This inspection took place on 12 and 14 November 2018. The first day of the inspection was unannounced. Chasedale 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.

Chasedale Care Home provides care for up to 60 people. There were 59 people living in the home at the time of the inspection, some of whom were living with dementia.

We last inspected this service in May 2016 when we rated the service as good. At this inspection we found the evidence continued to support the rating of good overall but there had been a deterioration in caring which we have now rated as good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

A new registered manager had been appointed since the last inspection and registered with the Care Quality Commission in August 2018. 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 received mixed views about staffing levels which were immediately reviewed by the regional manager during the inspection. They redeployed staff to cover perceived gaps but we have made a recommendation to keep staffing under review considering the feedback we received.

Safeguarding procedures were in place and staff had received training. The registered manager was aware of their responsibilities in relation to reporting incidents of a safeguarding nature.

Medicine procedures were suitable and checks on stock levels were completed. Staff were aware of the correct procedures to follow.

The safety of the premises and equipment were monitored and individual risks to people were assessed and plans were in place to mitigate these.

The premises were clean and well maintained although there were plans for further cosmetic refurbishment. Attention had been paid to dementia friendly design features which we were advised would be further developed during future redecoration. new baths had been ordered and we made a recommendation to closely monitor the timescales for the replacement of baths to ensure there is no impact on choice for people using the service.

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.

Staff received regular training, supervision and appraisal and said they felt well supported.

People were supported with eating and drinking. The registered manager was auditing the mealtime experience with plans to enhance this for all people.

We previously rated the caring domain as outstanding. At this inspection, we found staff remained very caring and passionate about their work but expressed concerns about not having the time to do more than basic care at times. We therefore could not be sure that people continued to receive consistently outstanding care so we have rated this domain as good.

We received positive feedback about the responsiveness of the service. People’s needs were met by staff and relatives were involved in care planning and discussions about care.

A complaints procedure was in place which people and relatives were aware of and was followed by the registered manager.

A variety of activities were available to people. Records were kept showing what activities people had done and recorded their reactions.

Staff and relatives told us they were happy with the n

Chasedale Care Home is a residential care home situated in the Blyth area of Northumberland. The service can provide accommodation, personal care and support to 60 older people. On the first day of inspection there were 57 older people, most of who were living with a form of dementia, using the service. The service dedicated one unit to general residential needs including end of life care.

We previously fully inspected Chasedale in May 2013, at which time the service was compliant with all regulatory standards. There have been two responsive inspections in the interim. In December 2013 a warning notice was issued regarding record keeping, however in February 2014, the service was fully compliant.

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.

The service had an excellent person centred culture. The management and staff were fully committed to delivering a service which was caring and compassionate. The people and relatives we spoke with valued their relationships with the staff who they described as “second to none” and “genuinely interested”. Relatives told us they felt their loved ones were really cared for. Privacy and dignity was upheld and people were respected by the staff and treated as individuals. External professionals told us Chasedale was regarded as a service who supported people who display behaviours which can challenge staff very well.

Staff told us they were “a network of support for people and their relatives”. We saw staff were highly motivated and inspired to provide individual care and attention to people by managers who were described as “great leaders”, “supportive” and “approachable” by staff and relatives. Staff spent time with people and their relatives and made memory boxes which people enjoyed looking through and reminiscing. Picture and pen portraits were on display outside bedroom doors.

Relatives in particular were consulted in imaginative and creative ways in order to gather their opinion and were encouraged to get involved in the running of the service. A real time electronic ‘Quality of Life’ survey was available in the reception area for visitors to instantly record their responses at the push of a button to questions posed about each visit. Coffee morning drop-in sessions and scheduled ‘resident/relative’ meetings also took place. People and their supporters were actively encouraged to become involved with management decisions and in developing the service further through these meetings and a regular newsletter.

People told us they felt safe living at Chasedale and relatives confirmed this. Records and management systems were in place to support the staff to provide the service. Staff used the systems well which enabled them to provide safe, quality care. The records we examined were accurate and up to date.

There were a range of policies and procedures in place to support staff and ensure the smooth running of the service. These included a safeguarding policy which staff displayed an understanding of and they were able to tell us about their responsibilities towards protecting people from harm or improper treatment. We reviewed the staffing levels and found there to be an adequate amount of staff on duty to deliver safe care. There were no major concerns reported to us about staffing during the inspection.

Accidents and incidents were recorded and monitored to identify trends. Staff routinely updated care records after an incident and recorded reduction and preventative measures in risk assessments. People were referred to external healthcare professionals when there needs changed to receive additional support.

The premises were well maintained. Che

We found that people's care records were accurate and fit for purpose, because they were up to date and included detail of people's assessed needs and the care to be provided. Care plans had been reviewed to ensure they reflected changes in people's needs and the advice of other health care professionals. Other documents, such as positional charts and food and fluid record charts were also up to date.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a Care Quality Commission (CQC) inspector joined by an “expert by experience” (people who have experience of using services and who can provide that perspective).

People said that staff provided them with enough to drink throughout the day. They said that they were helped to eat and drink if need be. People said that they had been involved in recent decorative improvements to the home. If their bedroom had been redecorated they had chosen their own colour scheme with the help of staff. Not many of the users of the service were able to talk to us, therefore information from other monitoring agencies was also obtained.

There were not very many of the people in the service who were able or well enough to give us their views. The ones that we were able to speak to said that they had noticed some improvements in the home. For example they said that a new cook did home baking now which they enjoyed. People told us that the home was usually clean and did not smell. They told us that a new manager was in the home and that they had noticed her checking on things. People said they had their medicines given regularly and were helped by staff whenever they needed it.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We saw that staff had undertaken regular training and systems were in place to provide updating training, as necessary. One staff member told us, "It is really easy to get. They put loads of training up all the time." Staff had regular supervision and appraisals to discuss work issues and consider future training needs.

We found that people’s personal records including medical records were not always accurate or fit for purpose. Care plans had not been regularly reviewed, were not always up to date and could not easily be located.