Chestnut House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

At our last inspection we rated this key question requires improvement. At this inspection the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The management team investigated incidents and accidents and took actions to reduce the risk of a reoccurrence. A member of staff said, “We do an incident form and body maps which are reviewed by the senior and managers. We put it in the daily notes, and it’s passed on in handover as well.”

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Initial assessments of people’s support needs and preferences were completed. Staff said they were informed verbally of people’s needs before they moved in and were able to read people’s initial care plans.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately. People were protected from harm, abuse and neglect. Staff understood how to recognise the signs of abuse and what to do if they suspected someone was at risk. Where people lacked capacity to make their own decisions, appropriate applications for Deprivation of Liberty Safeguards (DoLS) were made to protect peoples’ rights.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Potential risks were identified, and guidance written to manage these risks. Staff reviewed risk assessments regularly and when people’s care needs changed. People, and their families where appropriate, were involved in 6-monthly reviews of people’s support.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The service had the right equipment to meet people’s care needs and staff knew how to use it, for example using hoists to help people move safely. Equipment was clean and well maintained. The environment met the needs of people living with dementia with appropriate signage and décor. The home required some refurbishment, and a plan of redecoration was in place.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. People, relatives and visiting medical professionals said the staff were knowledgeable. The management team made spot checks and observations of staff practice. Staff meetings and supervisions were used to discuss good staff practices.

The service did not always assess or manage the risk of infection, as a part of the dining room was not clean on the first day of our inspection. They had systems in place to control the risk of infection spreading and shared concerns with appropriate agencies promptly. Cleaning schedules were in place, however, one part of the dining room had not been cleaned thoroughly. This was completed by the second day of the inspection.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. People received their medicines as prescribed, and staff followed best practice for administering medicines. People’s support needs for their medicines were recorded in their care plans.