Chestnut Lodge Care Home

Updated 6 April 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

This inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Chestnut Lodge 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 lodge is a care home without 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.

Inspection activity started on 2 March 2023 and ended on 7 March 2023. We visited the location’s office/service on 2 March 2023.

What we did before the 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 reviewed feedback we had received about the service. We used all this information to plan our inspection.

During the inspection

We spoke with 2 people who used the service and 9 relatives about their experience of the care provided. We met with the registered manager, deputy manager, 3 ancillary staff and spoke with 4 care workers. We looked at written records, which included 11 people's care records and 3 staff files. A variety of records relating to the management of the service were reviewed.

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.

Updated 6 April 2023

About the service

Chestnut Lodge Care Home is registered to provide accommodation and personal care for 60 older people and people living with dementia. There were 57 people living in the service at the time of our inspection visit.

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

Risks to people were not well managed. We found where people had known health conditions such as diabetes, risk assessments were not robust enough to give staff the information they required. Risk assessments were not always up to date and reflect a person’s current needs.

People had medicines prescribed as and when they were required ‘PRN’ however, it was not clear these had been effective. Appropriate recording was not carried out to identify why these medicines were given and if they had the desired effect. PRN protocols were not in place for all medicines.

Lessons were not always learnt when things went wrong. Audits were carried out on accident and incidents that occurred however, patterns and trends were not looked at to try and reduce falls.

The management team were responsive to the concerns highlighted to them on the inspection and acted quickly to rectify shortfalls found.

Staff were recruited safely. Some feedback we received highlighted that at times the service can appear busy especially the sound of the call bells. A dependency tool was used to assess how many staff were required to look after people safely. However, the registered manager identified where some improvements could be made to make the tool more effective.

People and relatives told us they felt safe using the service. Staff knew how to recognise signs of abuse and knew where to report any concerns. The registered manager referred concerns to the local authority safeguarding team.

Infection control procedures were followed in the service. We observed regular cleaning being carried out and relatives felt the home was clean when they visited.

There was a positive culture within the service and people, staff and the relatives spoke highly of the management team. Staff felt the manager was approachable and always had their door open if they had concerns.

Quality assurance audits were being carried out and some improvements have been made since our inspection to ensure a more effective oversight at the service. Actions were taken to make changes to the call bell system after feedback about the noise for people. People, relatives were encouraged to feedback about the service through questionnaires and meetings. This encouraged the management team to make changes where necessary.

The registered manager was clear about their roles and responsibilities. Notifications were sent into the care quality commission in line with regulations. The service was open and transparent and followed the duty of candour when things went wrong.

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 27 January 2020)

At our last inspection we recommended that the provider consult national guidance about the safe administration of medicines, due to medicines not being given as prescribed. At this inspection we found medicines were being administered according to prescription guidelines. Improvements were made and medicine errors were not occurring as they were.

Why we inspected

We received concerns in relation to staffing levels and people’s care needs. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.