Chestnut Court Care Home

Chestnut Court Care Home is a residential care home providing the regulated activities personal and nursing care and treatment of disease, disorder or injury to up to 62 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 60 people using the service.

The care home is purpose built over three floors, with care being provided on all floors.

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

Systems were in place to help protect people from the risk of abuse. There were enough staff working at the service and the provider had robust staff recruitment practices in place. Accidents and incidents were reviewed and analysed to help reduce the risk of further such occurrences. Steps had been taken to ensure the premises were safe. Infection prevention and control measures were in place. Medicines were managed safely. People’s risks had been assessed to help ensure they were supported in a safe way. People had access to health care services as needed.

People and staff told us there was an open and positive culture at the service. People were supported to express their views. Quality assurance and monitoring systems were in place to help drive improvements at the service. The provider was aware of their legal obligations, and worked with other agencies to develop best practice and share knowledge.

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.

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 18 October 2018).

Why we inspected

The inspection was prompted in part due to concerns received about people not being referred to relevant health agencies in a timely manner. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and effective sections of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Chestnut Court Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

¿ Each visitor to the home, including health professionals and relatives of people in the home, were asked to complete a Covid-19 related risk assessment about whether they have experienced symptoms or been in recent contact with anyone with symptoms. Visitors were provided a fluid resistant surgical face mask during their visit. Visitors had their temperature checked on arrival to confirm it was at a safe level to enter. These practices helped to ensure the risk of transmission in the service was reduced.

¿ The home experienced an outbreak of Covid-19 in March. To help control the infection and prevent further spread, an 11 bed isolation zone was set up for people with symptoms or who had tested positive. The zone was used to help people self-isolate in line with government guidance. Barrier nursing was implemented immediately, which meant allocated nursing and care staff were fully protected when providing people who were self-isolating with support. The management team and staff worked together and received support from external professionals to ensure the virus was contained within the zone and did not spread through the service.

¿ People were supported to avoid social isolation and loneliness as much as possible. During the period of quarantine, people in the home were supported to stay in touch with each other through the use of technology, such as video calls and instant messaging. People were also supported to contact relatives. Small social bubbles were formed gradually to help ease people out of isolation and enjoy activities with each other, such as games, watching television or sitting in the garden.

¿ The provider carried out full testing of all staff for Covid-19. This ensured people and staff were protected because it was possible to test positive for Covid-19 without having symptoms. This meant there was greater protection in the home to prevent further outbreaks and keep people safe. Staff who tested positive were required to self isolate for the period recommended by the government. People in the home were also tested and their consent was obtained prior to the test. Best interest decisions were made for people who were unable to provide their consent.

Chestnut Court Care Home is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. This service is a purpose-built care home spread over three floors, each floor operates as an independent unit. The service provides support with nursing and personal care to older people, many of whom are living with dementia. The service is registered to provide support to a maximum of 62 people and 59 people were using it at the time of our inspection.

The service had a registered manager in place. 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.

There were enough staff working at the service to meet people’s needs and robust staff recruitment procedures were in place. Appropriate safeguarding procedures were in place and safeguarding allegations were managed appropriately. Risk assessments provided information about how to support people in a safe manner. Procedures were in place to reduce the risk of the spread of infection. Medicines were managed in a safe manner. Steps had been taken to ensure the physical environment was safe. Lessons were learnt when accidents and incidents occurred.

People’s needs were assessed before they started using the service to determine if those needs could be met. Staff received on-going training to support them in their role and undertook induction training on commencing work at the service. People were able to make choices for themselves and the service operated within the principles of the Mental Capacity Act 2005. People told us they enjoyed the food and that they had enough to eat. People were supported to access relevant health care professionals.

People told us they were treated with respect and that staff were caring. Staff had a good understanding of how to promote people’s privacy, independence and dignity. Confidentiality was respected and records were held securely.

Care plans were in place which set out how to meet people’s individual needs. Care plans were subject to regular review. People were supported to engage in various activities. The service had a complaints procedure in place and people knew how to make a complaint. End of life care was managed in an appropriate way.

Staff and people spoke positively about the senior staff at the service. Quality assurance and monitoring systems were in place which included seeking the views of people who used the service. The service worked with other agencies to develop good practice.