CQC report explained · a residential care home
What the CQC found at The Chestnuts
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors looked specifically at infection prevention and control. They found effective measures, safe use of protective equipment, infection testing and support for visits.
- Effective?
- Good
- People received personalised support from trained staff. Care plans reflected people's needs and aspirations, and people were supported with food, healthcare and decision-making.
- Caring?
- Good
- This question was not inspected in this focused inspection.
- Responsive?
- Good
- This question was not inspected in this focused inspection.
- Well-led?
- Good
- Inspectors found effective audits and governance systems, managers who worked directly with people, and staff who felt supported and able to raise concerns.
What inspectors found, July 2022
Rated Good overall; inspectors found kind, person-centred care and improvements in staff training and management systems.
This was a focused inspection on 29 June 2022. One inspector spoke with three people and three staff, observed people who could not speak with them, and reviewed care records, training records and management documents.
The home supported five people with learning disabilities and/or autism. Inspectors found that people had choice and independence, took part in activities, received personalised support and were supported by trained staff. Infection prevention measures were also effective.
The Effective and Well-led ratings improved from Requires Improvement to Good. Safe was inspected only in relation to infection prevention and control, so it was not re-rated. Caring and Responsive were not inspected in this report.
There is a contradiction in the report. Its ratings page says the overall rating is Good, but the summary also says the overall rating remains Requires Improvement. Families should ask the home or CQC to clarify which overall rating is current.
Choice and independence
Staff supported people to make choices, control their lives and develop their independence. People were also supported to follow their interests in the local area.
“Staff supported people to have the maximum possible choice, control and independence and they had control over their own lives.” from the report
Trained staff
The home had made enough improvement in staff training since the last inspection. Staff received relevant training, refresher courses, supervision and appraisals.
“People were supported by staff who had received relevant and good quality training in evidence-based practice.” from the report
Personalised support
Care and support plans reflected people's physical and mental health needs, communication needs and personal aspirations. People and those important to them were involved in reviews.
“People had care and support plans that were personalised, holistic, strengths-based and reflected their needs and aspirations” from the report
Infection control
Inspectors found effective infection prevention measures. Staff used protective equipment safely, infection testing was in place and the home supported visits in line with guidance.
“The service used effective infection, prevention and control measures to keep people safe, and staff supported people to follow them.” from the report
Management systems
The home had regular audits and clearer systems for checking quality and holding staff to account. This addressed the previous breach about quality monitoring.
“Governance processes were effective and helped to hold staff to account, keep people safe, protect people's rights and provide good quality care and support.” from the report
Inspectors raised no specific concerns in this report.
- 01The report gives two different overall ratings. Which overall rating is currently recorded by CQC, Good or Requires Improvement?
- 02When will Safe be reviewed fully, rather than only for infection prevention and control?
- 03What were the previous findings about Caring and Responsive, and what has changed since those areas were last inspected?
- 04How do you check that staff training and refresher courses remain up to date for each person's needs?
- 05How are people and their families involved in reviewing care plans and giving feedback about the service?
This was a focused inspection of Safe in relation to infection control, Effective and Well-led; Caring and Responsive were not inspected and the report says the other ratings were carried over from the last inspection. This explanation was written from the published report of 27 July 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, November 2020
Inspected but not rated; the previous Requires Improvement rating remained, with ongoing breaches in staff training and management.
This was a targeted inspection on 24 September, 1 October and 13 October 2020. Inspectors checked whether earlier problems with staff support and management had been fixed. They also looked at infection control during the COVID-19 pandemic. They spoke with one person, relatives, staff, the manager and the provider's representative, and reviewed records.
Some improvements had been made. A training matrix and supervision matrix were introduced. Staff had refresher training in fire safety and first aid, and staff said they received regular supervision and felt supported. People and relatives said they were happy with the care and felt able to speak openly with staff and managers.
However, training was still missing or overdue in areas including infection control, medicines, health and safety, safeguarding, the Mental Capacity Act and Deprivation of Liberty Safeguards. There was still no registered manager, some important notifications had not been sent to the CQC, and management checks did not cover infection control properly.
The inspection was not a full assessment of all five areas, so no new ratings were given. The previous overall rating of Requires Improvement remained. The provider was still in breach of Regulations 17 and 18, and the CQC asked for an action plan and said it would monitor progress.
Infection control arrangements
Inspectors were assured about most of the home's arrangements for preventing and managing infection, including testing, visitor controls and social distancing.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Staff supervision
A supervision system had been introduced. Staff said they received regular supervision and felt supported in their roles.
“Staff confirmed they received regular supervision and felt supported in their role.” from the report
Open communication
People and relatives felt supported by the management team and said they could speak openly. They felt listened to and said feedback was acted on.
“Staff, people and their relatives felt well supported by the management team and felt able to speak openly with them.” from the report
Accessible care records
Staff could find the care records and showed inspectors where daily records were stored and updated.
“Staff were able to access care records and showed us where care records were stored and where they updated people's daily records.” from the report
Incomplete staff training
seriousStaff still needed training in infection control, medicines management and health and safety. Other refresher training was overdue, and the provider could not always verify training completed elsewhere.
“However, we saw training was still required in a number of topics including; infection prevention and control, medicines management, and health and safety.” from the report
No registered manager
seriousThe home still did not have a manager registered with the CQC, despite this being a registration requirement.
“At this inspection the provider had not taken sufficient action to adhere to their CQC registration requirements and a registered manager was still not in post.” from the report
Weak management oversight
seriousThe provider had not sent some required notifications, had not completed a specific infection control audit and had not acted fully on earlier concerns.
“We had not received notifications about key events that occurred at the service, including in relation to deprivation of liberty safeguards (DoLS) applications and their outcomes.” from the report
COVID-19 planning
needs fixingThe business continuity plan did not explain how the home would maintain services during the COVID-19 pandemic. Inspectors also found the provider had not reviewed working arrangements against the Department of Health and Social Care's Winter plan.
“We found their business continuity plan did not specifically mention COVID-19 and how they would ensure continuity in regards to the COVID-19 pandemic.” from the report
Financial arrangements
needs fixingInspectors received concerns about the financial arrangements for one person. The provider said it would review them to help protect the person from financial abuse.
“We received some concerns regarding the financial arrangements for one person living at the service.” from the report
- 01Which staff still need training in infection control, medicines management, health and safety, safeguarding, the Mental Capacity Act and Deprivation of Liberty Safeguards?
- 02How do you now check and record training completed by staff who also work for another organisation?
- 03Who is currently responsible for the home while there is no registered manager, and when will the application be submitted?
- 04How do you record and notify the CQC about Deprivation of Liberty Safeguards applications and other key events?
- 05What changes have been made to the COVID-19 business continuity plan and infection control audits?
This was a targeted inspection of specific concerns about staff support, management and governance, together with infection control; it did not assess all five key questions and did not change the previous ratings. This explanation was written from the published report of 11 November 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 The Chestnuts
3 rated inspections over 6 years: the service has held its Good rating throughout.
- July 2022Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2020Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not ratedWell-led: Inspected but not rated
- November 2019Requires improvementdown from GoodEffective: Requires improvementWell-led: Requires improvement
- January 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2016
Registered with the Care Quality Commission on 4 May 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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At least 100 live-in carers within about an hour of Croydon
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Most charge £980 to £1,230 a week. 77 can care for a couple. 11 years' experience on average.
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