Tuesday, 20 November 2018

Inspectors say care home still requires improvement

Inspectors say care home still requires improvement

A CARE home in Henley is still underperforming, according to the industry watchdog.

The Chilterns Court Care Centre, off York Road, has been rated “requires improvement” — the second lowest rating possible — by the Care Quality Commission for a second time since it opened in November 2016.

The home, which is part of the Townlands Memorial Hospital campus but run by the Orders of St John Care Trust, underwent an unannounced inspection on March 20.

Inspectors found improvements had been made since the last inspection but more needed to be done.

The home is now rated “good” in terms of safety and effectiveness and in terms of caring compared with “requires improvement” and “good” respectively last year.

But it is rated “requires improvement” in terms of both responsiveness and leadership.

The inspectors said there were inaccurate patient records and information was not being kept up to date.

The report said: “Although staff knew people’s needs and how to support them, people’s records were not always accurate and did not always reflect people’s needs.

“Care plans were reviewed monthly. However, the main front page of the care plans was not updated to reflect those changes and this resulted in conflicting information. For example, one person’s mobility care plan review indicated they were using a walking frame. However, the front of the same care plan still reflected the person used a walking stick.

“We spoke to staff about this person’s mobility and they supported this person using a walking frame.”

There were also problems with recording the dietary requirements of some patients.

The report said: “People’s dietary needs and preferences were documented. However, we found some inconsistencies in one person’s record.

“The person’s dietary advice form in the care records indicated they were on a low fat diet [but] this person’s dietary advice form with the chef indicated they were on a normal diet.

“We spoke to this person and who told us, ‘food is not suitable. I need a fat-free diet but it’s not accommodated’.”

The inspectors also found measures to assess whether patients were at risk of being malnourished were not calculated correctly.

They also uncovered problems with care plan audits, which are to check the quality of the service being provided.

The report said: “Some quality assurance systems were operated effectively and used to drive improvement in the service. However, the provider’s care plan audits were not always used effectively. For example, in one care plan audit significant shortfalls were identified on one unit and were to be actioned within a set timeline.

“We found some of the action plans had been actioned. However, we still identified the same issues during our inspection and the set timeline had passed.

“The provider’s care plan audits had not picked up the concerns we also found in regard to the incorrect MUST scores and dietary form.

“Another internal audit was completed and identified inconsistencies in recording and un-updated care plans. However, there were no action plans or set timelines to show when the issues would have to be addressed. There was no clear process of following up on action plans to ensure they were completed.”

The report praised the home’s registered manager Margaret Coleman, who joined last year.

It saio: “The registered manager had a clear vision to develop and improve the quality of the service. On the day of the inspection [she] was away. The service was being run effectively in [her] absence, which showed good leadership.

“There was a clear leadership structure which aided in the smooth running of the service. During our inspection we found significant improvements had been made.”

However, when the inspectors spoke to residents the feedback on leadership was mixed. One said: “Personally, I feel that it is not well managed. New manager has been in place since March 2017 and things are still not running as smoothly as I would like.”

The inspectors did compliment staff on safeguarding and caring for patients.

The report said: “People told us they felt safe living at Chilterns Court. Staff were aware of people’s needs and followed guidance to keep them safe.

“Staff clearly understood how to safeguard people and protect their health and wellbeing. There were systems in place to manage people’s medicines. People received their medicines as prescribed.

“People told us they were treated with respect and their dignity was maintained. People were supported to maintain their independence.

“The home provided information in an accessible format to help people understand the care and support that was available to them.

“Where people had received end-of-life care, staff had taken actions to ensure they would have as dignified and comfortable a death as possible. End-of-life care was provided in a compassionate way.”

The building accommodates up to 64 people and is split into three units specialising in rehabilitation following hospital admission, dementia care and residential care.

It replaced Chilterns End, the trust’s former home off Greys Road, which is likely to be sold for redevelopment.

A spokeswoman for the operator said: "While we are disappointed with the recently published overall Care Quality Commission rating for Chilterns Court care home in Henley, we are very pleased that the inspectors were able to see the great progress the home manager has made with her team to continually improve the standards in the home.

"It was particularly pleasing to receive a ‘Good’ for the part of the inspection relating to care, safety and effective service. We have already discussed with CQC the issues raised around the RI ratings.

"We all remain committed to continue with this progress to ensure we are able to offer a wonderful service to the people of Henley.

"As always, residents and relatives are welcome to talk to the home manager at any time if they have any concerns."

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