Archived: Chestnuts Residential Home

Chestnuts Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service is owned and operated by Chestnuts Bargate Ltd.

Chestnuts Residential Home is in Grimsby and located close to the town centre. It accommodates a maximum of 26 people in one building, with rooms spread over three floors. At the time of the inspection 25 people were using the service. Some of the people who lived at the home were living with a dementia. Communal areas include a dining area, conservatory and a lounge with access to a secure garden. Toilet and bathroom facilities are located on all three floors. There are two shared bedrooms and the other bedrooms are single rooms, with some having access to an ensuite.

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

During this inspection we found three breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014. These breaches related to Regulation 12 (Safe care and treatment); Regulation 15 (Premises); Regulation 17 (Good Governance). We also found one breach of the Health and Social Care Act (Registration) Regulations 2014; Regulation 18 (Notifications). This was because registered persons had failed to notify us of events which they are legally required to do. You can see what action we have told the provider to take at the back of the full version of this report.

Areas of the service had strong odours and were not clean and hygienic, which placed people at risk of developing infections. Some items of furniture, linen and carpets were not fit for purpose and needed replacing. Not all aspects of the environment met best practice guidance relating to supportive environments for people living with dementia. You can see what action we have told the provider to take at the back of this report.

There was a quality monitoring system in place, however it did not identify the problems we found with the environment. Where quality shortfalls were identified, action plans were not implemented to resolve the problems.

People and their relatives felt the service was safe. Staff could recognise signs of abuse and followed procedures to report concerns. Accidents and incidents were monitored and analysed to reduce the risk of them reoccurring. Staff told us, they felt more staff were needed to meet people’s needs. The registered manager often provided care to people to support the staff. We made a recommendation in relation to staffing levels.

People’s needs were assessed before they moved into the service and reviewed regularly to capture any changes to their health and wellbeing. People were supported to have healthier lives through timely access to healthcare services. Staff worked closely with various agencies and followed professional advice. Staff had the skills and knowledge to support people. People were supported to eat and drink enough and had a balanced diet, including those people who required specialised diets.

Medicines were stored securely and people received their medication as prescribed. Protocols were not in place to support staff when administering ‘when required’ medicines. We have made a recommendation about this.

People were supported to have maximum choice and control of their lives. Staff had good knowledge of the Mental Capacity Act 2005 and supported people the least restrictive way. The policies and procedures supported this practice. Some people were deprived of their liberty and authorisations had been sought in line with Deprivation of Liberty Safeguards (DoLS).

Staff were kind and caring towards people. We observed positive interactions between staff and people. People were supported in a respectful and dignified manner until the end of their lives. Staff had explored people’s end of life wishes and plans were in place to ensure people had a pain free death.

Relatives and staff told us there was lots of activities going on within the service. Staff communicated with people in the way they understood. A complaints procedure was in place, though no complaints had been received.

This is the first time the service has been rated Requires Improvement.