Chestfield House

Updated 5 January 2023

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.

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 completed by one inspector.

Service and service type

Chestfield House 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. Chestfield House 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 used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with four people and two relatives about their experience of the service. We observed staff interactions with people in the communal areas. We spoke with five members of staff including the registered manager, nominated individual, nurse and care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included four people’s care plans and all the medication records. A variety of records relating to the management of the service, including checks and audits.

Updated 5 January 2023

About the service

Chestfield House is a residential care home providing personal and nursing care to up to 32 older people who may be living with dementia. At the time of our inspection there were 27 people living in one large adapted building.

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

People told us they felt safe living at the service and staff treated them with kindness and respect. However, potential risks to people’s health and welfare had not been consistently assessed and there was limited guidance for staff about how to mitigate the risks.

Medicines had not always been managed safely, records were not always accurate. Staff had been recruited safely but improvements were required to the documentation used such as references. Checks and audits had been completed by the registered manager and staff, but these had not been effective at identifying the shortfalls found at this inspection.

Staff were following current infection control guidance, and visitors were encouraged to visit people. The registered manager and staff understood their responsibility to protect people from discrimination and abuse.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People, relatives and staff were asked their opinions on the quality of the service and action was taken when suggestions were made. Relatives told us they were confident to raise concerns with the registered manager and they would take appropriate action.

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

Rating at last inspection

The last rating for this service was good (published 3 November 2017).

At our last inspection we recommended that the provider included checks on specific areas in the audits to drive improvements and deliver a consistent quality of care. At this inspection we found the areas identified had been included in the audits.

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

We 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 COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to risk management, medicines and governance at this inspection. Please see the action we have told the provider to take at the end of this report.

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.