Chestnut Lodge

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 79 (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.

People’s needs were assessed before they moved into Chestnut Lodge to ensure their needs could be met. We found people has been involved in creating person centred goals and that people were involved in regularly reviewing their care needs. Relatives told us care plans were reviewed regularly and that they were involved. A relative told us, “The care plan is reviewed with me, and they ask for my advice and guidance. They are quick to let me know if there are any changes and review my relatives care accordingly.”

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. They worked to develop evidence-based good practice and standards.

Staff completed body maps for people with wounds and tracked updates until the wound had healed. Relatives told us told us the provider monitored their relatives skin integrity. People’s hydration and nutritional needs were assessed and met. Staff ensured people had enough to eat and drink. A person told us, “Food is good, we had a good lunch today, you get plenty of choice and lots of vegetables.”A relative told us, “My relative has a varied diet and they make sure my relative always has plenty to drink.”

The provider worked well across teams and services to support people. They shared assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

We found communication with healthcare professionals was well documented. A staff member told us “we all work together and communicate effectively”. Another staff member told us “we all work extremely well as a team to provide the best care and support to our residents”. Management had regular multidisciplinary meetings with healthcare professionals. One healthcare professional told us the provider worked well with the families which meant they knew people’s histories well. For example, they know if people do not want to be admitted to hospital or if they wish for further investigation.

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.

Care plans contained information about people’s health and their wishes in the event emergency care is required. A deterioration and escalation policy and procedure provided very clear guidance to staff around how to recognise, respond and escalate concerns around a person’s deteriorating health, to reduce morbidity and mortality. Healthcare professionals told us that staff knew people well.

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.

We found the provider worked closely with healthcare professionals and that staff monitored people’s health conditions to ensure positive outcomes for people. For example, around healing following surgery. A person told us, “I've been worried about my surgery and I am glad they've arranged for me to see the nurse, they are a helpful bunch like that.”

The provider always carefully explained to people what their rights around consent were, made sure they fully understood them and always fully respected these when delivering person-centred care and treatment.

The provider had a Mental Capacity Act and Deprivation of Liberty Safeguards policy which provided clear direction to staff on how to uphold the principles of the Mental Capacity Act 2005, ensuring that decisions made regarding residents who may lack capacity are both lawful and respectful of their personal autonomy. It also provided direction as how to evidence requirements using the online care planning system. We found mental capacity assessments had been completed. For a person with fluctuating capacity the best interest decision and care plan considered their fluctuating capacity and provided very detailed guidance for each outcome. This provided staff direction to empower the person regardless of their presentation, how it gave the person an opportunity to maximise their freedoms and liberty. Records of lasting power of attorney were in place. A person told us, “Things here are changing all the time, no two days are the same and you have all the choice you could possibly ask for.” Relatives told us they were involved in reviews of their relatives care and a relative told us, “My relative chooses when they get up or go to bed and pretty much what they do with their days.”