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Reports


Inspection carried out on 1 November 2017

During a routine inspection

We inspected Chestnuts- Bognor Regis on the 1 November 2017, the inspection was unannounced. The service was last inspected in April 2015 when it was found to be good in all areas.

Chestnuts provides care and accommodation for up to six people who have learning disabilities. The service is part of the HF Trust Limited a charity that operates 70 registered services throughout England to support people with learning disabilities.

At the time of the inspection five people were living at the service. The service was based in a large detached building set within its own gardens in a rural location. One person had en-suite toilet and shower facilities. The other people shared a communal bathroom, along with a communal lounge and kitchen. The manager told us there were plans in place to make significant structural changes. The office was to be relocated and a self-contained flat developed.

The service is required to have a registered manager but there was no registered manager in post at the time of the inspection. The previous registered manager had left the service in September 2017 and a new manager had been appointed. The new manager was being well supported by the registered providers local leadership team and was due to complete a five day residential training course on their roles and responsibilities. Once this training was completed it was the intention of the manager to commence the registration process with the commission.

People told us, “[The manager] is lovely” and staff commented, “[The manager] is very conscientious, very approachable. I do not hesitate to contact her if I have a query” and “Morale is very good. It is a real team home here. Very supportive”. We saw that staff were well motivated and records showed staff had received regular supervision to support them in their roles. The new manager told us she was also well supported and able to access guidance from the provider’s local senior managers whenever necessary.

People told us they felt safe and staff understood their role in protecting people from abuse and avoidable harm. Care plans included detailed risks assessments designed to ensure people’s safety, while encouraging them to be as independent as possible. Where incidents and accidents occurred these were documented and investigated to identify any changes that could be made to improve people’s safety.

There were sufficient staff available to meet people’s needs. Two staff were on duty on the day of our inspection and staff told us, “For me yes I think there are enough staff.” People who used the service were actively involved in staff recruitment processes and records showed that all necessary pre-employment checks had been completed.

People were supported to engage with a variety of activities they enjoyed. During our inspection we saw people baking cakes, making blankets and planning model making tasks with staff and volunteers. People told us, “We played bingo last night” and “I have done a lot this week while staff commented, “People do a lot of activities, There is enough for people to do” and “We support people to do the things they enjoy”. The service had a minibus which all staff could drive and was used to enable people to attend various events in the local community.

Staff knew people well and had a good understanding of each person's individual care and support needs. New staff completed the provider’s formal induction training. Staff new to working in the care sector followed the induction standards for the care certificate. New staff were supported by more senior support staff by carrying out shadow shifts before they were permitted to provide care independently. One recently appointed staff member told us, “The training was good actually. I did a lot of shadowing. It was for something like six weeks.” There were systems in place to ensure training was regularly updated and staff told us, “I think the training is very good” and “It gets refreshed every year”.

Staff

Inspection carried out on 27 April 2015

During a routine inspection

This inspection took place on the 27 April 2015 and was unannounced.

Chestnuts-Bognor Regis is a service which is registered to provide accommodation for six people with a learning disability who require personal care. On the day of our visit there were six people living at the home. People were mainly independent but needed support from staff to access the local community,

This was the first inspection of the service since since new providers had taken over the home and

it was registered with the Care Quality Commission.

Throughout the inspection we were assisted by the registered manager. 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 and associated Regulations about how the service is run.

People and their relatives, said they felt safe with the staff. There were policies and procedures regarding the safeguarding of adults and staff had a good awareness of the correct procedures if they considered someone was at risk of harm.

Care records included guidance for staff to safely support people. People had risk assessments in place for staff to follow.

People told us the food provided was good. People had a meeting each week to plan menus and staff provided support to people to help ensure meals were balanced and encouraged healthy choices.

Recruitment checks were carried out on newly appointed staff so people could be confident they received care from suitable staff. Records confirmed all the required recruitment checks had been completed. Staffing numbers were maintained at a level to meet people’s needs.

Staff were supported to develop their skills by receiving regular training. The provider supported staff to obtain recognised qualifications such as National Vocational Qualifications (NVQ) or Care Diplomas (These are work based awards that are achieved through assessment and training. To achieve these awards candidates must prove that they have the ability to carry out their job to the required standard). All of the five staff had completed training to a minimum of (NVQ) level three or equivalent. People said they were well supported

The registered manager sought people’s consent and acted appropriately when she thought people’s freedom was being restricted. CQC monitors the operation of DoLS (Deprivation of Liberty Safeguards) which applies to care homes. The registered manager understood when an application should be made and how to submit one. We found the provider to be meeting the requirements of DoLS which meant that people’s rights were protected.

People were supported to take their medicines as prescribed by their GP. Records showed that medicines were obtained, stored, administered and disposed of safely.

Privacy and dignity was respected and staff had a caring attitude towards people. To provide additional support each person was allocated a key worker. A key worker is a person who has responsibilities for working with certain individuals so they can build up a relationship with them so they can help and support them in their day to day lives and give reassurance to feel safe and cared for.

Each person had a plan of care that gave staff the information they needed to provide support to people and these were regularly reviewed. Staff received specific training to meet the needs of people using the service. Staff were able to develop their skills by means of additional training. Relatives said the staff were knowledgeable and people said they were well supported by staff.

Staff were observed smiling and laughing with people and supporting them to take part in a range of activities inside and outside the home. People attended day services and were support to use facilities in the local community.

There was a policy and procedure for quality assurance. Quality audits were completed by the registered manager. These helped to monitor the quality of the service provided to ensure the delivery of high quality care.

The service delivery was open and transparent and the registered manager said they operated an open door policy and welcomed feedback on any aspect of the service. There was a small, stable staff team who worked well together and they were well supported by the manager. People and staff were provided with opportunities to make their wishes known and to have their voice heard. The registered manager showed a commitment to improving the service that people received and ensuring her own personal knowledge and skills were up to date.