We last inspected this service on 18 September 2013. At that time we found that the registered person had not managed medicines safely and that records relating to peoples care were not adequate. During that inspection we also found that there were not always adequate facilities for people to wash or bathe. We also found that the provider did not have an effective system to regularly assess and monitor the quality of the service. At this inspection we found that these issues had been adequately addressed.Chesterwood is home to five people with acquired brain injury. There were four people at home on the day of our inspection. We observed people during the day. People had limited verbal communication but could verbally express their choices and preferences. We talked with the manager and looked in detail at the care records of two people. We visited on a weekday and we spoke with two people, three members of staff and one senior manager. Below is a summary of what we found.
The summary describes the records we looked at and what relatives and staff told us.
Is the service safe?
The staff and manager had a good understanding of safeguarding and whistle blowing policies. Staff understood their role in safeguarding the people they supported. We saw people were cared for in an environment that was safe and clean. There were enough staff on duty to meet the needs of people who lived at the home. There were procedures in place to safeguard people from abuse.
The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We saw that proper policies and procedures were in place. The manager had an understanding of these safeguards which ensured people's rights and choices were protected.
Risk assessments and health and safety measures were in place to keep people safe. A member of staff told us, 'Everything is brilliant here. I love this home.'
Is the service effective?
Care plans specified people's individual needs, for example, a person's mobility, or food requirements. One member of staff told us, 'The manager is quite supportive. They really helped me, and you can talk to him.' The service worked well with other agencies and services to make sure people received their care safely and effectively.
We saw that people were treated with dignity and care. We saw that people were involved in the running of the home and took an active part in shopping and cooking and cleaning where possible.
Is the service caring?
We saw the staff and manager were patient and gave encouragement when they supported people. All staff were aware of peoples choices, preferences and support needs. We found the care and support was delivered with respect. One person told us, 'This is an OK place. It's quite a nice place. The food is well organised.' A member of staff told us, 'I think people are well looked after here, people aren't withdrawn and they choose what's in their room and their meals.'
Is the service responsive?
We saw clear and detailed recording that ensured the manager could make timely and informed decisions about a person's care and support. Records showed that other professionals had been involved in peoples care and support when needed. We saw that information from health professionals was acted upon and integrated into care plans. The home operated a key worker system. The manager told us the aim of the keyworker role was to ensure detailed information was collected for each person and made available to all staff. One member of staff told us, 'The managers are helpful and we have a good back up system with the other homes. We get the information we need.'
Is the service well-led?
The manager was aware of their responsibilities in meeting the essential standards of quality and safety. There were systems in place to ensure the quality of the service was regularly assessed and monitored. There was a clear structure of supervision responsibilities within the staff team. Staff had regular training and learning opportunities.
Staff we spoke with told us they thought the manager was approachable and provided good support. We saw that the manager was responding to recent changes in relation to the law and the possibility of depriving a person of their liberty.