The Chimneys Residential Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. One relative told us they and their family member had worked with staff to decide what care they wanted before they moved into the home, including their family member’s future wishes, health and care needs. The relative said they had the opportunity to visit the home and see the proposed room for their family member and to discuss their family member’s preferences. The preferences and wishes had been followed by staff. The relative said because of this, “[Person’s name] settled well, it’s down to the staff.” Staff told us they were supported to provide the care new people coming to live at the home required, through prompt communication about new people moving to the home and keyworker and care planning arrangements. Staff told us they were encouraged to advise of any changes in people’s needs and preferences, so people’s care plans would be reviewed. Relatives and staff told us they were involved in reviewing people’s care. We also found there were instances where other health and social care professionals specialist advice had been sought, to ensure appropriate care plans were developed.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. People were encouraged to have enough to eat and drink so they would remain well. Whilst people’s mealtimes were sociable and enjoyable occasions, staff also understood some people preferred to eat in quieter areas of the home, and recognised their right to do this. Staff used a variety of nationally recognised tools to identify if people needed additional help with eating and drinking and for other health related problems, and to monitor these. If staff had any concerns that people may not be having enough to eat and drink they sought advice from speech and language therapists. Staff followed their guidance so people would enjoy the best nutritional intake and health possible. Staff knew which people required a specific texture of food, and if elements of their diet and health needed to be recorded. One staff member said, “We have to record how much [person’s name] drinks, their repositioning and bowel movements.” Staff were provided with clear guidance on how to support people within their care plans. These were based on the International Dysphagia Diet Standardisation Initiative, (IDDSI). IDDSI is used to improve the safety and care for people with swallowing difficulties.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Relatives gave us examples showing how staff advocated for their family members so they could secure access to other health services when they wanted them. This included dentists, GPs and district nursing teams. Staff told us how they communicated information across shifts, so people would have continuity of care. Another health and social care professional who regularly worked with staff at the home to told us, “We work in partnership with the home and with [people's] permission we share care plans and risk assessments.” This helped to ensure people’s safety and well-being needs were met. Staff were positive about arrangements put in place to assist them to work across teams. Staff said there were regular opportunities for care and ancillary staff to work together. A senior staff member told us, “We ask staff in handover if they have found something that [helps] people. They will say, ‘I tried this, and it works’’, so it goes in the care plan.” Staff promptly contacted other health and social care professionals when people wanted additional assistance, including district nurses, chiropodists and people’s GPs. A health and social care professional told us, “I have witnessed staff members accompanying residents when there is emergency admissions to hospital by ambulance and no relatives to accompany them.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. People were confident staff would assist them to contact other health professionals when needed. Relatives were positive about the support their family member’s received to access routine health appointments. One relative said, “[Person’s name] had a hearing test conducted here at the home, and staff made a prompt referral to the physio.” This helped to ensure the person’s sensory and specialist equipment needs were met. Staff had put systems in place to monitor key aspects of people's health and to respond to any needs arising. Staff encouraged and supported people to make healthier choices with eating and drinking, and offered gentle exercise to promote their mobility.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. Relatives gave example showing how staff had successfully monitored changes in their family members presentation, such as their mobility, and sought specialist advice in a timely way. One relative told us about the support their family member received when they were unwell. The relative said, “Communication has been excellent when [person's name] was not well. We worked together, and with the paramedics, and reduced the likelihood of [person’s name] spending time in the accident and emergency department.” Staff gave us examples of people enjoying improved health and mobility because of the care provided to them.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People decided what day to day care they wanted from staff, and staff offered people options and listened to their decisions. Relatives were involved in key decisions about their family member’s care where this was appropriate. Senior staff understood which other organisations and individuals should be included in key decisions about care, where people lacked capacity to make all of their own decisions. A staff member said, “There’s no restraint here, because we know our residents well.” The staff member gave an example showing how they supported a person when they were anxious, because of sensory overload and said, “You do stuff you know works and try new things when needed.” A health and social care professional told us staff understood people’s mental capacity assessments and support requirements well. They told us staff recognised when people did have capacity to make their own decisions. Systems were in place to seek Deprivation of Liberty Safeguards, (DoLS), so people’s rights would be promoted.