Archived: Chestnuts Residential Home (Weymouth)

There was a registered manager in post at the time of our inspection. They had been managing the service for many years. 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 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 mostly supported this practice. Some best interest decisions had been made but not recorded. The registered manager and senior staff began to address this during our inspection.

Deprivation of Liberty Safeguards had been applied for when people did not have the mental capacity to consent to living in the home to receive the care they needed.

People felt safe. They were protected from harm because staff understood the risks people faced and how to reduce these risks. They also knew how to identify and respond to abuse.

People had support and care when they needed it from staff who had been safely recruited. They told us they were engaged with activities that reflected their preferences, including individual and group activities. People also told us they saw health care professionals when necessary and were supported to maintain their health by staff. People’s needs related to on going healthcare and health emergencies were met and recorded. People received their medicines as they were prescribed.

Staff were consistent in their knowledge of people’s care needs and spoke confidently about the support people needed to meet these needs. They told us they felt supported in their roles and had taken training that provided them with the necessary knowledge and skills. There was a plan in place to ensure staff received refresher training as deemed necessary by the provider. Where staff were due training this was scheduled.

Staff kept accurate records about the care they provided. These were not stored securely during our inspection. The owner assured us this would be rectified immediately.

Quality assurance had led to improvements being made and people, relatives and staff were invited to contribute their views to this process. Staff, relatives and people spoke positively about the management and staff team as a whole.

People were positive about the care they received from the home and told us the staff were kind and caring. Staff were cheerful and treated everyone with respect and kindness throughout our inspection.

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There was a registered manager in post at the time of our inspection. They had been managing the service for many years. 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.

At our last inspection we had concerns about: how people's consent to care was established; omissions in quality assurance and inconsistencies in care records. There were breaches of regulation. At this inspection we found that improvements had been made however there were a number of areas that needed further development. We have made recommendations about recording information about Mental Capacity Act (MCA) 2005 decisions, and ensuring training reflects current good practice.

Deprivation of Liberty Safeguards had not been applied for when people did not have the mental capacity to consent to living in the home to receive the care they needed. Senior staff ensured this was addressed during our inspection.

Staff understood how people consented to the care they provided and encouraged people to make decisions about their care. Care plans did not reflect that care was being delivered within the framework of the MCA when people did not have capacity to make decisions for themselves. However, staff showed they understood the importance of enabling people to make their own decisions wherever possible and providing care that is in a person’s best interests.

Training was not up to date at the time of our inspection and whilst there was a plan put in place to ensure this was addressed people were at risk of receiving inappropriate care because staff had not received current training. However, staff were consistent in their knowledge of people’s care needs and spoke with confidence about the care they provided to meet these needs. They told us they felt supported in their roles and had taken training that provided them with the necessary knowledge and skills.

People received their medicines as they were prescribed, however the administration process increased the risk of errors being made. The registered manager and provider assured us that this was changed immediately following our inspection.

People, relatives and staff were invited to contribute to the quality assurance process. The management were open to feedback and sought to improve the quality of the service people received. Some areas identified as requiring improvement had not been recognised through internal quality assurance processes. The registered manager told us they were increasing the role of senior staff to make their quality assurance and policy framework more robust.

People were engaged with activities that reflected individual preferences, including individual and group activities. Staff had time to spend chatting with people; people told us they enjoyed this and the more organised activities available to them.

People felt safe and well cared for. They were protected from harm because staff understood the risks they faced and how to reduce these risks. They also knew how to identify and respond to abuse. They knew how to access the contact details of agencies they should report concerns about people’s care to. Care and treatment was delivered in a way that met people’s individual needs. Staff kept accurate records about the care they provided.

People had access to health care professionals and were supported to maintain their health by staff. Staff understood changes in people’s health and shared the information necessary for people to receive safe care.

People described the food as good and there were systems in place to ensure people had enough food to eat and enough to drink.

People were positive about the care they received at the home and told us the staff were friendly and kind. Staff treated people and visitors with respect and kindness throughout our inspection.

We found systems and safeguards to ensure people experience appropriate care and support and to protect their human rights were not in place.

We spoke with people and observed that some people were unable to tell us what they thought about the care and support they received.

We found that people's privacy, dignity and independence were respected.

We found that people were treated with respect and kindness when interacting with staff.

We found care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

We found staff had completed safeguarding training and demonstrated skills and knowledge in this area.

Staff told us they felt supported and received training, supervision and peer support.

We found the manager did not have effective enough systems in place to assess and monitor the quality of services.

People told us they felt safe in the home and people were protected from harm as there were appropriate safeguarding procedures. We saw that staff were supported by the provider through regular training and that staff were encouraged in their professional development.

The home had suitable systems to monitor the quality of the service provided.

The home had failed to notify the Care Quality Commission of incidents as required.