CQC report explained · a nursing home
What the CQC found at Chestnut Court Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2022
Chestnut Court Care Home was rated Good overall, with safe and well-led care but staffing and medicines issues that inspectors addressed.
This was an unannounced inspection on 12 and 17 May 2022. An inspector and an Expert by Experience spoke with people, relatives and staff. They observed care and checked care records, medicines records, recruitment files and records about running the home.
The home was rated Good overall. Safe and Well-led were both rated Good. Inspectors found safeguarding systems, suitable recruitment checks, safety checks, infection control measures and medicines systems. They also found that people could access health professionals.
There were concerns about staffing on the top floor, two missing diabetes risk assessments and isolated medicines errors. The staffing issue was acted on between the two inspection visits. The inspection was prompted partly by a concern about delayed medical referrals. That earlier allegation was substantiated, but inspectors found steps had been taken to reduce the chance of it happening again.
Effective was inspected but not rated because the whole question was not reviewed. Its previous rating was Good. The report does not give ratings for Caring or Responsive.
Safeguarding systems
The home had procedures for reporting abuse, and staff had safeguarding training. Records showed allegations had been handled according to those procedures.
“Systems were in place to safeguard people from the risk of abuse.” from the report
Infection control
Inspectors were assured about visitor safety, admissions, protective equipment, testing, hygiene and outbreak arrangements.
“We were assured that the provider was using PPE effectively and safely.” from the report
Access to health care
Records showed access to several types of health professional. A visiting health professional also said staff sought appropriate help when needed.
“Records showed people had access to a variety of medical professionals, including GPs, Tissue Viability Nurses and speech and language therapists.” from the report
Quality monitoring
The home used audits, clinical indicators and action plans to look for problems and track improvements.
“The provider had various quality assurance and monitoring systems in place to help drive improvements.” from the report
Open culture
People, relatives and staff described communication and the culture positively. Inspectors saw person-centred risk assessments and systems for responding when things went wrong.
“The provider promoted a positive culture that was person centred and open.” from the report
Staffing on the top floor
seriousPeople's relatives and staff said there were not enough staff on the top floor, particularly during the busy morning period. The home added a care worker for these hours and a floating staff member between two floors during the inspection.
“I would say definitely no (there were not enough staff to keep people safe).” from the report
Missed medicine recorded as given
seriousInspectors found one medicine had not been given but had been recorded as given. The nurse followed the home's procedure, including seeking advice from the GP and reporting it.
“We found one instance where a medicine had not been given but was recorded as been given, on the evening before our inspection.” from the report
Missing diabetes risk assessments
needs fixingTwo people on the second floor did not have diabetes management risk assessments when inspectors checked. These were put in place by the end of the inspection.
“We found on the second-floor, risk assessments were not in place for diabetes management for two people.” from the report
Earlier delayed medical attention
seriousA safeguarding allegation about medical attention not being sought quickly enough in November 2021 was substantiated. The home then raised the issue with staff and introduced a daily meeting to discuss clinical risks and possible referrals.
“A safeguarding allegation was raised with the local authority relating to the service not seeking medical attention for a person in a timely manner in November 2021.” from the report
PRN medicine guidance
needs fixingOne person's instructions for an as-required medicine were missing. Staff created the protocol during the inspection.
“We found some isolated errors with the management of medicines.” from the report
- 01What staffing levels are now in place on the top floor, especially during the morning personal-care period?
- 02How do you check that diabetes risk assessments are present and kept up to date for everyone who needs one?
- 03What checks prevent a medicine being missed or recorded as given when it was not given?
- 04How do the daily clinical meetings make sure people are referred to health professionals promptly?
- 05What actions from your audits are still open, and how do you check that they have been completed?
This was an unannounced focused inspection mainly of Safe and Well-led, with part of Effective examined; Effective was not rated and the report does not give Caring or Responsive findings. This explanation was written from the published report of 11 June 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, September 2020
Inspected but not rated; inspectors found good infection prevention and control arrangements during the coronavirus pandemic.
This was an announced, targeted inspection on 18 August 2020. It looked only at infection prevention and control measures as part of a national coronavirus review.
Inspectors found that visitors were screened for symptoms and recent contact, given masks and had their temperature checked. They were assured that the home was using protective equipment safely, following distancing and shielding rules, and keeping its infection control policy up to date.
The home had experienced a coronavirus outbreak in March. An 11-bed isolation zone, protected nursing arrangements and staff testing were used to contain the outbreak. People were also supported to keep in touch with relatives and other people in the home.
The service was inspected but not rated. This means the report does not give a Good, Requires improvement or Inadequate rating for the home overall.
Visitor infection checks
Visitors were screened for symptoms and recent contact, given masks and had their temperature checked before entering.
“These practices helped to ensure the risk of transmission in the service was reduced.” from the report
Outbreak control
The home created an isolation zone and used protected nursing arrangements to help contain its coronavirus outbreak.
“The management team and staff worked together and received support from external professionals to ensure the virus was contained within the zone and did not spread through the service.” from the report
Keeping people connected
People were supported to contact relatives and use technology during quarantine. Small social groups and activities were introduced gradually.
“People were supported to avoid social isolation and loneliness as much as possible.” from the report
Testing arrangements
Staff and people using the service were tested, with consent obtained or best-interest decisions made where needed.
“The provider carried out full testing of all staff for Covid-19.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you currently screen visitors and provide protective equipment when there is an infection risk?
- 02What would happen if someone living here developed symptoms or tested positive, and is there still a separate area for isolation?
- 03How do you test people and staff during an outbreak, and how do you obtain consent where someone cannot provide it?
- 04How do you help residents keep in touch with relatives and avoid loneliness during quarantine or visiting restrictions?
This was a targeted inspection of infection prevention and control only; the service was inspected but not rated and the other areas of care were not assessed. This explanation was written from the published report of 10 September 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Chestnut Court Care Home
2 rated inspections over 4 years: the service has held its Good rating throughout.
- June 2022Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2020Inspected but not ratedSafe: Inspected but not rated
- October 2018GoodSafe: GoodWell-led: Good
- November 2016
Registered with the Care Quality Commission on 23 November 2016.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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