Archived: Chestnut Walk

to answer five key questions; is the service safe, effective, caring, responsive and well led?

As part of this inspection we spoke with four people who use the service, one relative, the manager, interim manager and four staff. We also reviewed records relating to the management of the agency which included care plans, risk assessments and other records.

Below is a summary of what we found. The summary described what people using the

service, their relatives and the staff told us and the records we looked at.

Is the service safe?

People received care and support in accordance with agreed care and behaviour management plans which were regularly reviewed. The care plans identified their needs and their wellbeing was monitored.

Where people had healthcare needs, the home had sought the advice of external healthcare specialists appropriately to maintain their wellbeing and safety. We saw that staff were aware of the needs of the individuals they were supporting.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes The manager was aware of a recent Supreme Court judgement relating to 'deprivation of liberty' and people in the home gave written consent to the building security arrangements. An assurance was given that people would be supported to access the community on request.

The people living in the home we spoke with told us the service was safe and they were well cared for.

Is the service effective?

We saw that people's needs were well met by the staff team. Changes in people's needs were reported to senior staff and acted upon through updating of the care plan. We saw that the people supported enjoyed positive relationships with the staff. The people we spoke with told us the home met their needs or those of their relative, effectively. Some comments were made that there were insufficient activities and stimulation at times.

Is the service caring?

Staff worked in a caring, patient and respectful way while supporting people. They enabled people to make decisions and choices and understood their individual communication well. We saw that staff gave people the time they needed to process the information they were given to make choices. Staff interacted with and engaged people in the course of meeting their needs.

The people we spoke with thought the service was caring. One told us: 'all the staff are very nice'.

Is the service responsive?

We saw that people's care plans and other documents recorded people's needs and had been amended where these had changed. Care files showed that the home responded to any changes and had sought appropriate specialist advice where necessary.

Care was provided based on people's known and indicated wishes and preferences. These were recorded within the care plan itself or within a specific document used to gather personal history.

People felt that they had been involved and consulted about their care and that the service responded to their needs. One relative told us that the manager had acted to address any issues that had been raised.

Is the service well-led?

We found that in general the home had provided consistent care to people and was well-managed. However there had been some lack of continuity with various changes of management while the registered manager had been seconded to manage other services. More recently people felt that management arrangements had become clearer. There were now clearer lines of managerial responsibility again.

A range of audit and monitoring systems were used by the management team and the provider to maintain an effective overview of the home's operation. Action had been taken to address issues where these were identified. The views of people in the home and relatives were sought and acted upon.

We found that people's consent was sought at all stages of care. They made their own choices, as far as they were able and decided whether they wanted to live in the home or not. People told us that they had made ''absolutely the right choice'' when agreeing to stay in the home.

We saw that people were cared for properly and safely. Everyone we spoke with told us they were happy living in the home. People said '' this is a really nice place to live'' and ''it's lovely here, we are treated very, very well''.

People were offered a varied and nutritious diet and could choose what they ate. The home had ways of making sure people were eating and drinking enough to keep them as healthy as possible. People told us ''we have lovely, lovely food''.

The home was clean, well maintained and comfortable. It was suitable to meet the needs of the people who lived there.

Staff were checked before they started to work in the home to make sure they were suitable people to work with the people who lived there. People described staff as ''really great, nothing's too much trouble''. They told us that they always felt safe with all of the staff.

The home had ways of making sure that good quality care was maintained. People who lived in the home were listened to and their views and opinions were valued.