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Archived: The Chestnuts Nursing and Dementia Care Home

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Inspection report

Date of Inspection: 18 July 2011
Date of Publication: 29 September 2011
Inspection Report published 29 September 2011 PDF | 81.68 KB

Food and drink should meet people's individual dietary needs (outcome 5)

Meeting this standard

We checked that people who use this service

  • Are supported to have adequate nutrition and hydration.

How this check was done

We reviewed all the information we hold about this provider, carried out a visit on 18/07/2011 and observed how people were being cared for.

Our judgement

People received meals that were generally consistent with their choice, nutritional and cultural needs. Meals were not always served hot in and in this state were unappetising to the people affected by this aspect of the service.

User experience

People told us that the food in the home was nice. One person told us; “When I get fed up with sandwiches, I request eggs because I like it and I do get it”. Another person told us; “We can have anything we like including a choice of white or red wine with our dinner”. One other person told us; “Breakfast is always good, we get to choose what we eat in here”. We saw that people were given varied diets that were consistent with their needs and choices. In one case we noted that a person preferred Kosher meals and this was made available to them. We were pleased to see that meals were served in different forms to people for example; pureed, soft and liquidised to enable them to maintain their nutritional well-being.

We witnessed people having their meals cut up into small pieces to allow them to use their fingers if they wanted to. This was particularly effective with people having a diagnosis of dementia as they were able to maintain their independence without worrying too much about having to use a knife and fork. We saw people being supported to eat their meals and in most cases this was done in a sensitive manner. However, there was at least one instance in which one staff member was feeding two people with little communication between them in the process. The time lapse between feeding one person and the other meant that their meals became cold. This was unappetising to some, who at times showed a disinterest in their food. Staff were also supporting people with their meals and at times left the area for brief moments, then returned to carry on supporting people with their meals. To add to our findings, a number of people told us that the food was served cold, by the time it got to them. We noted that the staffing levels at mealtimes were not appropriate to meet the dependency levels of the people requiring support with their meals. This is covered further under staffing – (Outcome 13) of this report.

Other evidence

We noted that the dietician was contacted to obtain specialist input for peoples’ benefit. There was evidence that nutritional screening and risk assessments were carried out on people, although in a small number of cases the recording of the information did not always accurately link to peoples’ care plans. This was particularly important for those people who were at risk of malnutrition, dehydration and predisposed to pressure sores.

We examined the results of a ‘relative and resident’ survey carried out by the service in December 2010 and noted the comments on food, which stated that food was ‘almost invariably cool’. We were concerned to have been receiving similar comments in July 2011 when we visited. We would expect the home to act on the information they collected to improve peoples’ experience at mealtimes. There were positive comments about the chef being always available, although at the time they felt that he was doing other maintenance jobs around the home. There was no evidence of this being the case when we visited, as a dedicated maintenance worker had been employed in the home.