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Archived: The Chestnuts Nursing and Residential Care Home

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Inspection report

Date of Inspection: 19 September 2012
Date of Publication: 8 October 2012
Inspection Report published 8 October 2012 PDF | 73.17 KB

There should be enough members of staff to keep people safe and meet their health and welfare needs (outcome 13)

Meeting this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by sufficient numbers of appropriate staff.

How this check was done

We reviewed all the information we hold about this provider and carried out a visit on 19/09/2012.

Our judgement

There were enough qualified, skilled and experienced staff to meet people’s needs. Despite this, management structures needed to be clearer and staff deployed in a more effective way to make sure staff had the right competencies, skills and experience to meet the needs of the people at all times.

The provider was meeting this standard.

User experience

People told us that although staff were busy there was "always someone about." One person commented “My call bell requests are always responded to quickly.”

Other evidence

Prior to our visit we received information alleging that staffing levels were inadequate.

At the time of our visit there were 39 people using the service. Throughout the morning period there was one nurse and six care staff on duty with the number of care staff falling to five in an afternoon. During the night there was a nurse on duty with three care staff. The service also had a registered manager and lead nurse.

In addition to the nursing and care staff the service employed four domestic staff, a laundry worker, catering staff, a maintenance manager and an administrator. The management team told us an advertisement was about to go out for the post of activity organiser.

Of the 39 people using the service when we visited, 17 of these people had nursing needs with the others needing residential care. Most people needed 2:1 support with mobility and eight people were bed bound.

During our visit we observed staff to be very caring and supportive towards the people in their care. We saw they were able to spend time talking and enjoying humour with people. People were generally sat within the lounge areas and we saw that there was always a staff member around to observe what was happening.

Whilst the duty rotas indicated staffing numbers were sufficient, we were unclear whether staff were being properly deployed. For example, duty rotas were being completed by care staff. At medication times one nurse was responsible for administering all the medications. The person responsible for organising activities also held a post as a senior care assistant which limited activities being available for people if the person was required for care duties.

One nurse told us on the day of our visit the morning medication round had taken them two and a half hours to complete. The management team told us they were looking into more effective deployment of staff in relation to medication practices in order to free up nurses so they would have more time to carry out other specific nursing duties.