Chestnut Lodge Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This is the first assessment for this newly registered service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People's needs were comprehensively assessed together with the person, relatives and health professionals to ensure the service had all the available information to best meet the person's needs and wishes.

People's protected characteristics as identified in the Equality Act 2010, such as their gender, age, culture, religion, ethnicity and disability were all part of the assessment process. People's care plans included their healthcare conditions and the care and support they needed. Relatives told us they were always invited to their family members reviews and if they could not always attend in person [such as over the pandemic] reviews would be done over Zoom so that they were still able to participate in the reviews of their family members.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Systems were in place to ensure information about people was shared appropriately with other services when needed. Staff worked well together and completed handovers to ensure all staff were updated on people’s care and health. A healthcare partner told us they felt the service was safe and responsive to people’s changing needs.
 

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff worked closely with community healthcare professionals such as the GP, dentists, opticians, specialised nursing teams and speech and language therapists to ensure people’s treatment and support was in line with best practice. This meant people received well-coordinated healthcare from all the professionals involved.

Relatives told us their family member’s health needs were met appropriately by health professionals. Comments included, “Everything is attended to for my [family member’s] health doctor, dentist, district nurse etc.”; “They ensure people’s health is well attended to”; “People’s health is a priority at Chestnut Lodge and they really work hard to help people experience the best quality of life possible.” Community healthcare professionals said communications with staff about people in the home were excellent and this had enabled effective coordinated care to be provided to people.
 

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Records confirmed that people had regular health checks. Relatives all told us they and their family members were kept well informed. Comments included, “Staff always let us know if my [family member] is unwell or if they involve the hospital, doctor or nurse as needed"; “Staff always ring me to update me on my [family member’s] progress.” Staff monitored people's oral care to ensure this was kept as healthy as possible. We saw dental appointments were made and check-ups took place.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The provider used clinical tools to assess and monitor emerging health needs. Digital care plans and risk assessments were updated regularly on the electronic care record. A manager was responsible for the oversight of this. They also had oversight of other clinical processes such as slips, trips and falls.

The provider worked in partnership with the GP, holding a weekly clinic on site to assess and monitor people’s health needs, including reviews of their medicines. Care records showed the provider liaised well with other health professionals, facilitating timely reviews and following clinical advice to maintain or improve people’s health and wellbeing.

Care records we inspected were person-centred, reflecting people’s own outcome goals. From our conversations with people’s relatives, we were assured these were meeting the hopes and expectations of people themselves.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS).

We checked whether the service was working within the principles of the MCA. We saw recent decision-specific mental capacity assessments for people who were suspected to lack capacity in specific areas. The registered manager demonstrated a clear understanding of what MCA assessments were and how they differed to DoLS. They showed us renewed DoLS applications made to the relevant local authorities, together with the local authority acknowledgement of receipt and were awaiting the outcomes. This meant staff were able to make decisions appropriately for people who did not have capacity to make them themselves.

Staff had received training in MCA and Deprivation of Liberty Safeguarding (DoLS) and told us about the core principles of the MCA and how this was used when supporting people.

Staff understood they needed to ensure any decisions made were in line with the person's best interests and was the least restrictive way. Records we looked at also confirmed people were supported with their best interests and safety in mind.