Chestnut Lodge

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This was the first assessment of the service since their registration with CQC. During this assessment we found that systems of oversight of the service were not always effective and robust to assess, monitor and improve the quality of care people received. Feedback from staff and people was positive in relation to the management of the service. Staff felt well supported by the management team. The provider and registered manager were passionate about delivering quality and compassionate care which was person centred to meet people’s needs. There were processes in place to ensure the service worked in partnership with other professionals to make sure people received the care and treatment they needed.

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.

Staff were happy within their roles and spoke positively about the people they supported and their work. Comments included, “I love working here, the residents are lovely, and staff are very helpful” and, “The residents come first, they are fun to be around and the staff who believe in teamwork.” Staff told us the vision and values of the service were, “The best care for everyone” and “To make sure all residents get the best care, those that are not well recover and it feels like their home.” The registered manager told us that since opening the service, they built a team from scratch which worked well and for them the evidence of this is the feedback from families. The provider representative told us that for them Chestnut Lodge meant, “Love, life and laughter. We don’t have service users, we have residents. You have to be proud of where you work.

The provider and registered manager were passionate about delivering quality and compassionate care which was person centred to meet people’s needs. They promoted a positive culture within the staff team, and they were determined to continuously improve. We established this by learning about the longer-term plans they were in the process of developing, such as a dementia framework and development to the provider’s system of oversight. Their shared vision and strategy were supported by staff.

The registered manager told us they were striving to be an outstanding rated service. They referred to the service as “Chestnut Group” which they described as comprising of the staffing team, residents, choices, benefits, involvement and caring and supporting families and staff. They stated, “We are here for them.”

Staff were complimentary about the management of the home. Staff said they could go to a member of the management team if they had any queries or wanted to make suggestions. Comments included, “The [registered manager] is always visible and easy to approach. Yes, I know I could go to anyone, even [registered manager] and [operations manager]. If I have a problem I would ask any of them, I feel really supported” and “[Registered manager] seems an understanding person.

He participates in handover in the mornings which I have never seen in previous care homes.”

The service’s management structure had the necessary experience and capability to deliver their vision and values. Both the registered manager and the provider were very receptive to feedback and started implementing changes during the assessment, which they shared with us. The provider understood the requirements of the duty of candour. This is their duty to be honest and open about any accident or incident that had caused or placed a person at risk of harm.

The service had a Whistleblowing policy in place. Staff felt able to speak up about any worries and concerns. All staff told us they would not hesitate to raise any concerns. One member of staff told us, “We can raise concerns anytime to [deputy manager] or [registered manager]. I have confidence if I reported something they would act on it.

The provider’s policies and procedures encouraged people, staff, and relatives to speak up through different channels. People, staff, and their relatives were provided with opportunities to raise any comments via an open-door policy at any time.

Staff felt that there was a good team of staff at the home who all worked together. Comments included, “Everyone works together. There is no separation between roles. If you need help people help” and “[The team] work together despite cultural differences, that’s what happens here.”

The service employed a culturally diverse staffing team, and the registered manager told us they adopted a non-judgemental approach when it came to the diversity of their workforce.

The service had systems in place to support staff. The registered manager provided us with an example of how they supported a staff member that morning.

Staff had access to a wellbeing helpline where they could receive confidential advice. Mental health first aiders were in place.

The management team told us about the systems in place to support them to review and assess the service delivery. We identified concerns regarding this which were discussed with the management team who started to address the issues during the assessment. The service had a management structure in place with defined roles and responsibilities. This included an operations manager who visited the service on a regular basis to monitor it's performance. Staff were aware of their roles and responsibilities. One staff member described how any issues identified within the department they worked was taken to the daily 10 at 10 meeting to discuss.

Numerous systems to monitor the quality of the service provided were in place, however they were not always effective or robustly implemented. It was not always clear if actions had been completed or progressed. The audits were delegated to members of the management team, however, there was no clear system in place for the registered manager to monitor the actions. There was a service improvement plan in place which contained some of the actions from the audits, but not all of them were included. There was no evidence on the service improvement plan of the actions which had been addressed already. The service carried out audits of the call bell response times and although it was identified over a few months that delays in answering bells were occurring, there were no actions identified and recorded. Some of the concerns we identified during this assessment had not been identified or efficiently actioned through the service's own systems, examples included environment checks, training and induction oversight, MCA oversight and risk management. The provider had systems in place to monitor staff training, however these systems failed to pick up the concerns we found. Although the service was carrying out their own audits of people’s care documentation and the provider, identified areas of improvement in relation to mental capacity assessments, it was not clear what these concerns were and there was no robust record of the actions taken. Other concerns, such as those related to the mealtime experience and the cleaning of the home had not been identified.

People told us about a visiting therapy dog which visits the service on a regular basis; “We have a (PAT) dog once a fortnight, a lovely little dog that sits on your lap and it’s nice to see him.”

People were seen by appropriate professionals to meet their needs.

The registered manager told us they felt that within the service they brought people together, built relationships and gave back to the community. They had links with local community organisations and were in talks with the local nursery to organise visits to the home. The provider representative was organising ‘cross homes’ events such as a gardening competition, a knitting competition and plans were in place for a small mock festival, which ran at the same time as a local renowned festival.

Staff told us there were good links with health professionals and referrals were made to the relevant health professionals promptly.

A visiting professional was positive about the effective collaboration with the service which they told us resulted in better outcomes for people.

There were processes in place to ensure the service worked in partnership with other professionals to make sure people received the care and treatment they needed. This included GP’s, speech and language therapists, dieticians and tissue viability nurses.

Staff told us they had a culture of learning and improving. One staff member told us, “We try to get better all the time.” Another staff member told us on our 2nd visit that information had been provided to the team following our feedback after the 1st day of our site visit.

The management team told us the provider organised regular meetings with all home managers to discuss various topics and share learning.

The operations manager told us learning was also shared across the organisation.

Processes were in place to ensure learning, improvement and innovation. This included various meetings at different levels which were regularly taking place within the service.