Chilmington at Home is rated Good overall, with Requires Improvement in Effective due to gaps in mandatory training (moving and handling overdue since 2021, Oliver McGowan training not yet completed) and inconsistent mental capacity documentation. All other key questions are Good, reflecting safe, caring, responsive and well-led practice with low staff turnover, strong person-centred care and effective partnership working.
Concerns (6)
moderate
Staff training
: “We found 2 staff had not received training in moving and handling since 2021.”
moderateStaff training: “The service's mandatory training did not include training on oral care, person centred care, dignity and communication.”
moderateStaff training: “Although the provider had completed training in relation to autistic people and people with a learning disability, staff had not yet completed the Oliver McGowan Mandatory Training.”
moderateConsent / capacity: “There was no evidence a mental capacity assessment or a best interest meeting had taken place regarding the decision [bed rails].”
minorRecord keeping: “People's capacity was not always documented in people's care plans. This was raised with the registered manager who ensured this was rectified immediately.”
minorEnd-of-life care: “The service had discussed people's requests regarding funerals however, did not have an end-of-life care plan in place.”
Strengths
· Staff had received safeguarding training and knew how to recognise and report abuse; safeguarding concerns were dealt with appropriately by the registered manager.
· Risk assessments were consistent, clear and in date, with guidance for staff to mitigate risks readily accessible in care plans.
· Sufficient staffing levels with continuity of care; staff reported never feeling rushed and always staying the allocated time.
· All care staff administering medicines had competencies reviewed annually and spot check audits conducted at least six-monthly.
· Very low staff turnover supported consistent, person-centred care from staff who knew people well.
Quality-Statement breakdown (22)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staff; continuous learning and improving careGood