Chestnut Lodge Nursing Home

Updated 9 March 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 Care Act 2014.

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

One inspector carried out this inspection.

Service and service type

Chestnut Lodge Nursing Home 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 Nursing Home is a care home with 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.

We visited the home on 6 February 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 used all this information to plan our inspection.

During the inspection

We spoke with 4 people about their experience of the care provided. We spoke with 5 members of staff including the registered manager, administrator, cook and 2 care staff.

We looked at the care records of 3 people, a sample of medicines records and other records related to the management of the home.

Updated 9 March 2023

About the service

Chestnut Lodge Nursing Home is a residential care home providing personal and nursing care to up to 17 people. At the time of our inspection there were 13 people using the service.

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

The home did not ensure appropriate checks were conducted prior to agency staff being deployed to support people. Choking risks had not been managed safely. Introduction of thickener had not always involved the advice from the Speech & Language Therapy Team (SALT) this placed people at risk of harm. Fire drills had not been conducted in line with the provider’s policy. The issues identified during the inspection had not been recognised or identified by the provider or registered manager. This meant the provider’s quality assurances were ineffective.

Permanent staff were recruited safely. Staffing levels were calculated using a dependency tool which looked at the needs of each person. Staff received supervisions and had the opportunity to speak out.

The provider had a system to investigate and record safeguarding incidents. Staff had completed safeguarding training.

Information gathered accidents and incidents was analysed to identify trends or patterns with actions put in place to minimise risk of further incidents.

The home was clean and tidy. Staff had completed training in infection control and followed protocols to reduce the risk of infection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The registered manager promoted an open culture. The provider and registered manager understood their duty of candour. The home had developed strong partnerships with health and social care professionals to ensure people received joined up care.

People told us they were happy living at the home. People told us staff were kind and caring and response to their needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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 good (published 20 February 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed to 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 Lodge Nursing Home our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, and the assessing and monitoring of the quality and safety of the home.

Please see the action we have told the provider to take at the end of this report.