Chesford Grange Care Home

Updated 5 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 3 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Chesford Grange is a care home. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Chesford Grange is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for 6 weeks and had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used information gathered as part of monitoring activity that took place on 9 August 2022 to help plan the inspection and inform our judgements.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people who used the service about their experience of the care provided. We spoke with 2 family members of people who received care. We spoke with 12 members of staff including the nominated individual, the manager, the ex-registered manager, deputy manager, one senior care team leader, care staff, activity coordinators, a laundry assistant and the cook.

We reviewed a range of records including support plans and multiple medication records. We looked at 3 staff files in relation to recruitment. We reviewed a variety of records relating to the management of the service including risk assessments, quality assurance records, training data and policies and procedures. We continued to seek clarification from the provider to validate evidence found.

Updated 5 January 2023

About the service

Chesford Grange is a care home providing personal and nursing care to up to 74 people. The service provides support to both younger and older adults some who may have a diagnosis of dementia, mental health conditions and or a physical disability. At the time of our inspection there were 53 people using the service.

People’s experience of using this service and what we found

The governance systems in place did not always identify issues relating to safety and quality within the service; this meant lessons could not always be learned when things went wrong. Some people’s care records had not been reviewed and updated to ensure they contained the correct level of information about people’s needs.

There was a new electronic medication system in place. However, not all staff were using the system correctly which meant we could not be assured people were receiving their medication as prescribed. We received mixed feedback about the level of staffing across the service, and some relatives told us they were unsure who the management team were.

Processes were in place to protect people from the risk of harm and abuse and staff were trained to respond to safeguarding concerns, although the lack of managerial oversight meant some safeguarding referrals had not been made. There were measures in place to mitigate the risk of the spread of infection across the service.

Care was delivered in line with people’s assessed needs and people were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported support this practice. People had access to healthcare as needed.

Staff were observed to be kind and supported people in a dignified way. People were encouraged to be as independent as possible.

Activities in the home were socially and culturally relevant for people and activity staff were enthusiastic about improving the programme of activities available. There was a complaints policy in place and compliments about the service had been received. People received good end of life care.

There was a new manager in place who was dedicated to improving the service and driving change to improve outcomes for people living at Chesford Grange. They were committed to ensuring people, relatives and staff had a voice and were encouraged to feedback about the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

This service was registered with us on 28 January 2022 and this was the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.