This comprehensive inspection took place on 1 and 2 October 2018 and was unannounced. The service was previously registered with another provider and transferred to the current provider, Optivo, in October 2017. This was the first inspection of the service following the change of ownership.

Chestnut Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.

Chestnut Lodge accommodates up to 64 older people across four separate units, each of which has separate adapted facilities. All four units provided care for people living with the experience of dementia and two units also provided care for people with additional nursing care needs.

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.

People using the service and their families told us managers, nurses and care workers in the service were extremely kind, caring and patient. Many people and their relatives commented very positively on the care and support people received. People and their relatives were involved in decision making and encouraged to express their views. Staff in the service respected people’s privacy and dignity and encouraged their independence.

The provider had systems in place to protect people from abuse. All staff completed safeguarding training and the provider carried out checks to make sure staff they employed were suitable to work with people using the service.

The provider assessed possible risks to people using the service and acted to mitigate any risks they identified. There were enough nurses and care staff to support people when they needed it and we did not see people waiting for care and support.

People and their relatives told us that nurses and care staff understood their care and support needs and they met these in the service. The registered manager, head of nursing and senior staff assessed people’s care and support needs in line with current legislation and evidence based guidance. People’s care plans included an assessment of their health care needs and details of how staff would meet these in the service. People using the service also received the medicines they needed safely and as prescribed.

Staff working in the service had the training they needed to care for people effectively.

People and their relatives told us they enjoyed the food provided in the home and where people needed support with eating and drinking, the provider included this in their care plans.

The service was working within the principles of the Mental Capacity Act 2005 and the registered manager and the head of nursing fully understood their responsibilities under the Act.

The provider employed a full-time coordinator who arranged a programme of activities and worked alongside care staff to provide an activity each morning and afternoon.

The provider had a policy and procedures for responding to complaints they received. Records showed they had received two complaints. The registered manager had investigated these in line with their procedures and acted to make sure people were satisfied with the outcome.

People’s relatives told us they thought the service was well led. Staff also told us they felt the service was well managed and said they were supported. The provider had appointed a qualified and experienced manager who had managed the service for another provider for nine years and reregistered with the Care Quality Commission (CQC) in October 2017 when the provider changed.

The provider had systems in place to mon