• Care Home
  • Care home

Churchfields Nursing Home

Overall: Good read more about inspection ratings

37 Churchfields, South Woodford, London, E18 2RB (020) 8559 2995

Provided and run by:
Yew Tree Care Limited

All Inspections

21 March 2023

During an inspection looking at part of the service

About the service

Churchfields Nursing Home supports people aged 65 or over, some of whom have dementia care or mental health needs. It is registered to accommodate and support up to 32 people. At the time of the inspection, 26 people were living at the home. The home has three floors with adapted facilities and en-suite rooms.

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

We found improvements had been made in the home following our last inspection. Risk assessments for people were more thorough and detailed to protect them from coming to harm. Risks such as those related to people’s health conditions and mobility were monitored and managed so staff could support them safely. Medicines for people were managed and administered safely. Safeguarding processes were in place to protect people from the risk of abuse.

The provider recruited staff appropriately and checked they were of suitable character to support people. There were enough staff working in the home. Systems were in place to prevent and control infections. Lessons were learned following accidents and incidents in the home.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were supported to achieve positive outcomes. They received care and support that was personalised for their needs.

People took part in activities, followed their interests and were supported to see their family and friends. We made a recommendation for the provider to look into improving the range of activities because we found some people had little to do during the day.

Systems were in place to manage and respond to complaints. People’s communication needs were met. Feedback was sought from people and relatives to help make continuous improvements to the home.

The provider and management team carried out quality audits to ensure the home was compliant with health and social care regulations and to identify areas for improvement. The management team learned lessons when things went wrong in the home. People’s dignity, privacy and human rights were respected at all times. Their equality characteristics were understood and respected.

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

Rating at last inspection

The last rating for the service was Requires Improvement, (published on 22 January 2022) and there were breaches of regulations.

We issued requirement notices to the provider for breaches of regulation 12 (Safe care and treatment) and regulation 17 (Good governance). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Churchfields Nursing Home on our website at www.cqc.org.uk

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 30 November 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe and Well-led which contain those requirements, and the Key Question of Responsive.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

Follow up

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

30 November 2021

During a routine inspection

About the service

Churchfield Nursing Home is a residential nursing home providing accommodation and personal care to 31 people, at the time of the inspection. The service is a three-floor building. Each floor has separate adapted facilities.

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

Risk assessments were not completed for people with certain health conditions to ensure they were safe at all times.

Pre-admission assessments were not robust to ensure people’s support needs were captured to determine if people can be supported in a person-centred way. We made a recommendation in this area.

Not all areas of the care plans were person centred. Care plans were not in place for people with dementia to ensure they received personalised support.

Quality assurance systems were not robust to identify the shortfalls we found during the inspection.

Some complaints had not been managed in a timely manner and the tone of language used when responding to some complaints would require a more courteous approach. We made a recommendation in this area.

Systems were in place to prevent and minimise the spread of infections. Medicines were being managed safely. Pre-employment checks had been carried out to ensure staff were suitable to support people. People told us they felt safe at the home and staff were aware of how to safeguard people from abuse. There were appropriate numbers of staff to support people when required.

Staff were trained to perform their roles effectively. People had choices during mealtimes and had access to healthcare services. People were supported to have maximum choice and control of their lives and were being supported in the least restrictive way possible and in their best interests; the policies and systems in the service support this practice.

People participated in regular activities and their communication needs were met. Staff had a good relationship with staff and were friendly and caring.

People received care from staff who were caring and had a good relationship with them. People were encouraged to be independent and to carry out tasks without support.

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

Rating at last inspection

The last rating for this service was good (report published 30 August 2019).

We also carried out a targeted inspection in January 2021 to respond to risks and check on the home’s infection prevention and control measures. This inspection did not change the home’s ‘good’ rating

Why we inspected

We carried out this inspection following a routine review of information we held about this service. Our intelligence indicated that that there may be a higher level of risk at 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.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to risk assessments and good governance. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

27 January 2021

During an inspection looking at part of the service

About the service

Churchfield Nursing Home is a residential care home providing personal and nursing care to 23 people at the time of the inspection. Most people living at the service were older people some of whom had dementia. The service can support up to 32 people.

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

Since our last inspection, improvements had been made with premises’ safety. Actions had been completed to ensure the building was safe in the event of a fire, new flooring was being laid and the lighting was switched on throughout the home.

Risk assessments had also been completed for people at risk of falls and malnutrition in addition to people’s health conditions. This included control measures, referral to professionals when required and monitoring the risks. People’s nutrition and hydration risks were recorded appropriately, and staff followed care plans and health professional’s advice.

Infection control procedures had been enhanced due to the risk of COVID-19 and we observed the service was clean and a cleaning schedule was in place. Personal protective equipment (PPE) was readily available and people and staff were tested regularly to help prevent the spread of infection.

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

Rating at last inspection

The last rating for this service was good (published 30 August 2019).

Why we inspected

The inspection was prompted in part due to concerns received about the management of falls and nutrition and hydration. This inspection examined those risks. We found no evidence during this inspection that people were at risk of harm from this concern. We also looked at infection prevention and control measures. 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 coronavirus and other infection outbreaks effectively. Please look at the Safe question of this part of the report.

The overall rating for the service has not changed following this targeted inspection and remains good.

CQC have introduced targeted inspections to follow up on specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Churchfields Nursing Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

18 July 2019

During a routine inspection

About the service

Churchfields Nursing Home is a residential care home providing personal and nursing care to 31 people, aged 65 and over at the time of the inspection. The service can support up to 32 people.

People’s experience of using this service

The home was not fully protected against the risk of fire and the provider was in the process of making improvements to ensure facilities and equipment were fire safe. The home itself was not well lit and many lights were switched off during the day, making some areas dark and potentially unsafe. We have made a recommendation for the provider to look at guidance on suitable lighting in care home settings.

People told us they felt safe in the home. Procedures to protect people from abuse were in place. Risks associated with people’s needs were assessed and staff understood how to reduce these risks. People were supported with their medicines, which were stored, recorded and managed suitably. Staff followed infection control procedures. Accidents and incidents were analysed and learned from to prevent reoccurrence.

There were enough staff on duty in the home. Staff were recruited safely and their backgrounds checked before they started working in the home. They were supported with training and development to ensure their skills and knowledge were up to date. We have made a recommendation for the provider to refer to reputable sources for guidance on helping staff develop their skills and understanding of people’s specific health conditions.

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 supported with maintaining their health. Appointments were made with health care professionals, such as GPs and speech and language therapists. People could choose their meals and were supported to maintain a balanced diet that was suitable to their needs and preferences.

Staff were respectful and caring towards people. They understood the importance of promoting equality and independence. People's dignity and privacy were maintained by staff.

Care plans were personalised and people were encouraged to maintain their independence. Staff communicated with people well but some people felt staff did not fully understand them and we have made a recommendation about overcoming language barriers between staff and people. People were supported to engage in activities and entertainment within the home. People were supported to make complaints or report any concerns they had. The home supported people with end of life care and their wishes were met by staff.

Staff felt supported by the management team. Quality assurance systems included obtaining feedback from people and relatives. The registered manager and representatives of the provider carried out checks to ensure staff were providing a good standard of care and the home was safe. They learned lessons when things had gone wrong to help make improvements to the home.

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

Rating at last inspection

The last rating for this service was Good (report published 13 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

1 December 2016

During a routine inspection

This unannounced inspection took place on 1 December 2016. At the last inspection of this service in October 2015, we made recommendations for the service to make improvements in order to have suitable arrangements in place for obtaining and acting in accordance with the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The provider was required to appoint a suitable manager to manage the service.

At this inspection, we found that the service had a registered manager in place. 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.

At this inspection we also found that staff had attended training in the MCA and DoLS. At this inspection, we found that improvements had been made to the systems, to ensure that people received care and support in line with the MCA and DoLS.

Churchfields Nursing Home is registered to provide accommodation and nursing care for up to 32 older people, some of whom are living with dementia. At the time of this inspection, 28 people were using the service. Accommodation is arranged over two floors and there is a lift to assist people to access the upper floor. There are 31 single bedrooms and one double room, which two people can choose to share.

Staff understood their responsibilities to protect the people in their care. They were knowledgeable about how to protect people from abuse and from other risks to their health and welfare.

Medicines were managed and handled safely. Arrangements were in place to keep people safe in the event of an emergency. There were sufficient staff to meet people’s needs. Staff were attentive, respectful, patient and interacted well with people. People told us that they were happy and felt well cared for. Risk assessments were in place about how to support people in a safe manner.

Staff undertook training and told us that they received supervision to support them to carry out their roles effectively. Staff training records showed they had attended a variety of training.

People were supported to maintain good health. They had access to health care services when it was needed. People received a nutritionally balanced diet to maintain their health and wellbeing.

People’s needs were assessed before they moved in to the home. Care plans were person centred and were regularly reviewed. Care plans were updated when people’s needs changed.

The provider had systems in place to monitor the service provided and people were asked for their feedback about the quality of service provided.

7 October 2015

During a routine inspection

This unannounced inspection took place on 7 October 2015. At the last inspection of this service in October 2014, we found breaches of legal requirements. This was because people were not safeguarded against the risk of abuse and were not protected against risks associated with medicines. The registered person did not have effective systems in place to monitor the quality of service delivery. They also failed to maintain accurate records in respect of each person who used the service. Care plans and risk assessments were not regularly updated and reviewed when people’s needs changed. The service did not have suitable arrangements in place for obtaining and acting in accordance with the Mental Capacity Act 2005 and the Deprivation of Liberty safeguards. The service’s recruitment practices required improvement and suitable arrangements were not in place to support staff working at the home. The provider wrote to us and told us about changes they planned to make to meet the regulations. They said they would make changes by June 2015. These included, improving the service’s quality monitoring systems, provision of training on safeguarding people, implementing a comprehensive medicines audit system to ensure the safe administration of medicines.

Churchfields  Nursing Home is registered to provide accommodation and nursing care for up to 32 older people, some of whom are living with dementia. At the time of this inspection, 28 people were using the service. Accommodation is arranged over two floors and there is a lift to assist people to access the upper floor. There are 31 single bedrooms and one double room, which two people can choose to share.

The service did not have a registered manager in place, however the provider had identified another person to manage the home.  A deputy manager had been in charge of the home since the last 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.

At this inspection, we found that some improvements had been made. Staff understood their responsibilities to protect the people in their care. They were knowledgeable about how to protect people from abuse and from other risks to their health and welfare. Medicines were managed and handled safely. Arrangements were in place to keep people safe in the event of an emergency.

There were sufficient staff to meet people’s needs. Staff were attentive, respectful, patient and interacted well with people. People told us that they were happy and felt well cared for. Risk assessments were in place about how to support people in a safe manner.

Staff undertook training and told us that they received supervision to support them to carry out their roles effectively. Staff training records showed they had attended training in Mental Capacity Act (2005) and Deprivation of Liberty Safeguards. However, improvements were needed to the systems in place to ensure that people received care and support in line with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People were supported to maintain good health. They had access to health care services when it was needed. People received a nutritionally balanced diet to maintain their health and wellbeing.

People’s needs were assessed before they moved in to the home. Care plans were person centred and were regularly reviewed. Care plans were updated when people’s needs changed.

The service did not have a registered manager but appropriate interim arrangements were in place. The service had not been consistently well managed but people were positive about the changes and improvements that were now taking place.

The provider had systems in place to monitor the service provided and people were asked for their feedback about the quality of service provided.

21 October 2014

During a routine inspection

At the last full inspection of the service in August 2013, the home were found to be non compliant with Regulation 21 Requirements relating to workers. However, they met the regulation at a subsequent follow up inspection carried out in March 2014. CQC carried out an inspection of this care service on 21 October 2014. This is a summary of what we found.

Churchfields Nursing Home is registered to provide accommodation and support with personal care and nursing for up to 32 older people including people who are living with dementia. Accommodation is arranged over two floors and there is a lift to assist people to access the upper floor. There are 31 single bedrooms and one double room, which two people can choose to share. There were 29 people living at the home at the time of our inspection.

The home’s registered manager left the service in October 2013. Therefore they did not have a registered manager in post at the time of this inspection. We were informed that an interim manager had been appointed and it was their first day in the post, on the day of the inspection. They had made an application to register with the Care Quality Commission to register to manage the home. 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.

The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People who used the service told us that they were mostly happy with the care provided by the staff. People described staff as kind, helpful and caring. However, they told us that they and their families had not been included in planning and agreeing to the care provided. We found that some people’s needs had not been continuously assessed or their care plans updated as their needs changed. People’s choice and dignity, in terms of personal care needs had not always been respected by staff. This meant people did not always receive support in the way they needed it.

People told us that they felt safe in the home. However, during the inspection we found that staff training, knowledge and understanding of safeguarding people was not up to date. People were not fully protected against the risks associated with medicines because proper procedures for the storage, disposal and administration of medicines were not in place.

Sufficient recruitment procedures were not followed before staff began to work at the home. Applicants attended an interview to assess their suitability, however recruitment records showed that appropriate pre-employment checks had not been carried out prior to them starting work. Training was not delivered by trainers who were specialists in their fields of knowledge. There was a lack of a consistent and thorough supervision and appraisal system for staff at the service. This meant that people were not cared for by staff who received effective training, support and guidance to enable them to meet their assessed needs.

People were happy with the choice of food provided. Their dietary needs were met in a way which promoted and maintained their health and well-being. They had been included in planning menus and their feedback about the meals in the home had been listened to and acted on.

People were able to see their friends and families when they wanted. All the visitors we spoke with told us they were made welcome by the staff in the home.

People’s views about the service provided were not consistently sought. Monitoring of the service had not been effective and timely in identifying where improvements were needed. This meant the quality monitoring processes were not effective as they had not always ensured that people received care and treatment that met their needs.

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

13 March 2014

During an inspection looking at part of the service

When we last inspected the service, in August 2013, we found that recruitment procedures were not effective. For example, two references were not always obtained before staff began work. People were at risk of receiving support from staff who were not suitable. We asked the provider to make improvements.

On this visit we found that changes had been made. Records showed that the provider had undertaken all the required checks before staff started work. People were supported by staff who were suitably qualified, skilled and experienced.

6 August 2013

During a routine inspection

People and their relatives were positive about the service. One person said 'I can't find a fault with it. I enjoy living here.' People said they were treated with respect by staff and they were cared for safely and effectively. Relatives told us they had been involved in planning and reviewing people's care to ensure the service met their needs. We saw evidence that the service had involved health professionals such as the GP and the tissue viability nurse to ensure that any risks to people's health were minimised. There were systems in place to monitor the quality of the care people received. When we inspected the service in March 2013 we found that there was not always sufficient staff on duty. Since then the provider has recruited staff. On this visit there was enough staff to meet people's needs. A person told us 'there are regular staff who know you and if you want a little word with them you can.' However, we were concerned that the provider had not undertaken all the required pre-employment checks to ensure the suitability of new staff. We have asked the provider to take action to ensure that their recruitment process is safe and effective.

14 February 2013

During a routine inspection

People were treated with respect and their care and welfare needs were being met. People who used the service and their relatives said they were happy with the service and staff were 'very friendly', and responded quickly when they rang their call bell. They told us they were getting the care and help they needed. There were systems in place to ensure that people received their prescribed medication safely.

People were accommodated in an environment that was appropriately maintained and suitable for their needs. Specialised equipment was available to assist people with mobility difficulties and equipment and services were serviced regularly and checked to ensure that they were in good working order and safe to use.

We found that there were not always enough qualified, skilled and experienced staff to meet people's needs and this placed people at risk of receiving an unsafe or inappropriate service.

During an inspection looking at part of the service

We did not visit the service or speak with people who use the service on this occasion. We visited this service in May 2011 and found that people who use the service could not be sure that the correct equipment was being used for moving and handling purposes or that staff were competent in this area. As a result, we made a referral to the HSE (Health & Safety Executive). The HSE subsequently confirmed that the service had complied with the requirements with regard to moving and handling and the safe use of bed rails. They told us that new equipment had been purchased and that the relevant staff had received appropriate training for its use and for manual handling. Therefore we were satisfied that people were protected from unsafe or unsuitable equipment and that staff had been trained to use such equipment appropriately.

17, 20 May 2011

During a routine inspection

With the exception of one person who did not want to be at the service people told us that they were happy there. They also told us that staff were kind, gentle, caring and helpful. People told us that they could choose what and where they wanted to eat and where they spent their time. One person said that the proprietor came and asked her about the service and if there were any problems. A relative said that the service was very good and the community matron said that she was happy with the service.