The Chestnuts

Updated 7 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

The inspection took place on 4 October 2017 and was unannounced. This was a comprehensive inspection carried out by two inspectors.

Before the inspection we reviewed the evidence we had about the service. This included any notifications of significant events, such as serious injuries or safeguarding referrals. Notifications are information about important events which the provider is required to send us by law. The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with five people who lived at the service. If people were unable to express themselves verbally, we observed the care they received and the interactions they had with staff. We spoke with the registered manager and seven care staff. We also spoke with three professional practitioners who visited the home on the day of our inspection. We looked at the care records of four people, including their assessments, care plans and risk assessments. We looked at how medicines were managed and the records relating to this. We checked records relating to staff recruitment, support and training. We also looked at records used to monitor the quality of the service, such as the provider’s own audits of different aspects of the service.

After the inspection we spoke with five relatives by telephone to hear their views about the care and support their family members received.

Updated 7 December 2017

The Chestnuts provides accommodation, personal care and support for up to 20 adults who have a learning disability, some of whom may also have physical disabilities and/or sensory impairments. There are three separate units within the home, two of which have eight bedrooms and one of which has four bedrooms. There were 20 people living at the home at the time of our inspection.

There was 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.

At the last inspection on 6 July 2015, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good.

People were safe because staff understood any risks involved in their care and took action to minimise these risks. The rota was planned to ensure there were sufficient staff to keep people safe and meet their needs. Staff understood their roles in keeping people safe and protecting them from abuse. The provider carried out appropriate pre-employment checks before staff started work.

Medicines were managed safely. Accidents and incidents were recorded and reviewed to ensure any measures that could prevent a recurrence had been implemented. Staff maintained appropriate standards of health and safety, including fire safety. The provider had developed plans to ensure that people’s care would not be interrupted in the event of an emergency.

People’s care was provided by regular staff who knew their needs well and provided support in a consistent way. Staff had access to the induction, training and support they needed to do their jobs. 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 supported this practice.

People were supported to eat food they enjoyed and were encouraged to maintain a healthy diet. Staff were aware of any dietary restrictions involved in people’s care. People’s healthcare needs were monitored and they were supported to obtain treatment if they needed it. People who had ongoing conditions were supported to see specialist healthcare professionals regularly.

People enjoyed living at the home and had positive relationships with staff. Staff treated people with respect and maintained their privacy and dignity. People were supported to maintain relationships with their friends and families and were able to invite guests whenever they wished. People were encouraged to manage aspects of their care independently where they were able to do so.

People’s needs had been assessed before they moved to the home to ensure staff could provide the care and support they needed. Care plans were person-centred and reflected people’s individual needs and preferences about their support. People had access to activities they enjoyed and had opportunities to enjoy an active social life. People were involved in their local community

People were encouraged to give their views about the service they received and the provider responded positively to feedback. Complaints were responded to appropriately and used to improve the service.

The registered manager provided good leadership for the service. They led an experienced management team that was accessible to people who lived at the home, their relatives and staff. Relatives told us communication from the management team was good and staff said they felt well supported and valued for the work they did.

Staff shared important information about people’s needs effectively. Handovers took place at the beginning of each shift to ensure staff were up to date with any changes in people’s needs. There was a plan in place for each shift which identified which member of staff was responsible for key tasks. Team meetings were used to ensure staff were providing consistent care that reflected best practice.

Regular quality monitoring checks ensured people received safe and effective care and support. Records were well organised and up to date. Staff worked co-operatively with other professionals to ensure people received the care and treatment they needed.

Further information is in the detailed findings below.