Chestnut Lodge

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 82 (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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People and relatives were involved in care planning. We found care plans included person-centred talking points for staff supporting people around their family members, job history, likes, dislikes and pets. Care plans provided person-centred guidance directing staff how to support people with their oral health, communication, environmental orientation and financial matters. We found a person’s health care needs were clearly documented throughout their care plan. It detailed about presentation around seizures and the changing level of support needs for the person: normal, confused, vacant and post seizure support. We found this outlined in each section of care plan. For example, what level of support is required around continence, dressing, pain management, mobility pressure care, eating and drinking, behaviours others may find difficult, memory, socialising and spiritual areas of their life. This provided staff direction to empower the person regardless of their presentation, and gave the person an opportunity to maximise their freedoms and liberty.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

We found staff recorded input from healthcare professionals and any screening people had and outcomes. Healthcare professionals and relatives told us that the staff knew people well and how to support them. A relative told us, “I feel assured about her welfare because they are very consistent staff who know her well”. A health care professional told us, “Chestnut Lodge is a lovely family home. They provide great care and attention to their residents living in the home. They are always appreciative of any support and/or advice they receive.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff told us they were informed about changes to people’s needs and when care plans and risk assessments were updated. Before moving into Chestnut Lodge people were provided with a guide providing them information about the service. The provider had an Accessible Information Standard policy. The Accessible Information Standard tells organisations what they have to do to help ensure people with a disability or sensory loss, and in some circumstances, their carers, get information in a way they can understand it. It also says that people should get the support they need in relation to communication.

The provider was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff always involved people in decisions about their care and told them what had changed as a result.

The provider involved people and their families in a meaningful way. People and their relatives had opportunities to provide feedback through surveys. The information gathered was used to improve the service. Management kept very detailed logs of concerns raised by residents and the action they took to make improvements for people. For example, following feedback from a person the bathroom light was too bright, the provider explored the person’s sensory needs and identified further action they could take to improve the person’s quality of life by ensuring they were not overwhelmed. Actions included, healthcare referrals, installing black out curtains in the person’s bedroom and shutters in the lounge and dining room. This holistic approach to improving the environment for the person meant they were less likely to suffer avoidable harm such as pain or increased risk of falls. People took part in resident’s meetings. We found that people’s choices and preferences were followed. For example, the provider organised for animals to come into the home, as people had asked to see animals. Management told us that they supported a person and their relative to regularly visit a garden centre, as the person used to visit the garden centre and was no longer able to do this independently. During a residents’ meeting the provider explained a new monitoring tool that they would be using so people understood what staff would be doing, the reasons why and provided an opportunity for any questions to be answered.

The provider had a complaints policy and process to manage any complaints. Management kept a log of all complaints made and actions taken in response. Management took complaints seriously, investigated and provided a timely response. All complaints were dealt with in line with the providers complaints procedures. Relatives told us they knew who they would speak to if they had any concerns.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

The home had a good relationship with the local surgery who supported them with weekly multidisciplinary meetings and home visits if needed. A relative told us, “They are very organised and arrange for anything medical that needs doing. If my relative has to attend an appointment, they will take them and stay with them. Because they understand them well, they notice quickly if something is wrong and call the doctor for help.”

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People and family members were positive about the care and support they were receiving and that they are supported with referrals to health professionals when needed. Communication and clear documentation meant people could transition through different services and this had supported continuity in care. Staff told us they had enough information for people to receive safe care.

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

The service is particularly skilled at helping people and their families or carers to explore and record their wishes about care at the end of their life, and to plan how they will be met so that they feel consulted, empowered, listened to, and valued. People’s needs had been considered as part of the end of life care plan and this had taken account of communication, ability to understand and capacity when decisions were made. The service was very responsive in enabling people to engage with their religious beliefs and/or preferences at the end of their life. The service worked closely with healthcare professionals around end of life care.

People had end of life care plans which were personal to them and included their future wishes and treatment plans and where they would like to receive care. The plans detailed what people identified as things they valued, such as being warm and their fears. Where appropriate these were acknowledged by a healthcare professional as known wishes prior to loss of capacity and people who had lasting power of attorney had agreed. A relative told us, “All of my relatives end-of-life care and plans are in place and we are all fully aware of their wishes.”

Management explained how through discussions with people whilst reviewing their care they are able, “to pick up little things you may not otherwise notice. The little examples of their needs changing, how it effects oral care or mobility and then you are prompted by the system to consider end of life needs. For some people we've managed to get a record of those advanced wishes and in some instances, we've then considered pain management or lorazepam before escalating for district nurse input when they are in last days.”