Canford Chase

Updated 5 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a routine comprehensive inspection. It took place on took place on 17 and 18 September 2018. The first day was unannounced.

We reviewed the information we held about the service and took this into account while planning the inspection. This included statutory notifications from the service about significant events such as deaths and information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make

The inspection team was made up of two adult social care inspectors, a pharmacist special advisor and a specialist advisor in general adult nursing. We made general observations around the service. We spoke with six people about their experience of the care they received, two relatives, six staff, the registered manager. We also spoke with the provider’s operations, clinical and quality managers. We viewed six people’s care records, seven people’s medicines records and stocks of further people’s medicines, three staff files, and other records relating to the quality and management of the service.

Following the inspection, we obtained feedback from seven health and social care professionals who have contact with the service.

Updated 5 December 2018

This comprehensive inspection took place on 17 and 18 September 2018. The first day was unannounced.

Canford Chase 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.

Canford Chase accommodates up to 55 older people in purpose-built premises. Nursing care is provided. There were 46 people living or staying there when we inspected.

The registered manager had been in post for several years. 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 service was committed to excellence in end of life care, working closely with health professionals so that when the time came people had a comfortable, dignified and pain-free death. Staff were particularly skilled and confident in caring for people who were dying and their loved ones. The service collaborated with a local hospice for staff development and to obtain specialist advice on symptom control when needed.

There was a vibrant activity programme based on people’s hobbies, interests and wishes and tailored to their individual needs. There were regular trips out for those who wished and were well enough. The service had established links with the local community and continued to develop these.

There was a strong emphasis on the importance of eating and drinking well. Positive relationships with staff encouraged people to eat and drink, particularly those who might be reluctant. Waiters and waitresses were employed to ensure that people who spent most of their time in their room had the same service as people who came to the dining room. The chef met people regularly to obtain their feedback and gather up-to-date information about dietary needs and preferences. The chef also spoke regularly with clinical staff to review people’s weights and individual nutritional needs. The provider had produced a comprehensive nutrition resource folder for care and catering staff.

People were supported to live healthily and obtain the care and support they needed from other health professionals. Where people had complex health needs, staff sought to optimise care by identifying and implementing best practice. Staff ‘champions’ actively supported colleagues to make sure people experienced the best possible health and wellbeing in view of their conditions.

The service worked in partnership with other organisations to keep up to date with new research and make sure staff were trained to follow best practice. Care was planned and delivered in line with current good practice and standards. Standards of nursing care were very high. People and where appropriate their families were meaningfully involved in planning care. Their choices were reflected in detailed, comprehensive care plans and staff understood their needs and preferences well.

People were protected against abuse and avoidable harm. Staff understood their responsibility to report concerns about abuse and knew how to do so. Medicines were stored and managed safely. We have made a recommendation about the scope of medicines audits.

Risks to people were regularly assessed and they were helped to stay safe in the least restrictive way possible. The premises and equipment were in good condition and there was regular maintenance. The building smelt pleasant throughout. Effective processes were in place to control and prevent infection.

There were sufficient skilled and competent staff on duty to provide the care people needed. Appropriate recruitment checks were made before staff started working at the service, such as criminal records checks and taking up references from previous employers. Staff were supported through training, supervision and appraisal to perform their roles effectively. Nurses were supported to maintain their professional registration with the Nursing and Midwifery Council.

Lessons were learned, and improvements made when things went wrong.

The building and garden had been adapted and decorated to a high standard, providing a comfortable, homely environment that suited people’s needs. The premises were accessible for people with mobility difficulties, with passenger lifts, wet rooms and adapted bathing facilities. The large garden had seating areas, raised beds, wheelchair-friendly paths and an accessible summer house.

Staff understood and worked within the principles of the Mental Capacity Act 2005 (MCA), including the Deprivation of Liberty Safeguards.

People were treated with kindness, respect and compassion. Their independence was promoted as far as possible. Staff were attentive and upheld people’s privacy and dignity. People were encouraged to personalise their room with items of their own to help it feel homely. There were no restrictions on visiting times.

People, and where appropriate their relatives, were consulted and kept informed about their care. Information was available for people and their relatives about outside organisations and sources of support.

Everyone we spoke with or had feedback from was positive about the way the service was run and said the registered manager was readily available. Communication was good. Staff were motivated in their work and proud of the service. Staff turnover was low.

The service had a positive, person-centred, open and inclusive culture. It worked openly and collaboratively with other agencies. The voices of people and staff were heard and acted upon. There was regular consultation, informally and through meetings and quality assurance surveys.

There was continuous learning and improvement through the monitoring and review of accidents and incidents, and through a programme of audits to assess and monitor the quality of the service. People’s concerns and complaints were listened and responded to and used to improve the quality of care.

Legal requirements were understood and met. The previous inspection rating was displayed prominently in the reception area. The service notified CQC of all significant events and the registered manager was aware of their responsibilities in line with the requirements of the provider's registration.