The Chestnuts provides accommodation, personal care and support for up to 20 adults who have a learning disability, some of whom may also have physical disabilities and/or sensory impairments. There are three separate units within the home, two of which have eight bedrooms and one of which has four bedrooms. There were 20 people living at the home at the time of our inspection.

There was a registered manager in place. 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.

At the last inspection on 6 July 2015, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good.

People were safe because staff understood any risks involved in their care and took action to minimise these risks. The rota was planned to ensure there were sufficient staff to keep people safe and meet their needs. Staff understood their roles in keeping people safe and protecting them from abuse. The provider carried out appropriate pre-employment checks before staff started work.

Medicines were managed safely. Accidents and incidents were recorded and reviewed to ensure any measures that could prevent a recurrence had been implemented. Staff maintained appropriate standards of health and safety, including fire safety. The provider had developed plans to ensure that people’s care would not be interrupted in the event of an emergency.

People’s care was provided by regular staff who knew their needs well and provided support in a consistent way. Staff had access to the induction, training and support they needed to do their jobs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People were supported to eat food they enjoyed and were encouraged to maintain a healthy diet. Staff were aware of any dietary restrictions involved in people’s care. People’s healthcare needs were monitored and they were supported to obtain treatment if they needed it. People who had ongoing conditions were supported to see specialist healthcare professionals regularly.

People enjoyed living at the home and had positive relationships with staff. Staff treated people with respect and maintained their privacy and dignity. People were supported to maintain relationships with their friends and families and were able to invite guests whenever they wished. People were encouraged to manage aspects of their care independently where they were able to do so.

People’s needs had been assessed before they moved to the home to ensure staff could provide the care and support they needed. Care plans were person-centred and reflected people’s individual needs and preferences about their support. People had access to activities they enjoyed and had opportunities to enjoy an active social life. People were involved in their local community

People were encouraged to give their views about the service they received and the provider responded positively to feedback. Complaints were responded to appropriately and used to improve the service.

The registered manager provided good leadership for the service. They led an experienced management team that was accessible to people who lived at the home, their relatives and staff. Relatives told us communication from the management team was good and staff said they felt well supported and valued for the work they did.

Staff shared important information about people’s needs effectively. Handovers took place at the beginning of each shift to ensure staff were up to date with any changes in people’s needs. There was a plan in place for each shift which identified which memb

The Chestnuts provides accommodation, care and support for a maximum of 20 adults with learning disabilities, some of whom also have physical disabilities and/or sensory impairments. There were 18 people using the service at the time of our inspection.

The inspection took place on 6 July 2015 and was unannounced.

There was a registered manager was in post. 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 and associated Regulations about how the service is run.

People’s medicines were administered and recorded accurately. Risks to people had been assessed and control measures had been put in place to minimise these risks. There were plans in place to ensure that people’s care would not be interrupted in the event of an emergency.

People were kept safe as the provider had a robust recruitment procedure to help ensure only suitable staff were employed. Staff were aware of their responsibilities should they suspect abuse was taking place and knew how to report any concerns they had. The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS), which meant that people’s care was provided in the least restrictive way.

People were supported to stay healthy and to obtain treatment when they needed it. People’s nutritional needs were assessed and any dietary needs recorded in their care plans. People enjoyed the food provided by the service and were supported to eat a well-balanced diet.

The service provided accessible, safe accommodation. The premises were suitably designed for their purpose and adaptations and specialist equipment were in place where needed to meet people’s mobility needs.

Staff were kind and caring and knew people’s needs well. People had good relationships with the staff that supported them. Staff treated people with respect and promoted their independence. People received support in a manner that maintained their privacy and dignity.

People’s needs had been assessed before they moved into the service and kept under review, which meant that their care plans accurately reflected their needs and preferences about their care. Care plans were person-centred and reflected people’s individual needs, preferences and goals. They provided clear information for staff about how to provide care and support in the way the person preferred.

People were involved in decisions that affected them. Staff worked co-operatively with other people who could support the person in making decisions, such as relatives and healthcare professionals.

People had opportunities to go out regularly and to be involved in their local community. They had access to a range of activities and were supported to enjoy active social lives. People were supported to maintain relationships with their friends and families and to share in celebrations and events.

There was an open culture in which people, their relatives and staff were able to express their views and these were listened to. Staff told us that senior staff were approachable and available for support and advice. Staff met regularly as a team to discuss any changes in people’s needs, which ensured that they provided care in a consistent way.

The provider had implemented effective systems of quality monitoring, which meant that key aspects of the service were checked and audited regularly. Records relating to people’s care and to the safety of the premises were accurate, up to date and stored appropriately.

This was a follow up visit to check whether the provider had taken the action needed to ensure that they were provider was meeting standards of cleanliness and infection control. We also checked whether there were people were cared for by staff who received adequate training and support.

We inspected the premises, spoke with five staff including the registered manager and looked at records. We briefly observed activities being carried out in the activity centre and saw that people seemed happy and engaged in their activities. We saw that people were smiling and that staff were attentive to people’s needs.

We saw that the home was clean and that regular checks of cleanliness were maintained. Staff we spoke with told us that they felt well supported and received regular training.

There were sixteen people at the home when we visited.

We spoke with people throughout our inspection and carried out observations including a music group that most people had attended. We spoke with one person at lengthin detail and one relative who was visiting that day.

We looked at records and spoke with five staff which included the registered manager of the service.

We saw that staff spoke with people respectfully and offered choices, for example, by pointing to pictures. We were told that the home was “A happy place with a good atmosphere” by one relative and a person who used the service supported this and told us they were “Very happy here.”

We saw that care plans were person centred, up to date and regularly reviewed. A relative described the care as “Very good.”

People told us that the house was usually kept very clean. However, on the day of our inspection there were issues with cleanliness, such as bathrooms and toilets that were not clean.

We saw that there were appropriate arrangements in place to administer, record and store medicines safely.

Staff we spoke with on the day told us that they felt well supported. However, we saw that not all staff had received a recent appraisal. We saw that mandatory training for staff was out of date.

There was a complaints system in place and we saw that complaints were appropriately investigated.

This was a follow up visit to check whether the provider had completed the action plan submitted to CQC following their last inspection in January 2012. On this occasion we did not ask people about the service, because during the original inspection they had told us that they were satisfied with the service. However we did spend a short time with service users in the garden and observed people being supported by staff and involved in a variety of activities.

People told us their views were taken into consideration by staff. They said they were involved in the planning and delivery of their care. They were able to sate their gender preference for personal care. Matters of personal care and hygiene and overall wellbeing had been discussed with them. They told us they attended review meetings as required to discuss their needs and progress.

People who used the service told us their relatives made the choice for them to enter this service. They said they and their relatives and social services made the decisions about the care they needed. They then had to sign the care plan to show they agreed with the proposed care.

People told us they knew who their carers were and that they were able to make and maintained good relationships with them. They said the staff were very good and did things for them when they asked them.

People who used the service informed us they felt safe in the service and they knew whom to speak to if they felt uncomfortable with a situation. They told us they would speak with their key worker or the manager who would act on their behalf.

People told us they knew whom to speak to if they had to make a complaint. They said any comments or concerns raised were listened to and dealt with to their satisfaction.