Archived: Chestnut Lodge Care Home

We set out to answer our five key questions:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service and a visiting relative, the staff and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The service was safe in that risk assessments included people's skin integrity, oral health, moving and handling and consideration of environmental risks. Risk assessments were reviewed regularly and care plans updated. Records confirmed that people were referred to healthcare professionals appropriately such as GPs and dieticians. We saw that systems were in place to make sure that managers and staff learned from accidents and incidents, concerns, complaints, and investigations.

People spoken with were asked if they had any concerns about the quality of care and whether they felt safe. Everyone said that they were happy living within the service and had no concerns about the quality of care.

The provider may find it useful to note consideration of mental capacity within the care plans was in need of development to fully ensure that decisions were not routinely made on behalf of people who lacked capacity, without their involvement. The manager gave an undertaking that all care plans would be reviewed to ensure compliance with the requirements of the Mental Capacity Act 2005.

Is the service effective?

The service was effective. People told us that they were happy with the care that they received and that their care needs were met. One person we spoke with told us, 'I am very happy here I have no concerns'. A relative said, "Staff treat my mother well". We saw that staff were attentive to people using the service and responded promptly when needed. People's health and care needs were assessed with them and /or their representatives where possible.

Is the service caring?

The service was caring. People were supported by kind and attentive staff. Staff showed patience and gave encouragement when supporting people. People we spoke with said they felt staff respected their privacy and dignity and staff were polite and caring.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We reviewed and discussed with staff the care records of six people who lived within the service. These had sufficient detail and guidelines about the support needed to meet the people's needs. Staff had an awareness of the detail in the care plans and of people's needs.

Is the service responsive?

The service was responsive. People told us that they were happy with the service. It was clear from observations and from speaking with staff that they had a good understanding of people's care and support needs.

Management and staff were approachable and encouraged people to voice any concerns or ideas for change. People were consulted and were given the opportunity to contribute towards the running of the service. We noted evidence of regular meetings which enabled people to air their views. We saw that regular surveys were undertaken to inform the service of any areas of concern and improvement.

People who used the service were weighed regularly and weight fluctuations were noted and acted upon. We found that food and fluid intake were appropriately logged and that special dietary requirements were respected where needed. People's dietary needs were met

People were supported to attend health appointments, such as, doctors or dentists. We saw records to show that the service worked closely with health and social care professionals to maintain and improve people's health and well-being.

Is the service well-led?

The service was well led. Staff told us that they felt well supported and were given the information they needed to support the people who lived in the service.

The manager took an active role in the running of the home and met with staff and people who lived in the service to listen to what they had to say. We saw minutes of regular staff meetings where changes or issues with peoples' care were discussed. In addition, we saw evidence of meetings with people who used the service to ensure they were consulted and encouraged to contribute their ideas about running the service.

People spoke very positively about the care they received at Chestnut Lodge with comments including 'We are very pleased with the care at Chestnut Lodge. The manager and the staff show compassion and really care about everyone's wellbeing'. Other people told us 'The staff are very good and caring and I have not been worried about anything' and 'Very impressed with the love and attention from all the staff'. People told us that they were treated with respect and that they felt safe in the service. One person told us 'I am assisted with my personal care in the privacy of my own bedroom'. Another said 'I prefer a female carer and my wishes are respected'.

People told us they had been given information about the service before deciding to move in and had an assessment of their needs. We found that the assessments did not always cover all areas of their needs, specifically those relating to their diagnosis of dementia, for example levels of confusion. This meant that the care that was planned for them did not always take account of these needs. Some of the risks to people's wellbeing had not been monitored effectively to ensure that lessons were learnt from incidents such as falls. We found that risk assessments had not been reviewed after a person fall to prevent them falling again which resulted in further hospital admissions.

Staff had received training in dementia, but there was an absence of effective systems for monitoring the delivery of care in the service to ensure the training was put into practice. People would benefit further from relevant research and best practice guidance being implemented in the service.

We found that people were involved in making decisions about their care and were regularly asked for feedback about the service.