We carried out a review of the data available to us about Chesfield 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 Chesfield House, you can give feedback on this service.
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.
There was a registered manager in post. 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 were supported to maintain some independence and to take positive risks. Staff knew how to recognise and report any concerns about people’s safety. Staff understood risks associated with people’s needs and how to keep them safe. There were enough staff on duty to respond to people’s health needs at the times when they needed support. The provider completed checks to ensure staff were suitable and safe to work at the home.
People had good relationships with the staff. It was a relaxed homely atmosphere with staff spending time with people and there was a homely atmosphere in the home. People were treated with kindness, compassion, dignity and respect. People received care and support to meet their diverse needs including people who had complex health needs and were supported to pursue their interests.
People’s health needs were responded to effectively with people being supported to access doctors and other health professionals when required. People were supported to have their medicines when needed. Medicines were stored and administered appropriately.
People had access to a varied diet of food and drink. People were supported to make choices over what they wanted to eat and drink. People told us they enjoyed the food and drink that they had. Where recommendations had been made by other professionals regarding their diet or health needs these had been acted upon by staff.
Staff understood people’s individual communication styles and were able to communicate effectively with people. People’s permission was sought before any care or support was given. Time was taken to make sure that people could make choices and decisions about the care and support they received.
People were supported by staff that had the knowledge and skills to understand and meet their health needs. Staff were well supported and had access to additional training specific to people’s needs. Staff felt that they were able to contact the registered manager at any time if they needed support or guidance.
People told us the staff and management were approachable, willing to listen to their views and opinions. People’s views on their care and support was gathered on a regular basis and the registered manager felt supported by the provider to make any changes as a result of any suggestions or feedback. A range of audits and checks were also completed regularly to ensure that good standards were maintained.
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People were treated with respect and dignity by the staff. People told us they felt safe.
Staff knew about risk assessments and risk management plans. They showed us examples where they had followed these. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.
Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.
The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant that people would be safeguarded as required.
We saw that policies and procedures were in place in relation to receiving, administering and storing medication. This meant people were protected because the service provided instructions so that staff handled medication safely.
Recruitment practice was safe and thorough. A robust staff recruitment process was in place.This helped to ensure that people were supported by staff members who were suitable for their required roles. From the staff records we looked at we were able to see that the staff currently working for the home had been appointed correctly.
Is the service effective?
People's health and care needs were assessed with them. Specialist dietary, mobility and equipment needs had been identified in care plans where required. We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.
Is the service caring?
People were supported by kind and attentive staff. Care workers showed patience and gave encouragement when supporting people. It was clear that they genuinely cared for the people they supported.
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
Is the service responsive?
People completed a range of activities in and outside the service regularly.
The service worked well with other agencies and services to make sure people received care in a coherent way.
Is the service well-led?
The provider had an effective system to regularly assess and monitor the quality of service
that people receive. The quality assurance records showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.
Staff told us they were clear about their roles and responsibilities. This helped to ensure that people received a good quality service at all times.
People told us that they felt able to raise any issues with the manager or staff should they have any concerns. Staff spoke of their awareness of how to keep people safe from harm. Staff told us about the training that the home had arranged for them to attend so that they would recognise abuse and how to report it.
People told us that staff were always available when they needed help. They said that the staff were friendly and always acted professionally. One person said, 'They are pretty good' and another said 'They take care of things for me'.
The provider had developed a system whereby they can monitor how well the home is meeting the needs of the people who live there.
We spoke with four people living at the home, three staff, the manager, the company health and safety officer and a company director. We observed staff interaction with people using an observational tool designed for the Care Quality Commission. We looked at the provider's quality surveys which were positive. We looked at care records for two people in detail and a variety of records for other people. We looked at records about staff and the running of the home.
The atmosphere was relaxed, friendly and staff interaction with people was positive. People led active lives, felt safe and were complimentary about their life in the home and their support.
People were asked to consent to care and medication. Most staff needed training to put laws into practice when best interest decisions were needed.
Care was provided which met individual lifestyles and preferences. People had access to doctors and health specialists. Measures to monitor one person's health and to support their nutrition were put in place after our visit to reduce potential risks.
Staff had been trained to recognise abuse but we found that when someone had complained about an incident when they were restrained it had not been dealt with as we would expect.
There were effective systems to make sure that there were enough staff to provide people with flexible and consistent support.
Quality and safety systems did not protect people from the risks of inappropriate or unsafe care.