Chestnut House

Updated 5 March 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of COVID-19, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice is safe and that services are compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 23 February 2022 and was announced. We gave the service 24 hours’ notice of the inspection.

Updated 5 March 2022

Chestnut House is a large, extended residential care home providing personal care to 13 people aged 65 and over at the time of the inspection. The service can support up to 19 people.

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

Improvements had been made since the last inspection for ‘as required’ medicine care plans to help ensure they were given to people safely, however the recording of some aspects of medication administration needed to be more consistent.

People were protected from the risk of infection. Staff wore personal protective equipment correctly and ensured people were socially distanced in communal areas of the home. Furniture had been rearranged to help with this. Risks to people were documented and risk assessments were personal to people. Monthly reviews of risk assessments did not always take into account incidents that had occurred that might elevate the risk.

People were protected from abuse. Relatives were complimentary about the home as management kept them updated and informed. Staff were happy working at the home and felt people living there were happy too. Staff were positive about the recent management changes and the improvements made to the service.

Audit processes were more effective in relation to 'as required' medicines, fire safety and care plan audits. These needed to be fully embedded and sustained. Medicine audits however had not identified the lack of consistency in the recording of some aspects of medicines administration, such as thickened fluids and the application of creams and pain patches. Some weekly safety checks had also slipped due to the absence of the maintenance person. Contingency measures were adopted by the service.

There was no registered manager at the time of this inspection. A registered manager from a sister home was providing oversight and management of the home, although was absent at the time of this inspection. They planned to submit an application to be the registered manager of Chestnut House. An area manager supported the interim manager and was at the home during this inspection.

Management had made changes to improve the quality and safety of the service. For example, improvements had been made to fire safety, the environment and standards of cleanliness.

Staff praised the support they received from the management team and said they were confident in their leadership. A relative told us, “This is a really nice place that is well run. I wouldn’t change anything. The atmosphere is alright.”

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 24 December 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 4 and 5 December 2020. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance.

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 Safe and Well-led key questions which contain those requirements. We have found evidence that the provider needs to make improvements. We found no evidence during this inspection that people were at risk of harm from this concern. You can see what action we have asked the provider to take at the end of this full report.

We also 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 coronavirus and other infection outbreaks effectively.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has not changed as this remains requires improvement. 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 House on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We have identified a breach in relation to management of the service. We will continue to monitor the service.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.