Archived: Chestnuts Arnesby

We also spoke with the acting manager, area manager, the cook and four care staff. We looked at some of the records held in the service, including the care files for three people who used the service. We observed the support people received from the staff and carried out a tour of the building.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

This is a summary of what we found-

Is the service safe?

People told us they felt safe. Comments received from people who used the service included, “I’m very happy and settled. The girls (staff) are all very good and keep me safe.”

People told us they felt there were enough staff available to meet their needs. Comments included, “The girls (staff) usually come and assist me when I call. I don’t have to wait long.”

Since our last inspection we found the provider had increased the staffing levels on the afternoon and evening shift, and had made a change to the staffing at night. This showed the provider had ensured there was adequate staff available and deployed appropriately.

The provider assessed and reviewed people’s needs to ensure care plans and risk assessments were up to date and reflective of people’s needs. This ensured people were cared for safely by competent, trained and experienced staff.

We found the provider had an appropriate policy and procedure in place in relation to the safe handling, storage and administration of medication. People could be assured they received their prescribed medication safely and appropriately.

People were supported in an environment that was maintained to a safe, clean and hygienic standard. We also found equipment at the home had been maintained and serviced on a regular basis.

Is the service caring?

People we spoke with told us they found the staff to show dignity and respect when providing care and support. Comments included, “I’m well looked after. The staff treat me well and always show kindness, dignity and respect when helping me.”

We found the service to have a warm, welcoming and relaxed atmosphere. Staff were observed to interact with people in a caring manner, showing dignity and respect at all times.

Is the service responsive?

People we spoke with told us they felt they had their needs well met and that they were confident the provider acted appropriately to any changes in need. Comments included, “I have had meetings with the manager and my daughter, to discuss my needs. If I’m unwell they arrange for the doctor to visit.”

We saw people received opportunities to participate in activities if they chose to do so. Some people told us they had been on an outing into their local community organised by the staff.

We saw examples from care records when the provider had been responsive to a change in a person’s needs, and had sought support from a health professional.

Is the service well-led?

We found the provider had systems in place that enabled them to monitor the quality and safety of the service. Information from the analysis of accidents and incidents had been used to identify changes and improvements to minimise the risk of them happening again.

The provider had a complaints policy that promoted people’s rights and choices. This was easily accessible to people who used the service.

The home does not have a registered manager but an acting manager is in place.

We looked at how care planning and risk assessments are completed and noted improvements are required in both these areas. We noted improvements are also needed to the fabric and upkeep of the building and staffing numbers.

We looked at how medicines are managed and noted that once again improvements are needed to this area which was only made compliant in November 2012 following a compliance action at our previous visit in September of that year.

We saw that some door locks had been changed to ensure that people with disabilities could not be detained against their will, and ensure their ongoing liberty.

We also looked at the recruitment process to ensure staff were subject to security checks so that people were safe. No new staff had started since our last visit, but we looked at a prospective new member of staff and were satisfied the employment process was now secure and would protect people in the home.

Quality assurance was now evident in many areas of the running of the home

We also saw improvements in the medication system where overstocking had reduced to an acceptable level. However there were other issues with the controlled medications in the home. Staff were not ensuring the process was correct and the stock balances were accurate when administering these to people. We have therefore made a compliance action to improve this area.