Chesfield House

Updated 29 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 04 December 2018 and was unannounced.

The inspection team consisted of one inspector. Prior to the inspection we reviewed information we held about the service including information from notifications. Notifications are events that happen in the home that the registered provider and registered manager are required to tell us about. We also considered the last inspection report, the Information supplied by the provider (PIR) and information that had been supplied by other agencies. We also contacted commissioners who had a contract with the home to support people who lived there.

During the inspection we met all five of the people who were living in the home. We spent our time in the company of people using the service provided and with staff who provided the direct care, some people spoke with us. Some of the people living in the home were unable to communicate verbally with us due to their health conditions and used individualised methods of communicating with staff who were supporting them. We spent time observing how people in the communal areas of the home. We saw how they were being cared for and supported by staff and used these observations to help us understand peoples’ experience of living at the home.

We spoke with the team leader and the provider’s representative (who had a lead role in providing training as well as monitoring the service) and four members of staff. We looked care records of one person in full, and looked at care plans, health action plans and medication administration records. We also sampled other records of care that had been provided. We looked at some records related to the management of the home. These included records relating to audits and systems in the home including some records of the checks of safety procedures.

Following the visit, we spoke by phone with two relatives of people who used the service to obtain their views about the care and support provided. We also contacted one professional about training provided for staff who support people who lived in the home.

Updated 29 December 2018

Chesfield House is a registered care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. Chesfield provides residential care for five people who have learning disabilities or mental health and physical health care needs.

The accommodation for people is spread over ground and first floors of two houses. People have single bedroom accommodation with en-suite toilet and shower or bathing facilities; two of the bedrooms also have small kitchen facilities. People have shared access to communal rooms, kitchen and laundry.

The care service had not originally been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. However, it was clear that people living in Chesfield House were given choices and their independence and participation within the local community was being encouraged and enabled.

At our last inspection in March 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good.

There was a registered manager in post. The registered manger was on leave at the time of the inspection. 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 continued to receive a safe service. They were protected from avoidable harm, discrimination and abuse. Risks associated with people’s needs including the environment, had been assessed and planned for and these were monitored for any changes. People did not have any undue restrictions placed upon them.

People continued to receive an effective service. 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 home supported this practice. The principles of the Mental Capacity Act (MCA) were followed.

Staff received the training and support they required to meet people’s individual needs, including meeting their nutritional needs. Staff worked well with external health care professionals and people were supported to access health services when required

The care people received was provided with kindness, compassion and dignity. People were supported to express their views and be involved as much as possible in making decisions and exercising choices and independence, wherever possible. People’s diverse care and support needs were recognised and staff enabled people to access activities when they could not access such services independently.

People using the service were well known by staff and the staff team worked consistently to provide continuity of care and ensure that the support provided respected their needs. People’s own individual communications methods were well known and consistently used by staff who were keen to advocate on behalf of people whenever they were indicating that they were unhappy, or demonstrating in any way that they were not at ease.

People and staff were encouraged to provide feedback about the service and it was used to drive improvement. Staff felt well-supported, they received regular supervision and participated in staff meetings and general discussions about the service that provided opportunities to share ideas, and exchange information. People continued to receive a service that was well led. Required information was available in the home and made available when requested.

Further information is in the detailed findings below.