Chestnut Lodge Care Home

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

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. This is the first assessment for this newly registered service. This key question has been rated outstanding. This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 93 (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 had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The service had a clearly established purpose and set of core values. All the senior staff encouraged staff to work to the standards set. Staff told us there was a strong culture of collaboration among the team. The registered managers and staff team were passionate about ensuring high quality care was provided.

The leadership created an open and positive culture of valuing people, respect and innovation. This was observed in practice by a staff team who were aware of and shared the provider’s values in relation to respect, equality and treating people as individuals. People and staff were involved in discussions and decisions about strategy and culture and how these impacted their lives.

A staff member told us, “We have great atmosphere here, we have a good team. That’s why staff like to work here for a long time, it helps a lot.” Managers ensured the culture of the service was person-centred, empowering and inclusive; and developed through collaboration with others. The provider invested in staff. Staff were well supported, could access extra training and development opportunities and progressed in their careers when opportunities arose.

The provider had exceptionally inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They always did so with integrity, openness and honesty.

The provider ensured people benefited from strong, credible and values-driven leadership. Senior managers had progressed through a range of operational and clinical roles within the service, which meant people received care and support from staff who knew the service well at all levels. It also meant staff had a more authentic understanding of the service’s standards, expectations and ethos. We noted decisions made by staff were person-centred, well-informed, proportionate and focused on maintaining safety, dignity and high-quality care for people. For example, where people expressed a wish to engage in external activities which otherwise might not have been possible, they were supported to engage in them safely with effective structured support and comprehensive risk assessments in place. An example of this for one person was where they were enabled and supported to attend football matches. People and their relatives told us they really appreciated this very positive approach that had improved the quality of people’s lives.

We saw managers remained visible and approachable, regularly working alongside teams, engaging with people and maintaining open communication with relatives and professionals. This approach has built trust and helped to ensure staff felt confident raising concerns early, which in turn enabled quick resolution and prevention of escalation. People knew who their leaders were, they told us they felt listened to and received the best support. Leaders were respected in the community which meant the service benefited from receiving the best community resources.

Staff reported feeling empowered to take time with people, be able to listen carefully and to tailor care to each person’s individual preferences. This strengthened emotional wellbeing and helped people to feel secure within their home environment. We noted diversity, equality and inclusion were championed proactively and were supported by Patient and Carer Race Equality Framework (PCREF) principles. We saw evidence of many examples of the celebration of cultural events and that swift action was taken against discriminatory behaviour.

The registered manager told us their leadership approach included to help balance of accountability with kindness. They said they encouraged open reflection and learning rather than blame, this was supported by comments were received from staff. We saw this transparency enabled staff to be honest about mistakes or near misses, which directly contributed to risk reduction, safer care and making necessary improvements.

The staff and management team were committed to meaningful engagement with people using the service. They spent time getting to know each person’s history, communication style and cultural background, ensuring that care plans reflected the whole person—not just their needs. This person-centred approach to decision-making has helped staff develop stronger, more trusting connections with people and their relatives.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

There was an effective complaint’s policy in place at the service. Where people had raised concerns in the past these had been looked in to and addressed promptly. Relatives told us they knew how to raise concerns. Staff told us they knew how to raise concerns and felt comfortable and confident in speaking up at the service. People were given easy to understand information about who they could speak with if they were worried about the service or wanted to talk about anything. They were also encouraged to feed back about the service in monthly meetings with staff members. Regular feedback surveys were also in place for people, their relatives, staff and other professionals and these also provided a channel for people to speak up and be heard. All the surveys were analysed to identify trends and information that led to service improvements where they were needed.

The provider strongly valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who worked for them.

We observed different cultures being celebrated in the activities programme offered to people. Practices throughout the home were designed to ensure fair access and representation across all roles, regardless of background or identity. Staff spoke positively about working in an environment where differences were not only respected but celebrated.

All staff received induction, training and support. Mandatory topics included Equality and Diversity training and was designed and monitored by the organisation’s central training team. Staff had flexible patterns of working to support their individual needs. An inclusive culture was observed in the home, diversity was celebrated and valued by people and staff.

The management team demonstrated a clear and proactive commitment to supporting both people and staff with differing needs. Where needed, adjustments had been made without judgement to promote a positive culture. Staff told us they felt supported in relation to their needs and identities, with the management team, and organisation, demonstrating genuine sensitivity and responsiveness to people’s backgrounds and beliefs. A ‘Staff of the month’ initiative was in place that recognised outstanding employees, highlighting staff members who had demonstrated an exceptional work ethic and positive attitude in their respective roles. Another example of was how International Nurses Day was celebrated at Chestnut Lodge. This was a national event arranged to recognise the hard working, caring and professional work of the nursing staff. Staff all told us this approach from management had really contributed to their sense of commitment to the service and the recognition they felt was given them.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. They always acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

They had excellent quality audit tools in place at both registered manager and provider level. Audits were tailored to gain specific information on topic areas that was meaningful and made a real-life impact to the quality of people’s lives. A comprehensive programme of service-wide audits and performance reviews included regular review of care records, medicines management, infection prevention and control, financial systems, health and safety, staff development, and people’s experiences of care. Audit outcomes were analysed and acted upon swiftly, with clear action plans and accountability structures ensuring continuous and measurable improvement. The impact of this was seen in improved decision making and overall performance. The culture of transparency and accountability has contributed to high staff morale and retention of staff. This has in turn generated much better outcomes for people. It has also increased confidence in the service for people, their relatives, staff and outside health and social care agencies.

The provider used high-quality data and intelligence to monitor risk and performance. This informed decision-making at all levels and enabled the service to remain responsive and resilient. Where concerns were identified, timely and sustainable solutions were implemented, and shared learning was embedded across the organisation.

Professionals also spoke highly about all aspects of care and staff practice. One professional told us, “I have found Chestnut Lodge to have effective and robust policies and procedures in place. I have not identified any concerns in relation to safeguarding, medication, communication, Infection Prevention Control [IPC], risk assessment or care planning. Their electronic care planning system seems very intuitive and well organised, providing quick access to the up-to-date information. The registered manager is always very approachable and happy to provide any information I have requested."

The provider clearly understood and carried out their duty to collaborate and worked in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

The organisations we spoke with were extremely positive about the relationships they had developed with the provider. They spoke of their confidence about how the service worked with them proactively to advocate for and ensure timely support was provided to the people in their care. There were clear robust pathways in place between organisations. The provider engaged closely with the wider community, and we saw evidence of the close relationships developed with a wide range of partners. This meant that people enjoyed profound benefits that transformed their experience from a place of residence to a vibrant and integrated part of local life. Active community engagement such as the visits people received from school groups and volunteers has helped combat social isolation and loneliness for people. It has also enhanced people’s sense of wellbeing and connection with the local community.

People were supported to access a variety of health and social care professionals to ensure their needs were fully met. Referrals were made proactively to ensure people gained the support they needed as quickly as possible. Staff and the management team had strong relationships with local professionals and all feedback we received was positive. One professional said, “All staff are very approachable and appear to have thorough meetings between themselves, as all staff are fully informed when I have contacted them about the people I work with.” Care records showed that there was robust partnership working especially with the specialist mental health teams.

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

Feedback from staff was encouraged. Staff told us they were asked to provide their views on how practice could be improved. They said these discussions took place during team meetings and in their supervision sessions. Based on the analysis of accidents, incidents, complaints and other feedback from people, their relatives and staff, the registered manager identified best practice and any areas that could be improved and discussed this with the whole team to agree how to continually improve.

People, relatives and professionals received feedback surveys, to enable them to raise concerns and suggestions. Records evidenced all of these people were extremely happy with the service and there were continuous high satisfaction levels. Comments included ‘So happy with all of the care, everyone is so kind and caring.’ An ongoing service development plan was in place, which focused on people's wishes, what was meaningful to them, goals they wished to achieve and activities they wished to undertake. The development plan provided an ongoing action plan, to ensure the service continuously developed and drove improvements, such as refurbishment plans and auditing systems. This approach ensured the service evolved responsively and always focused on what mattered most to people.