Archived: The Chestnuts Care Home

The Chestnuts Care Home is a residential care home providing personal care to 29 older people. At the time of the inspection there were 26 people living at the service.

People’s experience of using this service and what we found

People spoke positively about living at The Chestnuts Care Home. They said they felt safe and that the staff were kind and caring.

People were supported by enough staff who were recruited safely and were skilled and knowledgeable. Staff had time to sit and chat with people and were not rushed. People were protected from the risks of abuse, discrimination and avoidable harm by staff who understood how to keep people as safe as possible. People had their medicines safely and on time.

People’s health care needs were assessed with them. These were monitored and regularly reviewed. Care plans were kept up to date with any change in preference or need. People had access to health care professionals and were supported to stay as healthy as possible. People ate well and told us they enjoyed their meals. They were supported to drink plenty.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were treated with compassion. People told us staff listened to them and their opinions were valued. People’s privacy and dignity were respected, and their independence was promoted. They had access to communal areas and a well-maintained garden, which included a sensory area. Staff understood how to protect people’s confidentiality.

People told us they knew how to complain; however, they did not have any complaints. People told us they would speak with the registered manager or staff and felt confident any concerns would be addressed. People were given important information in a format that suited them best, such as in larger print or with pictures. People told us there was plenty to keep them occupied each day. There were various activities both in the service and in the local community which people enjoyed.

The service was well-led. The registered manager promoted an open and inclusive culture where everyone was valued. The staff team worked flexibly and cohesively to provide a good quality of care. Staff felt supported and spoke passionately about working at the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (Report published 11 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

There was a registered manager in post who was registered with the CQC. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. 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.

This inspection at The Chestnuts Care home was the first inspection under our new methodology since its new registration in February 2016.

The provider had systems in place to protect people against abuse and harm. The registered provider had effective policies and procedures that gave staff guidance on how to report abuse. The registered manager had robust systems in place to record and investigate any concerns.

Risks to people's safety had been assessed and actions taken to protect people from the risk of harm. However, there was no recent fire risk assessment in place that was carried out by a trained competent person. This was brought to the attention of the registered manager who took immediate action by booking an appropriate assessment and adding fire risk assessment to the auditing system.

Medicines were managed safely and people had access to their medicines when they needed them.

Staff were well trained with the right skills and knowledge to provide people with the care and assistance they needed. Staff met together regularly and felt supported by the manager. However, there were gaps in the frequency of one to one supervisions carried out by the management team. We reported our concerns to the registered manager who took immediate action by improving the supervision process. We have made a recommendation about this in our report.

There was sufficient staff to provide care to people throughout the day and night. When staff were recruited, they were subject to checks to ensure they were safe to work in the care sector. However, we found that there were inconsistencies in chasing two references prior to new staff starting work. Disclosure and Barring Service checks were being requested by the registered manager but these were not being reviewed. We have made a recommendation about this in our report.

The principles of the Mental Capacity Act 2005 (MCA) were adhered to for more complex decisions. People's mental capacity was being assessed appropriately and meetings took place to make decisions on people's behalf and in their best interests, when they were unable to do so. However, mental capacity assessments for less complex decisions were not decision specific. We have made a recommendation about this in our report.

The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people's freedom had been submitted and the least restrictive options were considered as per the Mental Capacity Act 2005.

People were assisted with their nutrition and hydration needs. Staff were completing fluid and eating charts for those that need it. People were involved with the development of the menu through meetings and tasting sessions with the supplier.

People had freedom of choice at the service. People could decorate their rooms to their own tastes and choose if they wished to participate in any activity. Staff respected people's decisions.

People told us they were very satisfied with the care staff and the support they provided. Relatives told us they were happy with the service their loved ones received. Staff communicated with people in ways that were understood when giving support. Staff and the registered manager had got to know people well. Staff could build positive relationships with people to fully understand their needs.

People and their relatives told us they were involved in the planning of their care. Care plans were being reviewed on a monthly basis by staff. The provider had ensured that people and relatives had ways of communicating their wishes before reviews.

People at the service had access to a wide range of activities that were designed for their individual needs. People told us they were very happy with the amount of activities on offer at the service.

Staff respected people's privacy and dignity at all the times. The provider had ensured that people's personal information was stored securely and access only given to those that needed it.

The provider had ensured that there were effective processes in place to fully investigate any complaints. Outcomes of the investigations were communicated to relevant people.

The registered manager was approachable and took an active role in the day to day running of the service. Staff were able to discuss concerns with the registered manager at any time and felt they would be addressed appropriately. The registered manager was open, transparent and responded positively to any concerns or suggestions made about the service. Audits were carried out in all aspects of the service to identify how the service could improve and action was taken as a result.