Chestnut Lodge

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

This was the first assessment of the service since their registration with CQC.

Although during the assessment we observed one interaction when a person was not supported in a person centered manner, people and relatives told us were caring, treated people with kindness and promoted privacy and dignity.

The provider had considered people's personal histories, cultural needs, and protected characteristics as part of their assessment and care planning improvements, however improvements were needed to ensure consistency in relation to the information they gave regarding how staff should encourage people’s independence.

The provider had processes in place to ensure workforce wellbeing and enablement.

We observed staff offering people choices. People had access to activities of their choice both within and outside the home.

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.

People and their families spoke very positively about staff attitudes, kindness, friendliness and attention to privacy and dignity. Some also mentioned how good standards of personal hygiene and attention to clean clothing, helped to maintain dignity. Comments included, “The staff are so helpful, they respect my privacy and dignity very well. They always knock, they listen to me, they try to keep me covered up when they’re washing me” and “Everybody is lovely, I know (Name of person) is safe and loved. He’s well cared for. His hair gets cut, his clothes are fabulous, which keeps his dignity. We have privacy together.”

The concern we identified regarding an interaction observed during the assessment was discussed with the management team who advised they would investigate the concerns raised.

Staff knew how to maintain people’s dignity. One staff member said, “If someone needed the toilet, I would crouch down beside them and ask if they wanted the toilet. I wouldn’t shout.”

A visiting professional said, “Staff here do know [name of person] and their needs. Staff were keen to learn from me about [name of person]” and, “[Name of person] is settled here, always smiling and back to their old self.”

On day 1 of the assessment, we saw that some people’s records were held in an unlocked filing cupboard in an unlocked cupboard. We discussed this with one of the nurses and a lock was subsequently put in place.

Other records were held electronically and were secure.

On 1 occasion we observed one interaction when a person was not supported in a person centred manner. However, through other interactions observed we saw staff treating people with kindness. There was a friendly atmosphere and people appeared relaxed with staff, they were chatting and laughing with them.

We saw 1 person was becoming anxious and the staff member calmly distracted them and took them somewhere quieter.

People and their families told us how staff showed their understanding of individual’s needs and history. One relative, whose loved one had strong cultural needs told us how the home ensured these were met. Another relative told us how staff were engaging in activities with their loved one based on their previous occupation and understanding and ability to converse in a different language.

Staff said they learned about people’s preferences and choices by reading care plans.

All staff said they had access to care plans and had time to read them. One staff member said, “I read the care plans” and another staff member said, “I talk to people and their families as well and find out about people.”

A member of the nursing team told us, “We remind staff to be respectful, it’s about communication.”

During our assessment, we observed staff providing appropriate personalised support to ensure people's needs were met. Staff were respectful of people's preferences.

The provider had considered people's personal histories, cultural needs, and protected characteristics as part of their assessment and care planning.

Every care plan that we looked at stated “Remember I am still me.”

People and their families told us staff supported them to maintain their independence and have choice and control over their lives. One person told us, “I fall over a lot unfortunately. The staff encourage me to use the bell and ask for help, but I want to stay independent and to do what I can, so I take the risk. They’ve got a marvellous invention which inflates under you and lifts you up off the floor. They check me over, so far, luckily, I’ve had no serious injuries. I want to keep going while I can.”

Staff told us people were offered choices and understood what was meant by person centred care. Comments included, “We don’t make people do things, it’s not institutionalised here. We prompt, we encourage, and we ask, but it’s about choice, the person’s choice” and, “Every time I start supporting someone I introduce myself, ask permission, explain what I am doing, explain other options if they don't want my support, explain their right to refuse, if they do refuse I would explain what could happen.”

Throughout our visits we saw staff offering people choices. People had access to activities of their choice both within and outside the home.

Care plans were mixed in relation to the information they gave regarding how staff should encourage people’s independence. For example, in one person’s care plan it was recorded, “Can do some things [themselves] if prompted. Can clean teeth if given toothbrush.” However, some plans needed more detail. For example, in another person’s plan it was documented “To remain as independent as possible” but the plan did not detail what the person could do for themselves or how much help was needed.”

Other people’s plans we looked at informed staff, “Aim to keep [name of person] mobilising.”

Care plans provided information for staff on people’s choices and preferences.

People and their families told us they felt confident staff would respond to any change in need. A relative told us, “They look after (Name of person’s) well-being very well. I feel confident that they’d act on any change of condition.”

Records showed staff responded to people’s deteriorating health.

Staff were proactive at seeking medical advice when required.

Staff told us they felt confident to inform the nurse on duty if people were unwell.

Staff were provided with information on what to do if there was a change in a person’s needs. For example, how to monitor for signs of a urinary tract infection.

Whilst we did not observe anyone that required medical attention during our visits, we did see when people needed immediate support with personal care or where they had concerns regarding their care, staff responded appropriately.

Staff told us they felt supported in their roles. Comments included, “I feel more supported here than I did in my last job. We’re like a little family, we get on, we have such a good skill mix, with lots of experience” and, “I really do feel supported. I’ve never had a problem. I’m happy to go to [registered manager] with any questions.”

Staff said they had regular supervision sessions with a line manager or supervisor.

Staff said they attended regular team meetings and that if they were unable to attend, minutes of meetings were provided.

The provider had processes in place to ensure workforce wellbeing and enablement. Staff received support and supervision and the management team were operating an 'open door' policy and were accessible to staff when needed.