About the service: Chatsworth Lodge is registered for 40 beds and provides personal care and accommodation for older people. On the day of our visit 24 people were using the service.

People’s experience of using this service:

People were support by staff who understood their role in protecting them from the risk of harm. The infection control procedures in place minimised the risk of people acquiring an infection. Risks were assessed and managed. Safe systems were in place to support people to take their medicines. People were supported by staff who had completed the required safety checks before they commenced employment.

People told us they liked the meals and were supported to make decisions about what they wanted to eat and drink; to ensure their preferences and dietary needs were met. Drinks were available to people throughout the day. Where people were unable to make specific decisions regarding their care; assessments were completed to ensure their rights were protected. This ensured people were supported to have maximum choice and control of their lives and were supported in the least restrictive way possible. People and their representatives were involved in their care to enable them to receive support in their preferred way. People had access to healthcare services and received coordinated support, to ensure their preferences and needs were met.

Opportunities to take part in social and recreational events were available to enhance people’s well-being. People were supported to maintain their cultural and faith needs and were treated with consideration and respect by the staff team. Information was available in an accessible format, such as pictures, to enhance people’s understanding. People were supported to maintain relationships with people that were important to them.

There were systems in place to monitor the quality of the service and drive improvement. This included, supporting people to raise any concerns they had and giving feedback about the services and support provided to them. Since our inspection Derbyshire Fire and Rescue Service have served an enforcement notice on the provider, following their inspection at Chatsworth Lodge on the 14 March 2019. They have asked the provider to take action within an identified timescale. The provider has shared with us their action plan, which shows the actions taken and planned to address these improvements within the timescale set.

More information is in the full report below.

Rating at last inspection: Requires Improvement (report published 17 May 2017)

Why we inspected: This was a planned inspection based on the rating at the last inspection. At this inspection we saw that improvements have been made.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Chatsworth Lodge is registered to provide personal care for up to 39 adults, which may include some people living with dementia. This inspection was unannounced and took place on 15 March 2017. At the time of our inspection there were 36 people living there.

There was a registered manager at this service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. This is the first inspection under this provider. The registered manager and staff transferred to the new provider ensuring continuity of care. All care planning and paperwork was carried over. This was not always suited to purpose.

During our inspection visit we observed that staff were friendly and approachable. When possible they spent time sitting with people to offer them comfort or stimulation. We observed staff delivering care which met people’s individual needs and which supported them in a respectful and appropriate way.

Accidents and incidents were investigated and plans put in place to reduce risk. However some staff members who delivered care had very long finger nails and this had not been addressed. This could cause damage to fragile skin.

There were training and processes in place to keep people safe and staff followed these. People’s physical and mental health was generally promoted. However staff were not trained to meet the special needs of people such as people living with the effects of strokes or living with dementia. Medicines were administered and recorded as prescribed. However storage of medicines was a little chaotic and unorganised.

We saw staff ensured people were comfortable. We saw people were supported in a relaxed and unhurried manner. However there were not enough staff to meet people’s personalised needs and wishes. Some people had to wait longer than they wanted to for care or to use the toilet. There were very few social activities for people to partake in. We saw they were left un-stimulated and showed signs of boredom. There was a well-equipped craft room in the service, however people did not have access to this.

Staff were caring and communicated well with people. People were offered choices at meal times and were seen to enjoy their food.

Staff focused on people they were caring for rather that the task they were carrying out. Staff spoke in a positive manner about the people they cared for and had taken the time to get to know people’s preferences and wishes. Staff had a good understanding of people’s needs and this was demonstrated in their responses to people and recognition of when people required additional support.

People’s privacy was respected. People had their independence promoted. Where possible they were offered choice on how they wanted their care delivered and were given choices throughout the day. However, dignity was not always promoted while they were been assisted to move using a hoist.

People were supported to maintain relationships with family and friends. Visitors were welcomed at any time. Records we looked at were not always personalised and had not always included decisions people had made about their care including their likes, dislikes and personal preferences.

People, relatives and staff spoke well of the registered manager and felt the home was starting to be well-led.

The registered manager was relatively new in post and was managing in an inclusive manner. This was starting to be reflected in the service in so far as people and staff had their wishes and their knowledge of people respected. Most staff were aware of their roles and responsibilities for people’s care. The provider and registered manager had systems in place to review the service and to ensure the service responded to the on-going needs of pe