CQC report explained · a residential care home
What the CQC found at Chestnut House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found appropriate risk assessments, safety checks, staffing and medicines systems.
- Effective?
- Good
- People's needs were assessed before they moved in, and staff had suitable skills and training. People received healthy food and support to access healthcare.
- Caring?
- Good
- Staff treated people with dignity and respect. They promoted independence, choice and involvement in decisions about care.
- Responsive?
- Good
- Care was personalised and reviewed regularly. People were supported with communication, relationships, activities and access to the local community.
- Well-led?
- Good
- The home had registered management, regular audits and a service improvement plan. People, relatives, staff and professionals spoke highly of the leadership.
What inspectors found, April 2020
Chestnut House was rated Good; inspectors found safe, kind and person-centred care, with more detail needed in end-of-life care plans.
This was a planned inspection over two visits in December 2019 and January 2020. One inspector spoke with people living at the home, staff, management and visiting professionals. The inspection also included care, medicines, staff and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were safe, supported by trained staff, involved in their care and encouraged to be independent.
The home offered personalised support, activities and access to the community. People had their communication needs considered, and relatives and professionals gave positive feedback about the care and management.
The only shortfall highlighted was that end-of-life care plans contained only basic information. No one was receiving end-of-life care at the time, and the manager agreed to review this.
Personalised support
Support was planned around each person's wishes, interests and goals. People were encouraged to make choices and become more independent.
“People living at the home received planned and co-ordinated person-centred support that was appropriate and inclusive for them.” from the report
Safety and risk management
Inspectors found detailed individual risk assessments, regular building checks and suitable staffing. Medicines were managed safely and incidents were reviewed for learning.
“People's care plans included detailed and appropriate individual risk assessments with emphasis placed upon supporting people to be as independent as possible whilst supporting people to remain safe.” from the report
Kind and respectful care
Staff promoted dignity, privacy and independence. People and relatives were involved in decisions about care.
“People received care and support which was a direct reflection of the provider's own vision statement which included, 'Our vision is a world where people with a learning disability are valued equally, listened to and included.'” from the report
Activities and relationships
People were supported to maintain important relationships and take part in social and physical activities, including activities in the community.
“Emphasis was placed upon people having access to a host of activities including both social and physical activities.” from the report
Strong leadership
The manager used audits, feedback and an improvement plan to develop the service. Staff said they felt listened to and valued.
“The registered manager used a wide range of information, feedback and audit outcomes to drive continuous improvement within the service.” from the report
End-of-life planning
needs fixingCare plans contained only basic information about people's end-of-life wishes. The manager agreed to review this so that more information could be recorded where possible.
“Care plans included basic information regarding people's end of life care.” from the report
- 01What changes have been made to end-of-life care plans since the inspection?
- 02How will my relative and our family be involved in creating and reviewing the care plan?
- 03How are risk assessments updated when a person's needs or independence change?
- 04What activities and community opportunities would be available for my relative?
- 05How would staff support my relative's communication needs and personal choices?
This planned inspection looked at the care home, its premises and care, and rated all five CQC questions; the previous inspection in 2017 was also rated Good. This explanation was written from the published report of 1 April 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.
What inspectors found, May 2017
Chestnut House was rated Good; inspectors found safe, kind and personalised care, with some records and nutrition checks needing attention.
This was a comprehensive, announced inspection on 16 March 2017. The inspector reviewed care, medicines, staff and management records, spoke with all six people living there, spoke with staff and observed interactions.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe recruitment, suitable risk assessments, correct medicines records and caring relationships.
Care plans were personal and regularly reviewed. People were supported to make choices, stay healthy, use community facilities and take part in activities. Inspectors also found that some best-interest decisions were not always recorded in writing, and nutritional screening was not being done at the time.
Safe medicines and staffing
Inspectors found that medicines were administered by trained staff and records checked were complete. Staffing levels were judged sufficient to meet people's needs.
“Medicine administration records (MAR's) that we looked at were completed correctly with no gaps or anomalies.” from the report
Kind and respectful care
Staff were patient, friendly and discreet. They supported people's privacy, independence, choices and preferred ways of communicating.
“Observations throughout the inspection showed staff were caring and respected people's privacy.” from the report
Personalised support
Care plans included detailed information about people's preferences and routines. People were involved in planning their care and making decisions.
“We saw people's needs had been individually assessed and plans of care drawn up.” from the report
Activities and community life
People were supported to go out, develop skills, maintain relationships and take part in activities that mattered to them.
“People were supported to access activities in the community, which included visits to shopping centres, cafés, social clubs and the local church.” from the report
Quality monitoring
The manager and senior staff carried out checks on areas such as medicines, care planning and health and safety. Staff and people had opportunities to share their views.
“The registered manager and other senior staff carried out a number of quality assurance checks” from the report
Best-interest decisions were not always recorded
needs fixingStaff said best-interest decisions had been made with professionals and families where needed, but inspectors found that written records were not always kept. The manager later sent some decision-specific assessments and best-interest decisions.
“Where people lacked capacity to make decisions, staff told us they, other professionals and family had made best interest decisions, however, we noted there wasn't always a written record kept of this.” from the report
Nutritional checks needed improving
needs fixingPeople were not weighed at regular intervals and staff were not using nutritional screening. The manager said screening would be introduced for everyone as a matter of importance.
“Staff did not undertake nutritional screening with people who used the service.” from the report
- 01Have nutritional screening checks now been introduced for every person, and how often are weights recorded?
- 02How do you record best-interest decisions for people who cannot make particular decisions themselves?
- 03How are overnight staffing arrangements monitored, given that one support worker sleeps when people have gone to bed?
- 04How are people and their families involved in reviewing care plans and risk assessments?
- 05What recent quality checks have been completed on medicines, care planning and health and safety?
This was a comprehensive inspection covering all five questions, and the report says the service remained Good compared with January 2015. This explanation was written from the published report of 4 May 2017 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 House
3 rated inspections over 5 years: the service has held its Good rating throughout.
- April 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 2 March 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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45 live-in carers within about an hour of Stockton-on-Tees
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,190 a week. 40 can care for a couple. 10 years' experience on average.
“I found Alison to be kind , caring helpful concencious... Alison has a heart of gold”
“Petty introduced herself to Mum every time she was caring for her and responded very quickly to Mum if she was distressed in the night.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.