We carried out a review of the data available to us about Chestnut Street (59) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Chestnut Street (59), you can give feedback on this service.
Chestnut Street is a care home providing accommodation and personal care to three people aged 18 and over at the time of the inspection. The service can support up to three people whilst they attend Arden College in Southport.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence and inclusion.
There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
We saw many examples where staff had supported people to become more independent, make choices and increase their physical and emotional wellbeing. Independent living skills learned whilst they attended Arden college were encouraged by staff to be put into practice. People had made significant achievements. This included personal care and daily activities such as laundry, cleaning their home, shopping, preparing snacks and drinks.
Chestnut Street is located in an area that enabled people using the service to participate in their own local community, for example, local restaurants and leisure activities.
Staff had developed effective communication with people. This meant that they were able to make their own decisions about their support; staff ensured they were supported to make choices on a day to day basis. Staff gave people the time they needed to make decisions and communicate them.
Risks that people faced had been assessed and those identified were safely managed. Medicines were managed safely. Staff showed a good understanding of their roles and responsibilities of keeping people safe from harm.
People were offered choice and control and where able consented to their support. People were encouraged and supported to eat and drink well. People were given a choice of suitable meals and snacks. Staff supported people to make meals of their choice throughout the week. People were supported to access healthcare when needed.
Staffing levels were appropriately managed, and people received support from consistent, regular staff. Enough staff were employed each day to meet people's needs, keep them safe and give them the opportunity to take part in their chosen activity.
Staff received a range of training appropriate to their role and people's needs, and were supported by the registered manager through regular supervision.
Effective systems were in place to check the quality and safety of the service. The environment was clean and safe and in a good state of repair and decoration.
The leadership of the service promoted a positive culture that was person-centred and inclusive. The registered manager and the staff team showed a desire to improve on the service provided and the quality of life experiences for the people at Chestnut Street.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (report published 28/06/2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
59 Chestnut Street is a student residence for Arden College. The home provides accommodation for up to three people between the ages of 16 and 25 with learning disabilities. This home comprises of individual bedrooms, bathrooms, lounge, dining room, kitchen and a garden.
At the last inspection, the service was rated Good. At this inspection we found the service remained Good.
Why the service is rated Good.
People were protected from the risk of abuse or harm because staff knew people well and were vigilant in monitoring risk. Risk assessments had been completed to monitor people's health and to keep them safe when inside the home or when out in the community.
The provider had a robust recruitment process to ensure that staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults.
Sufficient numbers of staff were on duty to meet the needs of people in the service and enable them to access the community.
Medicines were administered and stored safely at the home by trained staff and in accordance with best practice guidance for care homes.
Staff completed training courses in subjects relevant to support the needs of the people in the home. Staff were knowledgeable about people’s needs and how they liked to be supported.
People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.
People were supported to eat and drink and maintain a healthy diet, in accordance with their wishes and preferences.
People had access to healthcare professionals and their healthcare needs were met.
People's needs had been assessed and identified the support they required.
People were supported to be independent.
Person centred plans were in place detailing how people wished to be supported, as well as action plans detailing people's hope and aspirations, and their progress in achieving them. People were able to make decisions relating to day to day living.
The service coordinated well with other services to help ensure a smooth transition for people in or out of the service.
Staff were supported through supervision and regular staff meetings.
The home manager used a variety of methods to assess and monitor the quality of the service provided at Chestnut Street. These included regular audits of the service, meetings with people in the service and questionnaire to relatives to seek their views about the quality of care. Feedback demonstrated that people and their relatives were happy and satisfied with the level of care which was being delivered.
Further information is in the detailed findings below.
This inspection was announced and took place on 11, 12 and 17 November 2014. The home is registered to provide residential care for up to three adults with learning disabilities who attend the provider's college. Three people were living at the home at the time of our inspection. The property comprises of individual bedrooms, bathrooms, lounge, dining room, kitchen and a garden. The home is situated in Southport, close to the town centre and local bus routes.
A registered manager was in post. ‘A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’
People were kept safe because there were arrangements in place to protect them from the risk of abuse. People said they were supported in a safe way by staff and they felt safe when staff accompanied them when they were out in the community. Staff understood what abuse was and the action to take should they report concerns or actual abuse.
We looked to see if the service was working within the legal framework of the Mental Capacity Act (2005) [MCA]. This is legislation to protect and empower people who may not be able to make their own decisions. We were told that the home currently supported one person who is on a deprivation of liberty authorisation [DoLS]. DoLS is part of the Mental Capacity Act (2005) and aims to ensure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom unless it is in their best interests.
Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. People told us there was always enough staff on duty to support them as they needed.
Staff received an induction and regular training in many topics such as basic life support, crisis management, fire safety, food hygiene, infection control, challenging behaviour, medication administration, moving and handling, the Mental Capacity Act (2005) and safeguarding adults. Records showed us that staff were up-to-date with the training. This helped to ensure that they had the skills and knowledge to meet people’s needs. Staff we spoke with told us the manager was not based at the home but kept in regular contact with staff, by visits to the home and holding staff meetings at least once a week.
The care files we looked at contained relevant and detailed information to ensure staff had the information they needed to support people in the correct way and respect their wishes, likes and dislikes. A range of risk assessments had been undertaken depending on people’s individual needs. They included risk assessments for keeping people safe when accessing the community.
People told us they received their medication at a time when they needed it. We observed that medication was stored safely and securely in people’s bedrooms. Risk assessments had been completed to enable people to take their medication independently.
People told us they felt listened to and involved in the running of the home. They met with staff each week to make decisions about the week’s menu and activities.
People told us they were happy at the home, and our observations supported this. Staff knew people’s individual needs and how to meet them. We saw that there were good relationships between people living at the home and staff, with staff taking time to talk and interact with people.
Throughout the inspection we observed staff supported people in a caring manner and treated people with dignity and respect. Staff demonstrated they had good knowledge of people’s needs and supported them as they preferred. People had access to the local community and had individual activities provided.
A procedure was in place for managing complaints and people living at the home and their families were aware of what to do should they have a concern or complaint. We found that complaints had been managed in accordance with the complaints procedure. An easy read / pictorial version of the procedure was displayed in the home for people who were unable to understand the written version.
The home was well run by the manager. There were sufficient staff provided to support people to help ensure their needs were met. The building was clean and well maintained. We found audits/ checks were made regularly to monitor the quality of care provided and ensure it was safe.
People did not just use words to communicate their needs, they used some signing as well as the home introducing people to a pictorial system called boardmaker. We observed staff responding respectfully and sensitively to their nonverbal communication and actions. Staff were supported in their approach to care through access to detailed, person centred care, support plans and regular meetings. During the visit the staff demonstrated a person centred approach in the way they provided care to people.
Assessment of people's need was thorough and person centred, with focus on their individual circumstances and immediate to longer-term needs. Care and support plans placed an emphasis on people's right to be self-determining in how they lived their lives and take risks.
Peoples' capacity to make their wishes known when they did not use words was recorded and appropriate communication methods used.
The right of people to take informed risks had been acknowledged and risk assessments ensured a balance of safety and effectiveness. People were cared for by staff that were recruited properly and well trained.
One person was unable to communicate verbally; we observed staff responding respectfully and sensitively to their non verbal communication and actions. Staff were supported in their approach to care through access to detailed, person centred care records and regular meetings. Throughout the visit the staff and managers demonstrated a person centred approach in the way they provided care to people.
The home had a number of policies and procedures in place to assess and monitor quality including incident and accident reporting. The staff we spoke with were knowledgeable about what to do if they had any safeguarding concerns and told us they had received training as part of the mandatory foundations for growth learning package.
There was evidence that families were involved in reviews of the care of people living in the home and about how the service was delivered through family surveys, however a family member told us that that their involvement could be improved through better communication and regular meetings with staff at the home.