Chestnut Lodge

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff reported concerns appropriately around accidents and incidents and these were fully investigated by management. Lessons learned were recorded, to prevent safety concerns from happening again. A staff member told us, “management will feed back to staff how to work differently or ways to avoid something happening again. Sometimes things happen and it needs to be reported to safeguarding or CQC and management keep us updated on the outcomes and any advice or guidance that has been given”.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Pre-assessments were completed prior to people moving into Chestnut Lodge and formed the basis of their care plan. A guide was in place to provide additional support for the transition. People’s information was kept up to date by being regularly reviewed.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Staff had undertaken training in safeguarding and the provider had a safeguarding policy, to provide staff with guidance on types of abuse and reporting concerns. Staff knew who they would report any concerns to both internally and externally. Safeguarding systems and processes were in place to identify, report and investigate concerns. The provider maintained clear and detailed records that showed appropriate action had been taken where necessary.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessments were in place where required for people, for example around falls and epilepsy. There was a robust system for reviewing and updating risk assessments to take account of any changes in people's risks. Staff told us they were provided with all the information they needed to support people safely and they were informed when risk assessments were updated.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider had environmental risk assessments in place, for example around fire and infection prevention control. The provider was in the process of carrying out works around creating a new fire exit. The building and equipment used to meet people’s needs were regularly serviced and well maintained. Relatives told us equipment was in place to keep people safe, such as a floor mat. A relative told us “my loved one was having lots of falls at home and hasn’t had one since they have been here”.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Managers followed safe recruitment practices and made sure staff training was up to date. Regular staff supervision and competency assessments took place. Staff had completed training required to meet peoples’ need safely and effectively. Staff told us they have the training they need to support people’s individual needs. One staff member told us “we also have the option to discuss any further training we feel we need or we would like to complete when we have supervisions and each year, we have a meeting to discuss our personal development plans”.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The provider had an infection control policy in place and staff received training in infection prevention control. A person told us “the rooms are kept nice and tidy”. Food hygiene records were clearly maintained around temperature checks of fridges, freezers and food.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

For example, the provider had clearly identified on a label for the pharmacy to see, a person disliked a particular flavour of medicine. This person centred approach to communication meant the person was only prescribed flavours they liked. Another person had an agreed plan with a healthcare professional to space pain relief out to ensure maximum benefit. The system the service used would not allow administration of medicines too early. Where people had regular pain relief, people actively participated in oversight of this by choosing when they wished to take a single tablet and when they required two tablets. Staff received medicine training, and the provider completed regular medicine audits.