CQC report explained · a residential care home
What the CQC found at Chestnut Court Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm, with enough staff, suitable recruitment checks, safeguarding training and medicines records showing medicines were given as prescribed. Inspectors still found water management concerns, incomplete cleaning records and worn furniture that needed action.
- Effective?
- Good
- People received support with food, drink, healthcare and consent. Staff had training and supervision, and redecoration had started, although parts of the building had appeared shabby.
- Caring?
- Good
- This question was not inspected during this focused visit. The report says no areas of concern were identified in the other key questions.
- Responsive?
- Good
- This question was not inspected during this focused visit. The report says no areas of concern were identified in the other key questions.
- Well-led?
- Good
- Management systems had improved, maintenance records were of a good standard and relatives and staff were positive about the management. Quality checks were in place for care records and medicines.
What inspectors found, April 2021
Rated Good; inspectors found safer, caring support and better management, but some water safety and cleaning issues still needed action.
This was a focused inspection on 11 and 16 February 2021. One inspector reviewed records, observed care and medicines, spoke with staff and managers, and gathered views from relatives, staff and health professionals. Infection control measures were also checked.
The home was rated Good overall. Safe, Effective and Well-led were each rated Good. Inspectors found enough staff, safe medicines systems, trained staff, good healthcare support and positive relationships with people and their families.
The home had improved from Requires Improvement at the previous inspection in May 2020. The two earlier breaches had been addressed, so the home was no longer in breach of regulations. However, inspectors found that water safety work, some cleaning records and replacement of worn furniture still needed attention.
Caring and Responsive were not inspected during this visit. The report says there were no areas of concern identified in those questions, so earlier ratings were used in the overall rating.
Enough staff
Inspectors found enough staff to meet people's needs. Staff were not rushed and responded promptly and compassionately.
“There were sufficient staff to meet people's care needs. We observed that staff were not rushed and responded promptly and compassionately to people's requests for support.” from the report
Safe medicines
The electronic medicines system kept stock and administration records. Staff were trained and checked as competent before giving medicines.
“Medicine administration records (MARs) confirmed people had received their medicines as prescribed.” from the report
Kind relationships
Inspectors saw positive and caring relationships between staff and people. Relatives and health professionals also gave positive feedback.
“Staff had developed positive and caring relationships with people and their families.” from the report
Good healthcare support
People were supported to see doctors, nurses and other health professionals when needed. Families were kept informed about significant changes in health.
“People were supported to access healthcare services when needed. Records showed people were seen regularly by doctors, district nurses and chiropodists.” from the report
Improvements after the last inspection
The home had addressed the two previous regulatory breaches and improved its Safe, Effective and Well-led ratings from Requires Improvement to Good.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Water safety work
seriousA new water risk assessment found concerns requiring immediate action. Work was booked, but the report was written before inspectors could confirm it had been completed.
“The report highlighted areas of concerns which needed immediate action to be taken to keep people safe.” from the report
Emergency planning
needs fixingThe business continuity plan covered several emergencies but did not include a plan for another COVID-19 outbreak.
“However, this had not been updated to include a contingency plan in case of another COVID-19 outbreak in the home.” from the report
Cleaning records
needs fixingThe home looked clean, but some daily cleaning records were incomplete, so the home could not show that cleaning had taken place on every day.
“However, not all days were filled in, so the service couldn't evidence if cleaning had taken place that day.” from the report
Worn furniture
needs fixingSome chairs and over-bed tables were worn and could not have been cleaned properly. Replacements had been ordered during the inspection.
“We observed some chairs and over bed tables were worn and could be an infection control risk as it would not have been possible to clean them properly.” from the report
Building condition
minorRedecoration had started and a plan was provided for further work. A health professional still described the décor as shabby, although the home was clean.
“It can appear shabby in décor, but this is beyond the control of the local team and should perhaps be considered by the owners.” from the report
- 01Has all the work identified in the water risk assessment been completed, and has the required water management training taken place?
- 02Has the business continuity plan been updated to cover another COVID-19 outbreak?
- 03Are daily cleaning records now completed and checked every day?
- 04Have the worn chairs and over-bed tables been replaced?
- 05What are the current ratings and most recent findings for Caring and Responsive, which were not inspected during this visit?
This was a focused inspection of Safe, Effective and Well-led, with infection control also checked; Caring and Responsive were not inspected and their previous ratings were used in the overall rating. This explanation was written from the published report of 15 April 2021 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, May 2020
Requires Improvement; inspectors found kind, responsive care but serious failures in safety checks and record keeping.
This was an unannounced planned inspection on 26 February and 3 March 2020. One inspector spoke with people, relatives and staff, and reviewed care, medicines, recruitment and management records.
The home was caring and responsive. People were treated kindly, involved in choices and supported with personalised care, activities and communication. Staff were recruited safely, staffing levels met people's needs, and medicines were managed using an electronic system.
However, safety checks for water temperatures, call bells, pressure mats and sensors had been copied and altered to look complete. Some parts of the building and kitchen also needed cleaning or repair. Staff supervision records did not show that supervision was giving staff enough opportunity to raise concerns and improve care.
The overall rating was Requires Improvement. Safe, effective and well-led were Requires Improvement, while caring and responsive were Good. The previous overall rating was Good, published on 1 August 2017.
Kind and respectful staff
Inspectors saw friendly, appropriate interactions. Staff knew people well, respected their choices and supported their independence.
“We saw staff having respectful, friendly and appropriate chats with people.” from the report
Personalised care
Care plans included people's life histories, communication needs and preferences. People could choose how they were supported wherever possible.
“People's needs were met in their chosen way whenever possible.” from the report
Activities and social contact
Activities took place every day and were flexible. Staff also visited people in their rooms to chat or read with them.
“Activities were run on a daily basis, including weekends.” from the report
Safe medicines systems
Medicines were stored securely and staff were trained and checked for competence. Inspectors found the electronic records and medicine stocks were accurate.
“The system maintained an accurate running total of medicines stock and of medicine administration.” from the report
Staffing and recruitment
The home completed the necessary recruitment checks and had enough staff to meet people's needs promptly.
“There were sufficient staff deployed to meet people's needs and provide support in a timely way.” from the report
Safety checks were falsified
seriousRecords for water temperatures, call bells, pressure mats and movement sensors had been copied with dates changed. This meant inspectors could not confirm that these checks had taken place.
“We found that these records for an eight-week period were photocopies of previous records with only the dates changed.” from the report
Poor repairs and cleanliness
needs fixingSome flooring, doorways, door frames and skirting boards needed repair or cleaning. Inspectors said some areas could harbour infection, and there were hygiene problems in the kitchen.
“Some areas of the premises needed to be repaired as in their current state there was a risk they could harbour infection.” from the report
Weak staff supervision records
needs fixingRecords did not show that supervision gave staff a proper opportunity to raise concerns, discuss performance or improve care. CQC made a recommendation about this.
“These did not provide assurances that the supervision provided had been designed to provide staff with an opportunity to raise concerns” from the report
Management checks did not identify problems
seriousThe provider's audits did not detect the inaccurate safety records. This led to a breach of the good governance regulation.
“The provider and registered manager failed to ensure that records were maintained accurately and audits of records did not detect the concerns we found.” from the report
- 01What has been done to ensure water temperature, call bell, pressure mat and sensor checks are completed at the time they are supposed to be?
- 02How do managers now check that safety records are accurate and that audits identify problems quickly?
- 03Have all the flooring, doorways, door frames and skirting board repairs identified by inspectors been completed?
- 04What changes have been made to staff supervision so staff can raise concerns, discuss performance and improve care?
- 05How are kitchen cleaning and food storage checks monitored now?
This was an unannounced planned inspection that assessed all five CQC questions, with the safe, effective and well-led ratings falling from Good and caring and responsive remaining Good. This explanation was written from the published report of 5 May 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
4 rated inspections over 6 years: the service has held its Good rating throughout.
- April 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- August 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 6 January 2011.
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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