We carried out a review of the data available to us about London Care (Chestnut House) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about London Care (Chestnut House), you can give feedback on this service.
London Care [Chestnut House] provides personal care and support to people living in an extra care housing scheme. This consists of 42 individual flats within a staffed building with some communal areas. A separate organisation manages the building. All 32 people using the service currently living at Chestnut House received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
At the last inspection, in 2018 improvements were required. the service provided was not always caring. People did not always receive a caring service as staff did not always have enough time to carry out agreed tasks or arrive at the agreed time.
At this inspection, improvements had been made and people and their relatives now received care and support from staff that were kind and caring and staff now had enough time to carry out their care calls.
People received a service that was safe for them to use and staff to work in. People said that staff did their utmost to meet their care needs and they did receive support at the agreed time, although occasionally they may be a little delayed whilst meeting other people’s needs. They were informed if staff were going to be late. People had risks to themselves assessed, monitored and reviewed. This enabled them to take acceptable risks, enjoy their lives and live in a safe way. Accidents, incidents and safeguarding concerns were reported, investigated and recorded. There were enough staff who had been appropriately recruited to meet people’s needs. Medicine was safely administered by trained staff.
People and their relatives said they liked the way staff provided care which met their needs. Staff provided them with care and support which was friendly, caring and empathetic. They felt staff acknowledged and respected their privacy, dignity and confidentiality. People were enabled to retain their independence by being encouraged and supported to do the things for themselves, that they still could. This promoted their self-worth and improved their quality of life.
The culture of the service was open and honest with a clearly defined vision and values that staff said they understood and followed. This was done in a way that was kind and sympathetic. The quality assurance systems and audits identified issues, that were then addressed. Staff had areas of responsibility and accountability that they were comfortable to take responsibility for and prepared to report any concerns. There were well-established working partnerships with health care professionals. Records including people’s daily logs and care plans were up to date, as well as staff information. People said the registered manager and staff had a caring and responsive approach.
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 (published 28 February 2019).
Why we inspected
This was a planned inspection based on the previous rating and specific concerns regarding the caring question of the previous report.
As no concerns were identified in relation to the key questions Effective, and Responsive, we decided not to inspect these questions. Ratings from the previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service remains good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for London Care [Chestnut House] on our website at www.cqc.org.uk.
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.
At our previous inspection on 27 November and 6 December 2017 we found the provider was not meeting regulations in relation to the outcomes we inspected, we found a breach of regulation in relation to Safe Care and Treatment. The service was rated Requires Improvement.
At this inspection, we found the provider had now met the breach identified at the last inspection. We also found improvements had been made in relation to record keeping. Therefore, the rating for the key questions ‘is the service safe?’ And ‘is the service well-led?’ has improved to Good. However, the rating for the key question ‘is the service caring?’ has deteriorated to Requires Improvement following feedback from people.
London Care (Chestnut House) provides personal care and support to people living in an extra care housing scheme. This consists of 42 individual flats within a staffed building with some communal areas. At the time of our inspection there were 33 people using the service. A separate organisation was responsible for managing the building and flats. Each flat consisted of one bedroom, a lounge/kitchen and a bathroom and was individually furnished.
There was a registered manager at the service. 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.
Feedback from people was mixed, although some praised the carers for their caring attitude, others said that their care sometimes felt rushed and care workers did not always engage with them or go over a basic level of care.
People said they felt safe in the presence of care workers who supported them with their medicines and meal preparation. Care workers demonstrated a good understanding of people’s needs and were aware of which people needed more help and support than others. Carers also demonstrated an understanding of people’s preferences.
People lived independent lives and, those that were assessed as being able to, managed their own medicines, meals and also their health care needs.
Staff received training that was relevant to the needs of people using the service. They also received regular mentoring through office based and ‘field’ supervisions based on certain themes such as medicines.
People had signed tenancy agreements and consented to various aspects of their care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Care plans were completed in the presence of people and were focussed on maintaining a good quality of life, mainly around personal care, safe medicines management and a healthy lifestyle.
Where people had raised any concerns or formal complaints these were investigated by the provider. Similarly, incidents and accidents were documented. Follow up actions in relation to complaints and accidents were documented and there was evidence that the provider took action where needed to try and make improvements.
This was the first inspection of the service since it registered with the Care Quality Commission.
London Care (Chestnut House) provides personal care and support to people living in an extra care housing scheme. This consists of 42 individual flats within a staffed building with some communal areas. At the time of our inspection there were 39 people using the service. A separate organisation was responsible for managing the building and flats. Each flat consisted of one bedroom, a lounge/kitchen and a bathroom and was individually furnished.
There was a new manager at the service who had submitted an application to become registered. 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.
People using the service were happy with the care and support they received. They said they felt safe in the presence of care workers who were friendly and caring. We observed care workers speaking to people in a polite manner and supporting them with their medicines and they did so appropriately, taking their consent and recording on the MAR charts.
People were satisfied with the support they received with regards to their nutrition. The majority of people had their shopping done by relatives or ordered in ready meals that were delivered to their flats. Staff supported them to prepare their meals.
We found that although risk assessments were in place, the level of risk was not always documented correctly and therefore there was a potential risk of the necessary support plans not being in place. We also found other areas of record keeping were not always completed in sufficient detail.
Recruitment checks were robust and there were enough staff to support people. We found that staff received a thorough induction and the necessary ongoing mandatory training. They received regular one to one supervision.
People told us they knew how to raise any concerns. The provider recorded complaints on their online reporting system and carried out investigations into complaints received, taking action where necessary and addressing the concerns of the complainant.
Thorough quality assurance checks, including audits and feedback surveys were in place. There was an action plan that the provider had in place in response to issues found in audits.
We found a breach of the regulations in relation to safe care. You can see what action we have told the provider to take at the back of the full version of this report.