The inspection was carried out by one inspector. We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive to people's needs?
Is the service well-led?
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, staff supporting them and from looking at records.
Is the service safe?
We found people were treated with respect and dignity by staff. People told us they felt safe. One person who used the service told us; "I like it here, the staff go out of their way to help you."
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards. The Deprivation of Liberty Safeguards (DoLS) are part of the Mental Capacity Act 2005 (MCA). The aim is to make sure people in care homes and hospitals are looked after in a way which does not restrict their freedom inappropriately. There were no authorisations restricting the freedom of anyone living at the home at the time we visited. Members of staff had received training about the Mental Capacity Act and Deprivation of Liberty Safeguards so they understood when an application should be made and how to submit one. The home had appropriate policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards.
Training was in place to protect the people who lived at The Chestnuts Care Home such as moving and handling, safeguarding adults and first aid. We saw training records and certificates which showed staff had received training to enable them to meet the needs of the people who used the service. This meant the people who used the service were supported by staff who had the necessary skills and experience.
Is the service effective?
From speaking with people who used the service or their relatives, it was clear people's health and care needs were assessed with them. Assessments had taken place prior to someone being admitted into the home. The assessments formed the basis of the care plan. We found people were involved in writing their plans of care. People also told us they had been consulted during reviews about the changing needs of their relatives who received care. Care plans were reviewed regularly and when people's needs changed.
Family members we spoke with said they were kept informed about their relative's care. They also told us that if they had any concerns they were comfortable with talking to the staff team. People we spoke with told us they were happy with the care they received and said their needs were met. They spoke positively about the care they received and the staff who supported them. From what we saw and from speaking with staff it was clear they had a good understanding of the care and support needs of the people who used the service.
Specialist dietary, mobility and equipment needs had been identified in care plans where required.
Visitors confirmed they were able to see people in private and visiting times were flexible.
Is the service caring?
People were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people. People commented, "Staff are good and all very caring." People we spoke with told us they liked living at the home. Comments included "I like living here."
We observed during our visit that people were treated with respect by the staff team whilst they carried out people's daily care. People told us staff respected their privacy and dignity. Observations during the visit showed staff and people who lived at the home were comfortable in each other's company. During the day we saw some positive interactions taking place and staff responding in a kind manner to people who lived at the home.
People's preferences, interests, aspirations and diverse needs were recorded, and it was clear care and support had been provided in accordance with people's wishes.
Is the service responsive?
People's needs had been assessed before they moved into the home. The records we saw confirmed people's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. People had access to activities which were important to them and had been supported to maintain relationships with their friends and relatives.
We saw risk assessments and care plans were in place that reflected the person's care needs to ensure they received appropriate care. The care plans contained information from GPs, district nurses and other health care professional's visits such as dieticians.
Is the service well-led?
We were told by people and families who used the service and the staff team if they had any concerns about the care being provided they would inform the manager. No one we spoke with had ever made a complaint. There was a complaints policy and procedure available.
The service worked well with other agencies and services to make sure people received their care in a joined up way.
From speaking with staff we found they had a good understanding of the home's values. They told us about their roles and responsibilities and they were clear about these. We saw quality assurance processes were in place to make sure the provider monitored the care provided and made improvements where necessary.