About the service:

Chesterton Lodge is a residential care home providing personal care for 56 people some of whom may have a diagnosis of dementia.

People’s experience of using this service:

People were supported by safely recruited staff who had skills and knowledge to provide safe and effective support. People’s risks were managed and independence was encouraged as far as possible promoting independence. Medicines were managed safely. Effective care planning was in place which guided staff to provide support that met people’s needs which also took into account people’s preferences.

People consented to their care and were supported in their best interests. People were supported to eat and drink sufficient amounts which were in line with dietary requirements. Professional advice was sought when needed to ensure people’s overall health and wellbeing was maintained.

Staff were caring and treated people with kindness. Staff promoted choice and were treated with dignity and their right to privacy was upheld.

People were supported to access a range of activities. This included local community involvement, which involved people from the local community going to the service to provide entertainment. People were also supported to access local community activities.

Systems were in place to monitor the service, which ensured that people’s risks were mitigated and lessons were learnt when things went wrong. The management team were approachable to people, staff and other professionals, demonstrating a culture of openness and honesty. The provider continually sought ways to improve the service that people received.

The service met the characteristics of ‘Good’ in all areas; more information is available in the full report below.

Rating at last inspection:

Good (report published 04/06/2016)

Why we inspected:

This was a scheduled inspection based on the previous rating.

Follow up:

We will continue to monitor the service through the information we receive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 20 April 2016 and was unannounced. At our last inspection in December 2013 we found that the service was meeting the required standards in the areas we looked at.

Chesterton Lodge provides support and care for up to 64 people, some of whom may be living with dementia. At the time of this inspection 58 people used the service.

The service had a registered manager. 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.

Staff were aware of the actions they needed to take if they had concerns regarding people's safety. Risks to people's health and wellbeing were identified, recorded, reviewed and managed. Procedures were in place that ensured concerns about people's safety were appropriately reported to the registered manager and local safeguarding team.

There were enough suitably qualified staff available to maintain people's safety and meet their individual needs. Staff received regular training and supervision that provided them with the knowledge and skills to meet people's needs. Staff were only employed after all essential pre-employment safety checks had been satisfactorily completed.

People’s medicines were managed safely; staff were knowledgeable and supported people with their medication as required.

People were supported to make important decisions about their care and treatment. Some people who used the service were unable to make certain decisions about their care. In these circumstances the legal requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) were being followed.

People told us they enjoyed the food and were provided with suitable amounts of food and drink of their choice. Where people needed help with eating and drinking, staff provided the level of support that each individual person required. Health care professionals were contacted when additional support and help was required to ensure people's health care needs were met.

Various leisure and recreational activities were provided within the service; these were either on a one to one basis or in groups. People could choose whether they wished to participate or not and staff respected their choices.

Staff told us they felt well supported by the management and worked well as a team. People were aware of the complaints procedure and knew how and to whom they could raise their concerns. The safety and quality of the home was regularly checked and improvements made when necessary.

During our inspection we looked at how care was provided to 39 people with dementia. We spoke with ten people who used the service and eight relatives. We also spoke with seven members of staff and the registered manager.

People were protected from harm, because their individual risks had been assessed and managed. Staff received training in dementia which enabled them to provide safe and professional care. One relative told us, “The staff really understand my relative who is unique and can be challenging”.

People and their relatives told us they were happy with the care. One relative told us, “I have never seen my relative look so well. It’s all down to the staff”. Another relative said, "I think the care is very good and the residents are given the care they deserve”. We saw that care was provided in an unrushed manner and in accordance with people's support plans.

Care records showed that staff were responsive to changes in people’s needs. We saw that health and social care professionals were consulted with, and staff worked with other providers to ensure that people received the right care at the right time.

The service was well led. Effective systems were in place to enable the quality of care to be assessed, monitored and improved. Relatives told us and we saw that feedback was used to improve the care.

During our inspection we spoke with four people who used the service; four relatives, four care staff, a visiting health care professional and the registered manager. People who used the service told us, “It’s a nice place. I am quite impressed with the attention I have had” and, “It’s very good here. I couldn’t do better”. Relatives told us, “I’m always happy with what I see” and, “I have full confidence in the staff”.

We saw that where appropriate, before people received any care or treatment, they were asked for their consent and the provider acted in accordance with their wishes. Where people could not consent, we saw that staff followed legal guidance to support decision making.

We saw that people received their planned care in a professional and safe manner by staff who had received the necessary training.

Effective arrangements were in place to ensure medicines were stored and recorded safely, and improvements were being made to ensure that people received their medicines as prescribed.

The registered manager had effective systems in place to regularly assess and monitor the service so that improvements could be made.