Archived: The Chestnuts Residential Care Home

We found the following examples of good practice.

Staff were required to enter the home through a designated entrance, where they had their temperatures checked, washed their hands and were part of a regular COVID-19 testing programme.

At the time of our inspection several people had finished their 14-day isolation period. There were clear signs to identify areas where people were still isolating. All people were supported by staff who wore full personal protective equipment (PPE), to help prevent spreading infections.

Staff completed training in infection control, hand washing and how to put on and take off PPE. The provider completed daily visual inspections of the home to ensure best practice. Staff received regular competency assessments around their infection control practices.

The building looked clean and free from clutter. Appropriate cleaning products were used, to ensure good infection control was maintained. All frequently touched areas were cleaned regularly for example, door handles and handrails.

The provider told us that they were working collaboratively with colleagues from the Local Authority and Clinical Commissioning Group (CCG). They were proud of their staff and how hard they worked to support people and each other. They confirmed that support and communication from the GP had been excellent.

This unannounced comprehensive inspection was undertaken by one inspector and an expert by experience and took place on 18 July 2017. At the previous inspection on 12 March 2015 the service was rated as ‘Good’. At this inspection we found the service remained 'Good'.

A registered manager was in post at the time of the inspection but they were on leave. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Staff knew what procedures to follow to keep people safe from harm.

Accidents and incidents such as medicines recording, were identified and acted upon when required.

People were supported with the safe management and administered of their prescribed medicines.

Where people had been identified as being at risk, risk assessments such as those for malnutrition and skin integrity were being used to help manage risks effectively.

There were enough competent staff with the right skills to provide people with support when they needed it.

Staff had received appropriate training, support and development to carry out their role effectively.

People were effectively supported with their health care and nutritional needs. Staff supported people to access external health care professionals promptly.

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.

People were treated with compassion by staff who respected people's dignity and privacy.

People were given the opportunity to feed back on the service and their views were acted on.

People were offered and took an active part in a wide variety of interests and pastimes that were provided. People's needs were responded to in a person centred way.

The registered manager had had created an inclusive atmosphere within the service and this had fostered an open and honest team culture.

A quality assurance system was in place and this helped identify any shortfalls which were used to help drive improvement in the service.

Further information is in the detailed findings below.

People's right to give their consent was valued. However, the systems used to assess people's mental capacity to make valid decisions about their care and support, could be improved.

All of the people who we spoke with were satisfied with the quality and standard of their support and care. Assessments of people's risks and health and social care needs were carried out and planned. People received their support and care as planned.

Systems were in place to protect vulnerable people who used the service from the risk of abuse. This included the training of staff. People who we spoke with had positive comments about the staff.

Arrangements were in place to ensure that people who used the service had access to safe equipment.

Staff were supported to do their job, which they said was rewarding. There were arrangements in place for staff to attend training relevant to their role.

People had access to up-to-date information about the services provided at The Chestnuts Residential Care Home.

There was a system in place which allowed people to make their concerns and complaints known. People who we spoke with said that they knew who to speak with if they were unhappy about something but said that they had no cause to do so.

People who we spoke with were satisfied with the standard and quality of their care. One person told us, 'I don't think there is any room for improvement.' People's well being and health care needs were provided for. However, the quality of some people's personal care could be improved, with their consent.

People were protected from the risk of harm from abuse. However, information about safeguarding people from abuse could be made more publicly available.

People lived in a comfortable place and they liked the facilities provided. However, fire safety improvements were needed to ensure that people's health and safety were not placed at risk.

The lack of lockable doors on communal bathing and toilet facilities failed to promote people's privacy and dignity.

Staff were supported and trained to provide people with safe and appropriate support and care. One person who we spoke with said, 'The staff are very good here.' We found improvements could be made to record when staff received one-to-one supervision.

People said that they were listened to. One person, for example, said, 'Things get done as soon as we ask.'

People's health and safety were placed at risk due to inadequate audits of fire safety and care records and inadequate safety checks carried out on used wheelchairs.