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Chorlton Place Nursing Home, Manchester.

Chorlton Place Nursing Home in Manchester is a Nursing home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, caring for adults over 65 yrs and treatment of disease, disorder or injury. The last inspection date here was 11th January 2020

Chorlton Place Nursing Home is managed by HC-One Limited who are also responsible for 129 other locations

Contact Details:

Ratings:

For a guide to the ratings, click here.

Safe: Requires Improvement
Effective: Good
Caring: Good
Responsive: Good
Well-Led: Good
Overall: Good

Further Details:

Important Dates:

    Last Inspection 2020-01-11
    Last Published 2017-06-22

Local Authority:

    Manchester

Link to this page:

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Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

16th May 2017 - During a routine inspection pdf icon

Chorlton Place is a purpose built nursing and residential home for up to 48 older people, many of whom were living with dementia. The residential unit on the ground floor had 24 bedrooms, with a further 24 bedrooms in the nursing unit on the first floor. At the time of our inspection 47 people were living at Chorlton Place.

Rating at last inspection.

At the last inspection in January 2015, the service was rated as Good.

Rating at this inspection

At this inspection we found the service remained Good, with the safe domain rated as Requires Improvement.

Why the service is rated Good.

People said they felt safe living at Chorlton Place. Staff received training and information to meet people’s health and social care needs. Risks assessments were in place to guide staff to provide safe support. However we found the scores for one person’s risk assessments had not been calculated accurately, however appropriate support plans were in place to mitigate the risks and a referral was being made to the Speech and Language Team (SALT) with regard to the person’s risk of choking. Care plans were in place for each individual detailing people’s health and social care needs. The care plans were regularly reviewed.

A system was in place to recruit staff who were suitable to work with vulnerable people. A reference from one staff member’s last employer had not been obtained. This was requested during our inspection.

The home had recruited a new handyman who was due to start work the week after our inspection. Since December 2016 a handyman from another service had worked at the home whenever possible. However they had not been able to complete all the weekly fire and safety checks, which had been done monthly instead.

Medicines were administered as prescribed. Body maps for where creams were to be applied were completed for the first floor during our inspection. Health professionals were positive about the service, with the GP visiting the home twice each week.

Infection control procedures were in place. These enabled the staff team to safely support one person who had Methicillin-resistant Staphylococcus Aureus (MRSA) and Clostridium difficile (CDif).

People and relatives we spoke with were positive about the home and the staff team. There were sufficient staff on duty to meet people’s needs, although staff were busy, especially in the morning. Staff knew people’s needs and how to support them.

Staff were supported by the registered manager through regular supervisions and team meetings. Staff said they enjoyed working at the service and that the registered manager, deputy manager and residential unit manager were very approachable.

Where applicable capacity assessments were completed and the service was working within the principles of the Mental Capacity Act (2005).

People’s health and nutritional needs were met by the service. Referrals to medical professionals were appropriately made and any guidance provided was followed. People and relatives told us the food was good and they had a choice of meals.

Staff encouraged people to maintain their independence, with some people able to access the local community on their own. Staff explained how they maintained people’s privacy and dignity when supporting them.

People were supported to make decisions about their wishes at the end of their lives. Support was provided for people who wanted to stay at Chorlton House at the end of their lives.

People and relatives were able to provide feedback on the service provided through regular residents and relatives meetings and annual surveys.

Two part time activities officers had been appointed and a programme of activities was in place, which people said they enjoyed.

The registered manager had a comprehensive system of quality assurance and audits in place. A monthly report was used to monitor any trends in key indicators for the service. The provider’s area manager completed a monthly audit of the service. Any actions identified we

18th August 2014 - During an inspection in response to concerns pdf icon

Two inspectors carried out this this inspection in response to information of concern we received. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

During our inspection we spent time speaking with people who lived at the home, visitors, a visiting general practitioner (GP), a speech and language therapist (SALT), the acting manager, the quality manager and six other members of staff. We carried out observations, looked at medication practices and procedures, examined records including; six care plans and daily records of care, policies and procedures, staff records and quality assurance monitoring records.

Below is a summary of what we found.

Is the service safe?

We found there was a lack of consistency in care plans they had not always been updated to reflect the changing needs of the person. People at high risk of poor nutrition were generally identified as needing frequent monitoring of their weight and diet. However, we identified one person who had lost over 4 kg since admission in April 2014. There was no evidence to show any action had been taken to address this.

We found that people were not protected from the risks of unsafe or inappropriate care because staff used inappropriate moving and handling techniques. For example; we saw two staff members attempt to lift a person up in their chair by using an underarm lift. This is an unsafe and an inappropriate moving and handling technique that had the potential to cause bruising, damage fragile skin and cause shoulder and neck injuries. This was fed back to the acting manager and quality manager who told us they would speak with staff to ensure they used the correct moving and handling techniques.

There were no written guidelines (protocols) to tell staff when or why medicines prescribed ‘when required’ should be given. This meant there was a risk that some prescribed medicines might not be used as intended by the persons GP and may not be effective in their treatment.

We saw ‘gaps’ in administration records for prescribed creams. Arrangements for recording the use of creams were not being followed. This meant that medicines might not be used in the right way and may not be effective in their treatment.

Where beds were fitted with safety rails protective bumpers were used. These were used to minimise the risk of limb entrapment and keep people safe.

There were contracts in place to demonstrate equipment was regularly maintained and serviced to minimise risks to people who lived at the home.

The Care Quality Commission (CQC) monitors the operation of Deprivation of Liberty Safeguards (DoLS) to ensure people's rights and freedoms are not unnecessarily restricted. The staff we spoke with told us they had received introductory training in the Mental Capacity Act (MCA) 2005 and the DoLS. However their knowledge of this was limited. This meant people’s rights were not recognised, respected or promoted. There had been no applications made to deprive people living in the home of their liberty.

The recruitment process was thorough and the required safety checks such as; a check with the Disclosure and Barring Services (DBS) was made before new staff started work. This ensured that only suitable staff were employed.

The staff we spoke with and the visiting relatives spoken with said there were not enough staff to meet people’s needs. Our observations supported this view. Two visiting relatives told us that they had some concerns because staff were not quick to respond to requests for assistance. We saw one relative asked staff for some assistance for their relative. They asked staff twice for assistance and it took 25 minutes for the staff to give the required assistance.

Is the service effective?

We saw that one person was presenting with behaviour that challenged. Staff said they were struggling to meet this persons needs and told us other people living on the first floor of the home were frightened of this person. The acting manager told us that they were addressing this with the appropriate agency.

We spent time observing the interactions between staff and the people they cared for. Staff did not always respond to calls for assistance in a timely manner. This meant people were at risk of receiving inadequate or unsafe care.

People who lived at the home had access to regular support from health and social care professionals such as; GP, district nurses, dieticians, podiatrists and speech and language therapists.

Is the service caring?

People who lived at the home spoke positively about the care and support they received. Comments included: “I am happy here.” “I am satisfied with the help I get.” “Different people have different ways, they are kind in their own way.” “I have what I need.”

The atmosphere in the home felt busy and staff did not spend much time talking and interacting with people. We saw that a number of people were assisted to eat and drink without much conversation taking place. This meant the mealtime was another task rather than a social and enjoyable experience for the person.

Is the service responsive?

We saw, where necessary, referrals had been made to health and social care professionals such as GP’s, dieticians and speech and language therapists.

Care plans included information on people's social, religious and cultural beliefs. We spoke with one person who told us: “I must go to church it is a very important thing for me, and I like to go every Sunday.” “They make sure I can get there.”

Is the service well led?

The service did not have a registered manager. The provider is in breach of the conditions of their registration. The service has been without a registered manager for four months. The provider has sought to recruit to this position without success and a number of managers have been employed at the home and have left. The provider recruited a manager in March 2014 and had commenced the process of registration but the manager resigned. This has resulted in an inconsistent management approach for staff in the home. A relief manager has been in place at the home since March 2014.

There was a system of audits in place but these were not robust or effective and this had impacted on the delivery of care to people living at the home including poor record keeping.

21st May 2014 - During a routine inspection pdf icon

Two inspectors visited this service on 21 May to carry out an inspection. This was to ensure that improvements that were identified at our last inspection had been carried out. In addition and prior to our visit, we looked at all the information we hold on this service to help us to plan and focus on our five questions;

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

During our inspection visit to the home we spoke with three people who used the service, two relatives, five care staff, a senior carer, three qualified staff, the interim manager of the home and the quality assurance manager. We also looked at records and spent time in different areas of the home.

Is the service caring?

During the inspection we observed the interactions between staff and people who used the service. We saw staff were attentive to people’s needs and were patient when supporting people. During the inspection we spoke with two relatives to gain their views on the care and support provided. Some comments included; “My (family member) seems happy, the staff are very good.” And “I speak to the staff when I arrive and they let me know if there are any problems.” Our observations and the feedback from people we spoke with showed us that the service was caring.

Is the service responsive?

The service had systems in place to ensure people were regularly consulted about their views and ideas on how the service should be run. This was done by means of an independent survey and meetings with relatives. We spoke with two relatives who told us that they were kept informed regarding their family member’s care. One relative told us; “I’m very happy with the care, the staff work hard and look after (my relative) well.” We spoke with a visiting health professional who told us that they had no concerns. We saw there were audits in place to identify any areas that needed improvement. From our observations we considered that the service was responsive.

Is the service safe?

We saw that staff were observant of people’s needs and that there were sufficient staff available to support people effectively. We saw appropriate safety checks were carried out as required. For example we saw evidence that servicing of equipment was carried out to ensure that it was fit for purpose. This ensured that people’s safety and welfare was protected when using the equipment provided.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. During our inspection we saw that care plans and our observation of staff provided evidence of good practice in applying the least restrictive options to promote each person's autonomy.

We checked that there were sufficient staff to meet people’s needs. We saw that the home forecast staffing requirements and if there were any shortfalls, these were identified and replacement staff sought. This showed us that the home had systems in place to ensure that people’s safety was protected by the effective deployment of sufficient and suitably qualified staff.

Is the service effective?

We saw that people who lived at the home had care records that included assessments of their individual needs and risks. Each person had a care plan which contained information for care staff to enable care and treatment to be delivered in a way that met people’s needs. We also saw that each care record we viewed contained risk assessments to identify and manage any risks identified. This meant that the service assessed people’s needs in order to provide effective care. We spoke with three people who used the service who told us that they were consulted in the development of their care plans. One person told us that they had visited the home before making the decision to move in. They said; “I’ve never regretted it.” We saw that training and development activities were in place to ensure that staff had suitable knowledge and skills to support people effectively.

Is the service well led?

A review of our records showed that the manager of Chorlton Place Nursing Home was currently applying to the Care Quality Commission to become registered by us. At the time of the inspection they were not present. We met with the manager and saw that the service had systems in place to ensure that areas for improvement were identified. We saw that a records audit was carried out to check that the information contained in each person’s care records remained up to date and accurate. We saw that records had been reviewed and when identified, action had been taken to improve the documentation. We saw minutes of meetings that showed us that the manager consulted with people who used the service, and their relatives, in addition we viewed an independent survey which had been completed in 2013. We noted that this contained positive comments. During the inspection we noted that the staff were professional and relaxed and that the home was well organised with a calm atmosphere. The documentation we viewed, together with the observations we carried out and people’s comments, showed us that the home was well led.

25th March 2014 - During an inspection to make sure that the improvements required had been made pdf icon

We looked at a sample of five people’s care plans. We saw evidence to demonstrate a pre-admission assessment had been carried out prior to people moving into the home.

We saw some people had been assessed by a speech and language therapist (SALT). One of the care plans we looked at did not clearly identify a change from a soft diet (fork mashable) to a pureed diet.

We spent time observing interactions between people who lived at the home and staff. We saw staff approached people with respect and interactions were positive.

We spoke with people who lived at the home who told us they were satisfied with the care and support they received. Comments included: “It’s alright.” “I get help when I need it.” “The staff are nice, they’re alright.”

We spoke with two health professionals who told us the two floors appeared to work in isolation which raised concerns about communication and continuity of care.

We saw people were offered alternatives from the menu choice. We spoke with a member of the catering staff who showed us a list of people’s preferences for the day’s meal.

We looked at five care plans and saw nutritional assessments had been carried out. Where people were at risk of poor nutritional intake we saw referrals had been made to a dietitian. Where people had been assessed as needing thickened drinks the amount of thickener and consistency of drinks had been recorded.

15th October 2013 - During a routine inspection pdf icon

Some of the people living in the home suffered with varying degrees of dementia, which limited the number of people we could speak with in order to obtain their views about the service. Our expert by experience spoke with some of the people living in the home. All the people spoken with said they were happy with the care they received. One person told us: “Oh yes! I’m okay ... I can’t complain.” Another person gave the thumbs up signal when asked if he was comfortable and if the staff were friendly and listened to him.

We found the provider obtained consent from people who used the service before they provided care and support. When a person had limited capacity to make an informed decision, relatives and other relevant healthcare professionals were involved so that decisions were made in the person’s best interests.

Care plans and risk assessments were in place for each person. These were reviewed regularly to ensure that staff provided appropriate care. However we found people did not receive appropriate support from staff during mealtimes which put them at risk from inadequate nutrition.

Medicines were administered safely by appropriately trained staff. Staff undertook a range of training and new staff were given an induction to ensure they understood the requirements of their role.

The provider undertook audits to identify any risks or areas that required improvement. Where actions were identified, the provider took appropriate action.

22nd November 2012 - During a routine inspection pdf icon

A number of people living at Chorlton Place had a diagnosis of dementia or suffered with short term memory loss, because of this some people were unable to tell us their views about the service. We spoke with three people who used the service. One person said, “Everything is just tiptop as far as I’m concerned”. Another person told us, “I’m really happy, this place is heaven”.

We were told that staff were polite and friendly. Comments included, “The staff are wonderful”. And, “They’re nice, I like them”. A relative told us, “I think they look after (their relative) very well”.

We also spoke with one of the health care professionals who supported people who used the service. We were told the new manager was making positive changes to the home. They said, “She’s very dynamic…She’s really trying to move things forward”.

We found that people who used the service had detailed care plans in place. This meant Chorlton Place provided people with effective, safe and appropriate care, treatment and support that met their needs. Care and support was person centred and people’s views were taken into account in the way the service was provided and delivered. We saw there were sufficient numbers of suitably trained and qualified staff to support the health and welfare needs of people who used the service. There were effective systems in place to regularly assess and monitor the quality of the service provided.

1st January 1970 - During a routine inspection pdf icon

This inspection was carried out on 13 and 15 January 2015 and the first day was unannounced. This means we did not give the provider prior knowledge of our inspection.

Chorlton Place Nursing Home provides nursing and residential care and accommodation for older people. The home also provides respite care and end of life care where required. It has 48 beds and is situated across two floors with lounge and dining facilities available on each floor. The ground floor provides care and support for people who are assessed as requiring residential care and the first floor provides care and support for people who require nursing care. The first floor is accessed by a lift. The home is a large detached property set in its own grounds with off road car parking available.

We last inspected Chorlton Place Nursing Home in August 2014. During that inspection we identified breaches in five regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. For example the audit systems in place to assess and monitor the quality of care provided to people were ineffective as we identified improvements were required in the management of medicines, and the quality of the service in respect of nursing and clinical care. Some of the care records we viewed required updating to accurately reflect the needs of the people they related to and to reflect the instructions of other health professionals.

We also identified shortfalls in the staffing provision at the home and in addition, some of the staff we spoke with were unclear on the reporting procedures in place if they suspected someone was at risk of harm and abuse.

The provider sent us an action plan detailing how they would ensure improvements would be made.

During this inspection we saw legal requirements had been met. We saw there was an audit system in place to identify shortfalls and where shortfalls were noted, action was taken to ensure improvements were made. There were arrangements in place to ensure medicines were managed safely and care records we viewed accurately reflected the needs of people who lived at the home. We saw staff were caring and attentive to people’s needs and these were met without delay. The staff we spoke with were able to explain the signs and symptoms that may indicate abuse is occurring and the processes in place to report these so they could be investigated by external bodies if this was required.

The home had not had a manager in place who was registered with the Care Quality Commission (CQC) since February 2014. The 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. During the inspection we saw a manager had been recruited and had been in post since November 2014 and was currently going through the process of registration with the Care Quality Commission. 

We saw, and were told by people who lived at Chorlton Place Nursing Home that staff were kind. We observed people being supported with respect and compassion. Staff were attentive to people’s needs and offered explanations if they were delivering care. We saw people were spoken with patiently and with kindness. We observed people on the residential floor engaging in organised recreational activities and saw this was a positive experience for them.

People were supported to eat sufficient amounts to meet their needs and overall, the people we spoke with told us they enjoyed the food and were offered alternatives if they did not want the meal provided. We observed people being offered choice and if people required assistance to eat their meal, this was done in a dignified manner and in accordance with their assessed needs.

The care records we viewed showed us that people’s health was monitored and referrals were made to other health professionals as required. We saw evidence that if people’s needs changed this was recorded and the staff we spoke with were knowledgeable regarding the needs and preferences of people who lived at the home.

 

 

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