Chestnut View Care Home

Updated 6 March 2024

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 Health and Social Care Act 2008.

Inspection team

Our inspection was completed by 5 inspectors.

Service and service type

Chestnut View Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Chestnut View Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers 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 spoke with 14 people and 12 relatives of people who lived at the service about their experience of the care provided. We spoke with 18 members of staff including the registered manager, the regional manager, the nominated individual (The nominated individual is responsible for supervising the management of the service on behalf of the provider), care staff, nurses and ancillary staff. We received feedback from 4 external professionals.

We reviewed a range of records including 11 people's care records including daily care notes, multiple medication records, incident records and complaints. We reviewed a variety of records relating to the management of the service including 6 staff recruitment files, spot checks, policies and quality assurance records.

Updated 6 March 2024

About the service

Chestnut View Care Home is a care home providing personal and nursing care for up to 60 people. The service provides support to people who have care needs, such as, diabetes and Parkinson’s disease. Some people were living with dementia or had deteriorating mobility. At the time of our inspection there were 42 people using the service.

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

Risks associated with people’s care were not always managed safely particularly relating to moving and handling, people who were unable to use call bells and oral health care. Other risks were managed well including wound care and people that were nutritionally at risk. Aspects of the management of medicines were not safe.

People fedback they had to wait long periods of time before their call bell was answered and this was confirmed through checking call bell records. We found staff were not always deployed effectively to ensure safe delivery of care. Parts of the service were clean and tidy however we found some aspects of infection control needed improvement.

Detailed assessments of people’s needs and preferences were not always undertaken before people moved in. Care plans also lacked information around people’s life histories and preferences. End of life care was not planned appropriately.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People were not always treated in a caring and dignified way. However, we also observed instances where staff were kind, caring and respectful to people.

Whilst staff received training this was not always effective in ensuring good practice. We have made a recommendation on this. Staff said they felt supported. Nurses were provided with effective clinical supervisions.

There was a mixed response from people about the quality of the food. People were not always involved in decisions around the meal options.

Complaints and concerns were not always taken seriously, and changes were not always made when concerns were raised.

People and relatives were not always confident in the leadership at the service. There was a lack of robust oversight to ensure the quality of care. There were staff that felt they were not always listened to however other staff said they felt valued and supported.

The provider operated effective and safe recruitment practices when employing new staff. People had access to external health care and staff followed guidance from the professionals.

People had access to meaningful activities both inside and outside of the service.

Rating at last inspection and update

The last rating for this service was requires improvement (published 29 December 2021)

Why we inspected

The inspection was prompted in part due to concerns received about the safe care and treatment of people, infection control, staff levels and people not always being protected from abuse and neglect. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well led sections of this report.

Enforcement and Recommendations

At this inspection we have identified breaches in relation to the safe management of risks, the deployment of staff and the management of medicine. We also identified breaches in relation to the assessment of people’s care needs, complaints not always being responded to, and people’s capacity not always being assessed. We identified concerns about people not always being treated in a caring and dignified way and the lack of robust oversight. We have made two recommendations, that the provider improves how they support people with dietary needs and that the provider reviews the assessment of staff competencies to ensure safe and effective delivery of care.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

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