OSJCT Chestnut Court

Updated 25 December 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

OSJCT Chestnut Court is a ‘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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. Due to pressures from COVID-19 we gave the service 48 hours’ notice of our visit.

Inspection activity started on 18 November 2020 with a visit to the care home and continued with desk top activity which ended on 4 December 2020.

What we did before the inspection

We reviewed the information we held about the service since the last inspection. We reviewed information we had requested from the registered manager and representatives of the provider in relation to a range of the service’s management and quality assurance systems. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We looked around the building and reviewed housekeeping and social distancing arrangements. We spoke with the registered manager, deputy manager, area operation manager, two activity co-ordinators, nine care staff, a head of care and one member of housekeeping staff.

After our site visit

We continued to review evidence provided by the service provider in relation to people’s person centred care and the management of the service.

Updated 25 December 2020

OSJCT Chestnut Court is a residential and nursing care home registered to provide nursing and personal care to 80 older people and people living with dementia. One of the four households of OSJCT Chestnut Court had become a dedicated assessment unit, supporting the local clinical commissioning groups winter pressure / COVID-19 initiatives. This household had only been active for three days. At the time of our inspection 57 people were living at OSJCT Chestnut Court or receiving respite care. Three people were being supported on the assessment unit.

People’s experience of using this service and what we found.

The service had clear infection control processes in place and looked clean. Staff were wearing appropriate PPE and following recognised guidance. People and their relatives were kept informed of any changes and spoke positively of the communication they had received from staff during the Covid-19 pandemic.

The service had adopted a whole home approach to activities and engagement. Activity and care staff spoke positively about the engagement they provided people and that people now benefitted from access to more activities which promoted people’s wellbeing.

People were supported with a range of activities which were tailored to their individual needs and preferences. The service had outdoor areas which provided green spaces, in which people could take part in gardening activities.

The activity staff, care staff and domestic staff had kept records of the support people had been provided with to support their wellbeing. Changes in people’s abilities and needs had been identified and appropriate care and support provided.

Staff spoke positively about the consistent leadership provided in the home and how they now felt supported and valued. This was also reflected in feedback the service had received from people and their relatives. This consistency had led to improvements within the home, which were having a positive impact on the caring culture of the staff team.

The registered manager, deputy manager and provider had implemented robust governance systems to monitor the quality of care people received. There were systems in place focusing on the clinical care needs of people, including tissue viability, falls and weights to ensure people’s health needs were met.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update:

The last rating for this service was Requires Improvement (report published 28 November 2019) and we identified two breaches of the regulations. This included a breach of regulation 17 (Good Governance) and regulation 9 (Person Centred Care). We issued a warning notice to the provider in relation to regulation 9 to be met by the 31 January 2020.

We found significant improvements had been implemented and sustained at this inspection and the provider and registered manager were now meeting all of the relevant regulations.

Why we inspected

We undertook this focused inspection to identify if the service had improved and to confirm they now met the legal requirements. We also looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.

As part of CQC's response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe, and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them.

Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for OSJCT Chestnut Court on our website at www.cqc.org.uk.

Follow up

We will return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.