Archived: Chestnut Court

Updated 16 July 2016

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

On the first day of the inspection, the inspection team consisted of two inspectors and two specialist advisors. On the second day the inspection team consisted of one inspector and one specialist advisor. A specialist advisor is person who has professional experience in caring for people who use this type of service. Before the inspection we looked at the concerns raised and information we already held about this service. This included details of its registration, previous inspections reports and information the provider had sent us. We contacted the host local authority to gain their views about the service.

During the inspection we spoke with 15 people and nine relatives of people who used the service. We spoke with 21 members of staff. This included the registered manager and deputy manager for the service, a senior care assistant, three domestic staff, the chef, maintenance person, five nurses and eight care assistants.

We examined various documents. This included 17 care records relating to people who used the service, 59 medicines records, ten staff files including staff recruitment, training and supervision records, minutes of staff meetings, audits and various policies and procedures including adult safeguarding procedures.

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 to us.

Updated 16 July 2016

Chestnut Court provides 24 hour care, including personal care for up to 62 older people. This includes nursing care for people living with dementia and those with physical needs. The service is a large purpose built property. The accommodation is arranged over three levels. There were 59 people living at the service at the time of our inspection.

The service had a registered manager. 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.

We inspected Chestnut Court on 27 and 28 April 2016. This was an unannounced inspection. At this inspection we found four breaches of the Health and Social Care Act 2008 (regulated activities) Regulations 2014 regarding, medicines management, staffing levels and supporting staff. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

People were not safe at the service. There were poor arrangements for managing medicines and there were not enough staff available to meet people’s needs and keep them safe. Risk assessments did not always cover all areas of risk relating to people to ensure their risks were minimised and managed.

Staff did not always receive up to date training, supervision and appraisal. Staff did not always treat people with respect and dignity. Peoples care plans were not always regularly reviewed. There was a lack of activities at the service for people to take part in. There was poor record keeping and quality monitoring tools used by the service did not identify issues of safety and quality. Staff had mixed views about the staff culture and management team.

People and their relatives told us they felt safe using the service. Staff knew how to report safeguarding concerns. There were effective and up to date systems in place to maintain the safety of the premises and equipment. We found recruitment checks were in place to ensure new staff were suitable to work at the service.

Appropriate applications for Deprivation of Liberty Safeguards had been made and authorised. People using the service had access to healthcare professionals as required to meet their needs.

Staff knew people they were supporting. People using the service and their relatives told us the service was caring. Staff respected people’s privacy and encouraged independence. People and their relatives knew how to make a complaint. The service enabled people to maintain links with their culture and religious practices.