Archived: Pro-Care Dispersed Housing Ltd - Chesterfield Lodge

Chesterfield provides care and support for a maximum of six people who live with mental health conditions. At the time of our inspection there were five people living at the home. Chesterfield is situated in a residential area of Blackpool’s North Shore. It offers six single bedrooms over three floors. In addition, there is a dining room and communal lounge. A separate office and staff sleepover room is a recent addition to Chesterfield.

At the last comprehensive inspection on 11 November 2014, we rated the service as requires improvement. This was because breaches of legal requirements were found. The registered manager’s quality audits were overdue and poorly maintained. There was no evidence to show identified issues were managed to ensure there re-occurrence was minimised. Additionally, the registered manager failed to have suitable arrangements that sought feedback people who lived at Chesterfield. The registered manager had not always ensured people’s records were kept up-to-date and under review. We followed this up on 21 September 2015 and noted the service was meeting the regulations they were in breach of. However, we could not improve the rating from requires improvement because to do so requires consistent good practice over time.

During this inspection, we found the management team had sustained the improvements implemented to continue to meet the requirements of the regulations. People who lived at the home said they felt safe and well cared for. The management team had completed regular and up-to-date assessments to minimise the risks of harm or injury to people. Staff demonstrated a good awareness of safeguarding people from abuse and poor practice.

The provider followed their procedures when they recruited staff to ensure they were suitable to work with vulnerable adults. Staff and people who lived at Chesterfield said staffing levels were sufficient to meet their requirements. The registered manager provided a range of staff training to assist them in their roles. One staff member told us, “Training is really good and I’m glad it’s face-to-face so I can ask questions when I need to.”

The registered manager had systems to protect people from unsafe management of their medicines. We saw medication was stored in a clean and secure area of the home. We reviewed a sample of related records and saw there were no gaps and staff correctly recorded information.

People were supported to eat their meals when and where they chose. A range of systems monitored people against the risks of malnutrition.

The registered manager ensured staff had training about the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards. One staff member told us, “The residents often come to us for advice. We support them with this and then help them to decide what they want to do.” People had signed their consent to support throughout their different care records.

We found people were encouraged to be involved in their care planning. Staff demonstrated a caring and respectful approach to those they supported They were respectful of people’s privacy and dignity during our inspection, such as knocking on doors before entering bedrooms.

Staff completed and regularly reviewed a variety of assessments to measure people’s support levels and their related care requirements. They checked each person’s backgrounds and preferences to gain a better understanding of who they were and what they needed.

Staff, people and visitors told us the home was organised and had good leadership. One staff member said, “I feel supported in my new role and [the registered manager] really helps me. Since he’s become manager all the homes have improved.” The management team completed regular audits to ensure ongoing oversight of safety and quality assurance. Feedback was positive about Chesterfield and people’s experiences of living there.

We spoke with a range of people about the home. They included the registered manager of Pro-Care Dispersed Housing, the manager of the home, all six residents and a visitor to the home. We also asked for the views of external agencies in order to gain a balanced overview of what people experienced living at Chesterfield Lodge.

We spoke with people who lived at the home. They told us they could express their views and were involved in making decisions about their care. They told us they felt listened to when discussing their care needs. One person said, 'I like it here, I like the company, I wouldn't want to live anywhere else.'

We spent time in areas of the home, including the lounge and dining areas. This helped us to observe the daily routines and gain an insight into how people's care and support was being managed. We observed staff interactions with those in their care. We found staff treated people with respect and provided support or attention when requested.

We found that the plan to implement a structured system of support that concentrated on how to enable people to develop their skills and independence was available and this would further enhance people's experience. However, this was dependent on having appropriate staffing levels.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We had concerns that people were not always fully consulted and asked for their consent before they received care or treatment, and concerns that the provider did not always act in accordance with people's wishes. Some of the evidence we found suggested that some people didn't always experience care, treatment and support that met their needs and protected their rights. It was unclear if people who used the service were fully protected from the risk of abuse, because the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

The provider had a system in place to assess the quality of service that people received. However, we had concerns that this system was not always consistently implemented for the benefits for people who lived at the home.

People told us they could express their views and were involved in decision making about their care. Residents told us the staff team were friendly and supportive. They said routines were flexible, they could come and go as they please. People who used the service told us staff treated them with dignity and respect. We saw evidence of this when observing interaction with the staff member and residents. This included staff knocking on doors before entering and speaking to people using their preferred name.

We found only one member of staff on duty at any time. Talking with residents and staff this was difficult at times. One resident said, 'Sometimes we need more than one person to help.' Other comments about staffing levels included, 'We cope but sometimes more staff would help. For instance support to go for health appointments with residents, also spending time on a one to one basis if people have a problem would help.'

Responses were positive about the service and staff support. Comments included,

'I go to watch Blackpool and staff encourage me to do that.'