We carried out a review of the data available to us about Chestnut Court Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Chestnut Court Care Home, you can give feedback on this service.
Chestnut Court Care Home is a residential care home providing personal care to people aged 65 and over. The service can support up to 25 people. When we inspected it was caring for 11 people.
People’s experience of using this service and what we found
People felt safe living at Chestnut Court Care Home, and they were very much at the heart of the service. We received positive feedback from people’s relatives and professionals about the care provided.
Overall, improvements had been made to the management of risks to people and safety monitoring. The provider needed to implement safety measures for the safe management of water and these were already booked in to keep people safe.
There were plans in place for foreseeable emergencies. Staff were able to tell us how to keep people safe.
Relevant recruitment checks were conducted before staff started working at the service to make sure they were of good character and had the necessary skills.
Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. There were enough staff to keep people safe.
Medicines administration records (MARs) confirmed people had received their medicines as prescribed.
Staff received support and one to one sessions or supervision to discuss areas of development. They completed training and felt it supported them in their job role.
People were supported with their nutritional needs. People received varied meals including a choice of fresh food and drinks.
Staff had developed positive and caring relationships with people and their families. Staff were highly motivated and demonstrated a commitment to providing the best quality care to people in a compassionate way.
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.
The provider’s quality assurance system helped the management team implement improvements that would benefit people.
There were appropriate management arrangements in place and relatives were very positive about the management in the home.
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 requires improvement (published 05 May 2020) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
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.
The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Chestnut Court Care Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Chestnut Court Care Home is a residential care home which was providing accommodation and personal care to 17 people at the time of the inspection. The service can support up to 25 people in one adapted building. The service had recently become registered to also provide services to people who have learning disabilities.
People’s experience of using this service and what we found
The registered manager had not ensured that suitable safety checks were in place. Records relating to these appeared from photographic evidence to have been photocopied fabricated to make it appear that checks were taking place when in fact they had not. Audits had not identified these records. This was a breach of regulations.
Some areas of the premises were in a poor state of repair and as a result could present an infection control risk.
Supervision records did not provide assurances that supervision had been delivered in such a way as to provide staff with an opportunity to raise concerns, learn and discuss performance and improve the quality of care. We have made a recommendation about this.
Staff were able to recognise safeguarding concerns and were confident the registered manager would deal appropriately with them. Recruitment was safe and there were sufficient staff deployed to meet people’s needs in a timely way. An electronic medicines system was used to ensure medicines were safely managed.
People’s needs were thoroughly assessed before their admission to the service and the registered manager ensured that current good practice was followed. People were supported to maintain a balanced diet and meals were appetising. Health and social care professionals provided regular support as needed and people and their relatives were happy with the healthcare they received. Staff completed an induction and training.
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.
Staff were friendly and supported people as they wanted to be supported. We saw lots of friendly and appropriate interactions. People were involved as much as possible with care planning and staff encouraged them to maintain their skills and independence. Staff were respectful of people and were discreet when offering support with personal care.
Care support, activities and care plans were person-centred and communication plans ensured that the most effective way of communicating was used with people. Staff were aware of what people liked and disliked and tailored activity sessions accordingly. Complaints had been dealt with in line with the provider’s policy and to the satisfaction of the complainant. End of life care was provided in partnership with healthcare professionals.
Relatives and staff were very positive about the registered manager, who they said was always available to talk and were very supportive. The registered manager tried to engage with the local community, inviting them in for fetes and offering support with shopping during periods of inclement weather.
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 1 August 2017).
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of the full report.
You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The inspection took place on the 08 and 12 June 2017 and was unannounced. Chestnut Court Care Home provides accommodation and support for up to 25 older people including people living with dementia. At the time of our inspection there were 20 people living at the home.
At the last inspection in June 2015, the service was rated Good overall. At this inspection we found that they remained good.
The home had a registered manager who has been registered since January 2017. 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.
People felt safe living at Chestnut Court Care Home and risks to people were minimized through risk assessments. There were plans in place for foreseeable emergencies.
Relevant recruitment checks were conducted before staff started working at Chestnut Court Care Home to make sure they were of good character and had the necessary skills. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. There were enough staff to keep people safe.
People were supported to take their medicines safely from suitably trained staff. People received varied meals including a choice of fresh food and drinks. Staff were aware of people’s likes and dislikes and went out of their way to provide people with what they wanted.
Staff received regular support and one to one sessions or supervision to discuss areas of development. They completed a wide range of training and felt it supported them in their job role. New staff completed an induction programme before being permitted to work unsupervised.
Staff sought consent from people before providing care and support. The ability of people to make decisions was assessed in line with legal requirements to ensure their rights were protected and their liberty was not restricted unlawfully.
People were cared for with kindness, compassion and sensitivity. Care plans provided comprehensive information about how people wished to receive care and support. This helped ensure people received personalised care in a way that met their individual needs.
People were supported and encouraged to make choices and had access to a range of activities. Staff knew what was important to people and encouraged them to be as independent as possible.
The registered manager maintained a high level of communication with people through a range of newsletters and meetings. ‘Residents meetings’ and surveys allowed people to provide feedback, which was used to improve the service.
A complaints procedure was in place. There were appropriate management arrangements in place. Regular audits of the service were carried out to assess and monitor the quality of the service.
We inspected the service on 4 and 8 June 2015. The inspection was unannounced. Chestnut Court Care Home provides care and support for up to 25 older adults, including people living with dementia. On the day of our inspection 22 people were living there. Our previous inspection in June 2013 found the service was meeting all regulations inspected.
There was a registered manager but they had recently left the service. They had yet to apply to be deregistered. 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.
The service had recently gone through a period of transition with the departure of the registered manager and some other established staff.
The owner had taken prompt action to ensure disruptions caused by staff changes were kept to a minimum and to ensure staff were supported .A relief manager was in post and there was a very detailed improvement plan to ensure the quality of the service remained good.
The service had areas it needed to address for example staff needed to ensure they recorded what people had to eat and drink consistently to ensure they were monitoring people’s wellbeing effectively. Where people lacked capacity to consent to aspects of their care and support this needed to be documented more clearly. People needed to be more involved in developing the service.
The relief manager was aware areas needed to be improved upon and had already started work to do so. A new manager was being actively recruited and the service was also advertising for care staff to fill vacancies. In the meantime vacant posts were being filled by agency staff.
The atmosphere throughout the home was friendly, calm and caring. The staff spoke about people in a respectful manner and demonstrated a good understanding of their individual needs.
People said they felt safe and there were appropriate processes in place to protect adults from abuse, to minimise identified risks and to ensure people received their medicines safely. Safe recruitment practices were followed and appropriate checks had been undertaken, which made sure only suitable staff were employed to care for people in the home.
Staff received a range of training and their competencies were assessed to ensure they could meet people’s needs. People received prompt assistance when they needed medical intervention or support as staff liaised with health care professionals appropriately.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which apply to care homes. Where people’s liberty or freedoms were at risk of being restricted, the proper authorisations were in place or had been applied for.
People were confident they could raise concerns or complaints and that these would be dealt with.
There was an open and inclusive culture within the service, with clear values which were understood by staff. There were a range of systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving appropriate support.
Where people had the mental capacity to be involved in making decisions about how they were looked after, their consent had been sought and recorded. Relatives and health professionals had been involved in developing care plans for those people who did not have the mental capacity to be involved in planning their care.
Each person had had their needs assessed and care plans had been developed so that there was a consistent approach for looking after people.
Medication was stored and administered safely. Appropriate records were maintained of medication brought into the home, administered and disposed of.
There were robust recruitment checks carried out to make sure that suitable staff were employed at the home.
There were good systems in place to monitor the quality of service provided.
One relative told us, 'The staff do over and above what they need to do. I am very happy with the way they look my mother'. One person who lived at the home told us, 'I am happy here, the food is good and I get on well with the staff'.
We spoke with two people living at Chestnut Court who were able to tell us what it was like to live at the home. We also spoke of the number of other residents but they were not able to tell us about their experiences owing to their dementia. We therefore used the SOFI observations to help us understand their experience.
We also spoke with three visiting relatives and with two care workers.
We spent the majority of the inspection sitting in communal areas so that we could observe interactions between people.
We found that people were treated with respect and dignity. Their needs had been assessed and care plans put in place to support people. Their health and welfare needs were appropriately met by a competent and well trained staff team. We found that the home had good systems in place to make sure that the home run efficiently with good outcomes for people.