Chester House Care Home

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 50 (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 did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity.

Our observation outcomes were mixed in relation to treating people with dignity and respect. Some people did not always look well kempt and had an odour, unclean fingernails and unclean clothing/footwear. We did not see specific, robust guidance for staff to action if people initially refused personal care. We were not assured that care records were accurate in relation to people receiving baths and showers on a regular basis. For example, we observed one person to have unclean hair and nails; however, their care records indicated they had been receiving regular washes and showers. During lunchtime observations we saw support for people was mixed; some people were being assisted by engaging staff; however, we also observed instances where people were not always appropriately supported to eat and drink with dignity.

We observed some kind and caring interactions between people and staff. It was clear that staff knew people and had formed some good relationships. However, we also observed some people being spoken to in a direct manner and given instructions. Feedback from people and relatives was positive about how caring staff were.

Staff were helpful, accommodating, and positive during the site visits and people’s and relative’s feedback was generally positive about staff.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Work was needed to ensure people and, where appropriate, their relatives were consistently involved in the development and review of care plans. Some of the information in care plans was old and had not been updated. As a result, records did not always fully reflect people’s views, preferences and desired outcomes. For example, we found one person was in their room without any stimulation and the management told us this was their preference; however, this was not reflected in their care plan. Some people’s bedrooms had been personalised; however, some other people’s bedrooms were sparse and lacked personalisation.

People and their relatives did not raise any concerns with us about how caring the staff were. One person told us, “The staff have always been very supportive." One relative told us, “The staff are like friends now after mum has been there so long. They are easy to talk to, and I think that they do really care for the people they are looking after.”

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

Staff were mostly kind and caring during support and care delivery. However, we were not assured people were fully involved in all decisions about their care. For example, we saw no evidence people were consulted about decisions around what was on the daily menu for food as this was decided by the provider. However, staff told us they would make alternative meals for people, and we observed staff providing a person with an alternative meal. We were not assured that people who were cared for in bed, or chose to stay in their bedroom, received enough activity or staff time to ensure they received support that was meaningful and individual to them. Our observations of staff giving people choice were mixed; we observed some staff gave people choices throughout the day; however, we also saw some instances where people were directed by staff. One person told us they were happy with the support they received and told us, “I get up and go to bed when I want to and there is no one telling me what to do.”

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

We found concerns in relation to staff attending to a person when they required assistance. We observed communal areas were sometimes unattended, and, on several occasions, people were looking for staff to ask for a drink or to request assistance with using the bathroom. There was no system in place within the communal areas for people to get staff’s attention when in need. On one occasion we requested assistance ourselves from staff to provide support to a person who needed personal care. We did not see where regular checks were made on call bell functionality and were not assured people’s call bells were working as we tested a handset and it did not work.

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Staff did not raise any concerns with us during our inspection about their employment or the management of the home. Staff told us they were supported at work, and the management told us about the wellbeing support offered to staff, including, team building days and bonuses. However, we found care staff were the only staff currently employed, and additional to their daily caring duties, they had to clean the home, cook, carry out laundry duties, conduct audits and provide activities to people. This meant staff were taken away from their caring tasks and thus less time to spend with people and enable them to deliver good person-centred care.