This inspection took place on the 23 August 2016 and was unannounced. At our last inspection carried out on 19 March 2015 the provider was not meeting the requirements of the law in relation to safeguarding service users from abuse and improper treatment, safe care and treatment, good governance and notification of incidents.
Following that inspection the provider sent us an action plan to tell us the improvements they were going to make.
During this inspection we looked to see if these improvements had been made. We found that they had.
The Chestnuts provides care and support for up to 14 people who have mental health needs, learning difficulties or autistic spectrum disorders. On the day of our inspection there were nine people living at the service.
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.
People who were able to talk with us told us they felt safe living at The Chestnuts. Relatives we spoke with agreed. The staff members we spoke with had received training in the safeguarding of adults and knew what to do if they were concerned that someone was at risk of harm.
Risks associated with people’s care and support had been assessed when they had first moved into the service. These assessments provided the registered manager with the opportunity to properly manage the risks presented to both the people using the service and the staff team.
People’s care and support needs had been identified before they had moved into the service. This was so that the registered manager could be sure that their individual needs could be met. From the initial checks, plans of care had been developed. These plans provided the staff team with the information they needed in order to support the people using the service in a way they preferred.
Checks had been carried out when new members of the staff team had started work. This was to check that they were suitable to work at the service. An induction into the service had been provided for all new staff members and ongoing training was being delivered. This provided the staff team with the knowledge they needed in order to meet the needs of those in their care.
We asked the people using the service if they felt that there were enough staff on duty to meet their needs. Whilst the majority of the people thought there were, some felt that more staff would enable them to get out more. The registered manager told us that they would monitor the staffing levels so that appropriate numbers of staff were deployed on each shift.
People received their medicines as prescribed and in a safe way. Medicines were being appropriately stored and the necessary records were being kept, though there were minor inconsistencies when recording if a person had been assisted with the application of their cream.
People's nutritional and dietary requirements had been assessed. People had been fully involved in the development of the menus that were in place and these catered for their individual needs and preferences.
People were supported to maintain good health. They had access to relevant healthcare services such as doctors, dentists and opticians and they received ongoing healthcare support.
The staff team involved people in making day to day decisions about their care and support and understood their responsibilities within the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards.
The people using the service told us that the staff team knew them well and knew what help and support they needed. They told us that they were friendly and caring and observations during our visit confirmed this.
Meetings for the people using the service and for the staff team had been held. Monthly newsletters had also been developed and distributed to the people using the service and their families. These ways of communication enabled people to be involved in how the service was run.
Staff members we spoke with felt supported by the registered manager. They told us that they had the opportunity to meet with them on a one to one basis to discuss their progress. They also told us that there was always someone available for support and advice should they need it.
People using the service knew what to do if they were worried about anything. A formal complaints process was in place and people were regularly reminded of this so that they could be supported if they needed to use it.
There were systems in place to monitor the quality and safety of the service being provided. Regular audits on the documentation held had been completed. Regular checks on the environment and on the equipment used to maintain people's safety had been carried out. A business continuity plan was available for the staff team to follow in the event of an emergency or untoward event.