Archived: Chesterholm Lodge

This inspection took place on 29 and 30 July 2015 and was unannounced.

Chesterholm Lodge is registered to provide accommodation and personal care services for up to 15 people who have mental health needs or may be living with dementia. At the time of our inspection it was fully occupied. People were accommodated in a converted residential house with two shared lounges, one with a television and the other for more quiet activities. There was an enclosed garden with an outside sitting area and a shelter which was used by people who chose to smoke.

There was a registered manager in place. 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.

There was a friendly, cheerful atmosphere in the home. People found it to be well run, and staff found it a good place to work. There were systems in place to assess and improve the quality of service provided. The manager had a number of checks and methods to monitor the service provided. However they had not identified and addressed some examples of poor practice. The manager had not always notified the Care Quality Commission whenever certain events occurred in the course of providing the service.

The service had arrangements in place to protect people from risks, including the risks of abuse and avoidable harm, while allowing them to make choices. Staff were aware what they needed to do to keep people and themselves safe. There were enough staff to support people safely and the provider’s recruitment process was designed to make sure staff were suitable to work in a care setting. Staff followed appropriate procedures to store, handle and administer medicines safely. Checks were in place to monitor the management of medicines.

Staff received training and support by means of supervision and appraisal meetings to maintain their skills and knowledge. They were aware of the legal requirements when people lacked capacity to make decisions, although all the people living at Chesterholm Lodge when we inspected were able to consent to their care and support. People had access to a healthy diet which took into account their choices and any dietary requirements arising from medical conditions. The service supported people to maintain their health and wellbeing by access to other healthcare providers when they needed them.

People were complimentary about the kindness and respect shown by staff. Staff respected their dignity and independence and treated them as individuals. Staff were aware of how people’s religion, cultural and personal background could affect their support needs, and adapted their support accordingly. The service involved people in decisions about their care and support through participation in their care plan reviews. People were able to express their views and take part in wider decisions about the service in meetings.

People’s care plans and assessments reflected their needs, preferences and long term medical conditions. Staff reviewed people’s care and support on a regular basis and delivered support which promoted people’s health and wellbeing. People were able to take part in individual and group activities which took into account their interests and preferences. There was a complaints procedure in place, and people were aware of it but preferred to raise concerns informally with the registered manager or registered provider.

We found one breach of the Care Quality Commission (Registration) Regulations 2009 and made one recommendation about the management systems in use. You can see what action we told the provider to take in relation to the breach at the end of the full version of this report.