. The care home has 19 respite places and 11 intermediate care places (places supported by rehabilitation services from the local NHS provider.)

This was an unannounced inspection which took place on 4 and 5 October 2017. The last inspection was in April 2015 when the service had been rated as ‘Good’.

The service had 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.

We looked at how staff were recruited and the processes to ensure staff were suitable to work with vulnerable people. We found that required checks necessary to ensure a robust recruitment process had not been made.

When asked about medicines, people said they were supported well. We found some medication recording and administration records could be improved as well as safe storage for people who self-medicate.

Most people told us their care reflected their identified needs from admission and during their stay. There was evidence that care plans had been discussed with people so they felt involved in their care. For people admitted for intermediate care we found care plans and records were not fully developed to reflect choice and personal care. Some people told us they had not received a bath or shower when requested.

Quality assurance processes were in place to seek the views of people living at the home and their families. The information from these was not always collated and analysed to provide feedback of actions taken. The frequency and scheduling of audits was not apparent and actions following audits were not clear. Some of the issues we identified on inspection had not been reflected in the audits seen.

We saw a complaints procedure was in place and people, including relatives, we spoke with were aware of how they could complain. We saw that complaints had been made but these had not been tracked and recorded as part of the complaints process.

You can see what action we told the provider to take at the back of the full version of this report.

We observed staff provide support and the interactions we saw showed how staff communicated and supported people as individuals. Staff were able to explain each person’s care needs and how they communicated these needs. People we spoke with, relatives and health care professionals said staff had the skills and approach needed to ensure people were receiving the right care. Some key areas of staff training needed reviewing and updating to meet the provider’s training schedule.

We made a recommendation regarding this.

People told us the meals were good and well presented. Lunch time was seen to be a relaxed and sociable occasion. We found the choice of meals on offer could be better developed and promoted.

We made a recommendation regarding this.

When we spoke with people living at Chase Heys they told us they were settled and felt safe at home. All of the people we spoke with commented on consistent standards of care.

We found there were sufficient staffs on duty to meet people’s care needs.

There were two models of care running together at Chase Heys. The ‘respite’ service offered short stay support for people who then return home. ‘Intermediate care’ was also offered. This is for people who have completed care in hospital and need further support and rehabilitation before returning home. The health professionals involved in the management of people on intermediate care said Chase Heys provided effective support for people.

The staff we spoke with clearly described how they would recognise abuse and the action they would take

Sefton New Directions Limited - Chase Heys Resource Centre is a purpose built establishment providing accommodation and personal care for 30 older people. The care home has 19 respite places and 11 intermediate care places (places supported by rehabilitation services from the local NHS provider.)

This was an unannounced inspection which took place on 1 April 2015. The inspection team consisted of an adult social care inspector. The service was last inspected in January 2014 and was meeting standards at that time.

The service had 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.

When we spoke with people living at Chase Heys they told us they were settled and felt safe at home. All of the people we spoke with commented on consistently high standards of care. People said, ‘’Staff are very obliging and it’s very well organised’’ and “I feel so relaxed and safe here.’’

To support the 18 people accommodated at the home on the day of the inspection there was normally a minimum of five care staff. They worked on both respite and intermediate care. We saw from the duty rota that this staff ratio was consistently in place to provide safe care.

We looked at how staff were recruited and the processes to ensure staff were suitable to work with vulnerable people. We saw checks had been made so that staff employed were ‘fit’ to work with vulnerable people.

We found Chase Heys were good at managing risks so that people could be as independent as possible. We spoke with two health care professionals who supported people in the home. They felt that staff managed people’s care needs well and this included ensuring their safety.

When asked about medicines, people said they were supported well. We observed good practice when staff administered medicines to ensure people received medicines safely.

The staff we spoke with clearly described how they would recognise abuse and the action they would take to ensure actual or potential harm was reported. Training records confirmed staff had undertaken safeguarding training. All of the staff we spoke with were clear about the need to report any concerns they had.

Arrangements were in place for checking the environment to ensure it was safe. For example, health and safety audits were completed on a regular basis where obvious hazards were identified.

We observed staff provide support and the interactions we saw showed how staff communicated and supported people as individuals. Staff were able to explain each person’s care needs and how they communicated these needs.

There were two models of care running together at Chase Heys. The ‘respite’ service offered short stay support for people who then return home. ‘Intermediate care’ was also offered. This is for people who have completed care in hospital and need further support and rehabilitation before returning home. The GP involved in the management of people on intermediate care said Chase Hays provided a particularly effective service as people could also be referred directly from home so that a period of support might avert a hospital admission.

People we spoke with, relatives and health care professionals were aware that staff had the skills and approach needed to ensure people were receiving the right care.

We looked to see if the service was working within the legal framework of the Mental Capacity Act (2005) [MCA]. This is legislation to protect and empower people who may not be able to make their own decisions.

People told us the meals were particularly good and well presented. We observed and spoke with people enjoying breakfast. We were told that breakfast was flexible and there was always choice available with all meals.

We asked people if they were treated with dignity, respect, kindness and compassion. One person we spoke with had just completed a stay of respite are. We were told, ‘’Everybody has been lovely; the food is great and I’ve really enjoyed my stay.’’ Staff were particularly noted as kind, helpful and caring.

We made observations at times throughout the inspection. The interactive skills displayed by the staff when engaged with people were excellent and people’s sense of wellbeing was very evident.

We found that care plans and records were individualised to people’s preferences and reflected their identified needs from admission and during their stay. There was evidence that care plans had been discussed with people so they felt involved in their care.

Social activities were organised. One person said, ‘’Activities are organised every day. They are interesting and enjoyable’’. A recent development in the home had been the introduction of a Wi-Fi system. This was in response to people requesting to bring IT equipment in for their stay. This was an example of the service listening to people’s requests and it helped to increase people’s independence and avoid feelings of social isolation.

We spent time talking to the manager and asked them to define the culture of the home and the main aims and objectives. These are exemplified in the information provided before the inspection which stated: ‘A relaxed professional atmosphere is encouraged by senior staff to encourage a friendly and welcoming atmosphere for service users and visitors’.

A well-developed process was in place to seek the views of people living at the home and their families. The manager was able to evidence a series of quality assurance processes and audits carried out. These were fairly comprehensive and helped ensure standards of care where maintained consistently as well as providing feedback for on-going development of the service.

During our inspection at Chase Heys Resource Centre, we observed care plans that reflected a person-centred approach to providing support. One person using services commented, `it`s all fantastic here - it could not be better - staff always ask what we want.` We saw the personal care plans for people using services and observed they received effective, safe and appropriate care that met their needs and protected their rights. People using services were supported in a clean, hygienic environment and were protected from the risk of infection because appropriate guidance had been followed.

People were cared for, or supported by, suitably qualified, skilled and experienced staff which ensured they received appropriate and good quality care at all times. A new member of staff confirmed they were required to `undergo a thorough induction and training programme before being allowed to work independently.` People’s complaints were fully investigated and resolved, where possible, to their satisfaction because they had their comments and complaints listened to and acted on, without the fear that they would be discriminated against for making a complaint.

Peoples’ privacy, dignity and independence were respected. People at the home told us they received support in accordance with individual need and the staff supported them with their independence.

People experienced care, treatment and support that met their needs and protected their rights. One person said, ‘’It’s great. I’ve come from hospital and they are helping me get back on my feet and walking. I’ve had a session with the physiotherapist every day.’’

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We spoke with five people living at the home about how medicines were managed. Everyone we spoke with was happy with the arrangements in place when staff administered their medicines.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We spoke with four staff who told us that Chase Heys was a positive place to work and they felt supported in their role by good support systems such as training and supervision.

The provider had an effective system to regularly assess and monitor the quality of the service that people received. Regular checks were carried out to ensure safe standards and peoples views were collected via regular surveys. This showed a willingness and ability to listen to peoples views and take them into account when developing the standards in the home.

All five people we spoke with said they were well cared for and one said it was like a five star hotel. One person said they liked coming to the home for a rest because it’s like a holiday. Another said they felt safe and enjoyed the company but they would have preferred to have an en suite room.

We spoke with five people that were looking after their own medicines. All were happy to do this but we found they could not store their medicines safely because they had not been provided with a key to their lockable drawer. Unsafe storage of medicines can lead to them being misused and mishandled.

We spoke with six people who lived in the home about their medicines and observed some medicines being given to people. All six people said they were happy and comfortable living in the home. Some of the people were looking after their own medicines and they all said they were happy to do this. Two people that were having their medicines administered by care workers said they thought this was done properly.