Archived: Chestnut Lodge Residential Home

The home is registered to provide personal care and accommodation for up to 15 older people. At the time of our inspection, there were ten people living at the home and four people having a respite stay at the home.

The registered provider had registered with the Care Quality Commission. The registered provider was not required to have a registered manager in place and they had chosen to manage the service as a ‘registered person’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People and relatives told us that they were safe at the home. We observed that most people were at ease and comfortable around staff and others, although some people expressed a lack of confidence in the support they received from some staff.

Staff were not consistently able to fully explain how they would recognise and report safeguarding concerns to promote people’s safety. We were informed that refresher safeguarding training had been planned to address this shortfall in staff knowledge.

People’s risks were not consistently managed safely and care plans did not always equip staff with a full understanding of the people’s individual risks and associated support needs. Incidents were not always addressed and investigated in line with the registered provider’s processes. Opportunities were missed to help minimise risks and future reoccurrences of incidents.

People were supported by sufficient numbers of staff at the home. People were supported to access the support of other health professionals to address concerns and changes to their care.

Improvements had been made in respect of medicines management at the home and people received safe support with this aspect of their care. The registered provider was making ongoing improvements to the health and safety of the home and had ongoing plans to continue to improve the quality and safety of the support people received.

The home is registered to provide personal care and accommodation for up to 15 older people. At the time of our inspection, 13 people were living at the home.

The registered provider had registered with the Care Quality Commission. The registered provider was not required to have a registered manager in place and they had chosen to manage the service as a ‘registered person’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People could not be confident that they would always be kept safe at the home through effective risk management and appropriate processes being followed to safeguard people. People were not always supported to receive their medicines and supported to apply their skin creams as prescribed. People were not always protected by the use of best practice guidelines for safe medicines management.

People were not always supported by staff who were equipped with sufficient training and support in their roles. People told us that staff understood and met their needs, staff demonstrated awareness of most people’s needs. Some staff did not feel supported in their roles.

People were not always supported in line with the principles of the Mental Capacity Act (2005) due to practices in place at the home.

People told us that they enjoyed the food at the home, although people’s dietary needs were not always monitored. People were supported to access healthcare support to ensure people stayed well, although records did not always reflect this.

People had developed good relationships at the home with staff, relatives told us that staff were kind and caring and we observed good care in practice.

Staff practice at the home failed to consistently promote people’s privacy and dignity and to reflect a person-centred approach. Relatives told us that they had been involved in care planning, although people were not always supported to make decisions about their care. Some people were not always engaged in activities that met their needs as this had not been discussed with staff.

People told us that they were happy with the care they received. Most people were supported to participate in activities of interest to them, although care had not been taken to explore the interests and needs of all people living at the home. People and relatives we spoke with told us that they felt comfortable raising concerns, although there were no formal processes in place to empower people to do so.

The registered provider had failed to implement systems and processes to monitor and improve the quality of care that people received. The registered provider had not adopted a leadership role or established clear oversight of the service and we identified several examples where systems and processes failed to reflect the care that most people received. The registered provider demonstrated their ongoing intention to provide people with person-centred care and to address areas of concern that had been identified during our inspection.